Abstract

Background: Echinococcosis of the skin occurs rarely, localized in the subcutaneous tissue or skin, in only 0.1-1% of cases. From our practice, the unusual case of a 52-year-old worker of Bosnian origin from Germany, who in the period from 1979-1996 worked as a forest worker in the Swabian Alps collecting dead foxes and badgers, was presented. Objective: The goal of this article was to present an unusual form of multiorgan echinococcosis, which manifested itself during chronic borreliosis transmitted in childhood, and the difficulties in the diagnosis and therapy of both diseases Case presentation: Since 1986, extensive unusual cutaneous and subcutaneous cauliflower-like and round formations appeared on the back of the head and face, which were surgically removed on several occasions, then echinococcosis of the liver was verified and treated surgically, and echinococcosis of the brain. Due to depression and suicidal intentions, he was treated by a psychiatrist for a while. The patient was on prolonged therapy with albendazole since 2008, he was mentally stable, and the skin changes were in remission for a while. He again consulted an infectious disease specialist at the end of 2018, due to complaints that had worsened over the last three years, when the tingling of the hands, legs, joint pain, visual disturbances, ringing in the ears, skin itching and the reappearance of previous skin changes increased, regardless of continuous taking Albendazole. Conclusion: Amnestic-epidemiological, clinical and serological confirmed chronic Lyme Disease and recommended treatment according to the WHO protocol. defects over proximal phalanx of the index finger. The flap provides adequate soft tissue coverage and good aesthetic results.

Key words: FDMA flap, FDMA, Foucher’s flap, kite flap.