LAUSR

A 46-year-old man presented to our clinic with a 3month history of a painful umbilical nodule associated with malodorous discharge. He also reported lethargy and weight loss with nonspecific intermittent abdominal pain. Previous treatments for the condition included multiple courses of antibiotics. The patient’s medical history included diet-controlled Type 2 diabetes. On physical examination, the patient’s abdomen was found to be soft and occasionally tender with no organomegaly. At the umbilicus, there was an indurated tender nodule, 18 9 12 mm in size, with weeping and maceration (Fig. 1). Laboratory investigations showed normal levels of carbohydrate antigen 19–9 (27 kU/L; normal < 35 kU/L) carcinoembryonic antigen (3 lg/L; < 10 lg/L) and erythrocyte sedimentation rate (7 mm/h; 0–15 mm/h). Bone profile, full blood count, and urea and electrolytes were all normal, and no pathogens were isolated from a wound swab. Computed tomography (CT) of the abdomen and pelvis showed no evidence of malignancy. No cause for the symptoms was identified.