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Primary cutaneous nocardiosis in 2 patients on immunosuppressants

Two female cases of primary cutaneous nocardiosis due to Nocardia brasiliensis are described. The first was associated with polymyositis and the second with chronic immune thrombocytopenic purpura. Both patients had received corticosteroids. In both cases the responsible actinomycetes were sensitive to trimethoprim/sulfamethoxazole. This drug was administered to both patients with excellent results. Treatment was continued for 3 months to prevent recurrence, a common consequence of short-term therapy. N. brasiliensis should be included in the differential diagnosis of any case of nodular lymphangitis, especially in immunocompromized patients.