Unusual presentation of cactus spines in the flank of an elderly man: a case report

Abstract

IntroductionSplinters and spines of plant matter are common foreign bodies in skin wounds of the extremities, and often present embedded in the dermis or subcutaneous tissue. Vegetative foreign bodies are highly inflammatory and, if not completely removed, can cause infection, toxic reactions, or granuloma formation. Older patients are at increased risk for infection from untreated plant foreign bodies. The most common error in plant splinter and spine management is failure to detect their presence.Case presentationHere we report a case of cactus spines in an 84-year-old Caucasian man presenting on the right flank as multiple, red papules with spiny extensions. This presentation was unusual both in location and the spinous character of the lesions, and only after punch biopsy analysis was a diagnosis of cactus matter spines made.ConclusionsOur patient presented with an unusual case of cactus spines that required histopathology for identification. Skin lesions with neglected foreign bodies are a common cause of malpractice claims. If not removed, foreign bodies of the skin, particularly in elderly individuals, can result in inflammatory and infectious sequela. This report underscores the importance of thoroughly evaluating penetrating skin lesions for the presence of foreign bodies, such as splinters and spines.

Cactus‐induced keratoconjunctivitis in Texas: A case series of three dogs and one cat

“…Protracted urticaria, intense discomfort, and pruritis are features of a human occupational hazard known as sabra dermatitis, a condition reported in people who frequently handle cacti of the Opuntia genus. This condition is associated with a granulomatous hypersensitivity reaction to residual glochids, and clinical signs have been reported to persist for several months in affected humans . A similar hypersensitivity to residual glochids may have caused granuloma formation, persistent irritation, and may have influenced the delayed healing observed in case 2.…”

“…This condition is associated with a granulomatous hypersensitivity reaction to residual glochids, and clinical signs have been reported to persist for several months in affected humans. 4,5,[25][26][27][28] A similar hypersensitivity to residual glochids may have caused granuloma formation, persistent irritation, and may have influenced the delayed healing observed in case 2. This observation reinforces the recommendation to pursue aggressive surgical extraction of conjunctival glochids early in the course of disease in a controlled surgical setting (ie, operating microscope and inhalant general anesthesia) as a means of potentially avoiding this complication.…”

“…Examination features of and treatment strategies for cactus‐induced ocular injury have been reported in humans, but, to the authors’ knowledge, have not been reported in companion animals. Thus, the purpose of this report is to document the examination findings, treatment strategies, and clinical outcomes for three dogs and one cat who were evaluated by two of the authors (LV and ES) at the Comparative Ophthalmology Service at Texas A&M University's Veterinary Medical Teaching Hospital (TAMU‐VMTH) for cactus‐induced ocular injury over a 1‐year period of time.…”

“…Contact with cacti of the Opuntia genus is well‐known to induce significant and sustained inflammation to the skin and the eye of affected humans. Cacti within this genus induce inflammation by readily shedding numerous 1‐3 mm, thin, semi‐translucent spines that are known specifically as glochids.…”

Beware the BATUS Cactus – Cactus Dermatitis in Exercising Soldiers on the Albertan Prairie

“…Secondary infections are thankfully rare as cacti spines are not heavily contaminated with bacteria [2]. Immunological reactions can occur including a granulomatous response that can develop 24-72 hours after injury [1,6].…”