A 58‐year‐old man attended a Sydney outpatient dermatology clinic in November 2022 for a lesion on the vertex of the scalp, enlarging over 3 years. On examination, elevated rolled edges with a large central haemorrhagic crust suggestive of basal cell carcinoma were observed; however, the mass was unusually boggy on palpation, raising the question of a superimposed infective process (Box). The patient was systemically well. Biopsy confirmed nodular basal cell carcinoma and the Public Health Unit was notified by a laboratory that Corynebacterium diphtheriae had been isolated from the tissue culture. This was accompanied by growth of Staphylococcus aureus. Polymerase chain reaction testing performed at the Institute of Clinical Pathology and Medical Research returned a positive result for diphtheria toxin gene 5 days later, and public health follow‐up of toxigenic cutaneous diphtheria commenced in accordance with control guidelines.1,2
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Patient consent:
The patient gave written consent for publication.
We thank the patient described in this report for his gracious cooperation with public health authorities and consent for publication, and all staff who assisted with this response, particularly Phillip Read, Cathy Macknight, Matt Larkin, Jose Vargas‐Castillo, Lilia Graham, and laboratory staff at SydPath and NSW Health Pathology. We also thank our public health colleagues in North Queensland for sharing their insights and experience with us.
No relevant disclosures.