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Cutaneous anthrax

Cutaneous anthrax is an infection of the skin caused by direct contact with the bacterium Bacillus anthracis. Cutaneous anthrax is an uncommon cutaneous (skin) infection due to a bacterium (Bacillus anthracis) that is found in the environment and typically causes illlness in animals. Cutaneous (skin) anthrax is marked by a boil-like lesion that eventually forms an

ulcer with a black center.

Anthrax is caused by the bacterium Bacillus anthracis. While anthrax commonly affects hoofed animals such as sheep and goats, humans may acquire this disease as well. Cutaneous anthrax is the main form of anthrax worldwide, accounting for 95% of all anthrax cases. The infection occurs when the bacteria enter a cut or scratch in the skin. Most cutaneous anthrax infections occur when people touch animal products (like wool, bone, hair, and hide) that come from an animal that died of anthrax.

Historically, the main risk factor for acquiring cutaneous anthrax is contact with animal hides or hair, bone products, and wool, as well as contact with infected animals. Hence, the populations most at risk for anthrax include farm workers, veterinarians, and tannery and wool workers.

Cutaneous anthrax is an anthrax infection of the skin. The disease occurs after the bacteria contact skin cuts or abrasions. Usually within two weeks, an itchy skin lesion develops (similar to an insect bite). This lesion may later blister and then break down, resulting in a black ulcer, which is frequently painless. The skin lesion is usually surrounded by significant swelling. Sometimes painful lymph nodes may develop. A scar is often formed, which then dries and falls off within two weeks. In 20% of UN-treated individuals, the infection may spread through the bloodstream and become fatal. However, in most individuals who receive appropriate treatment, death is extremely rare.

Anthrax is a potential agent for use as a biological weapon or for bio-terrorism. While at least 17 nations are believed to have a biological weapons program, it is unknown how many nations or groups are working with anthrax. Most bio-terrorism experts have concluded that it is technologically difficult to use anthrax effectively as a weapon on a large scale. Cutaneous anthrax would most likely occur by direct contact of anthrax spores with non-intact skin.

The mainstay of treatment is early antibiotic therapy. Several antibiotics are effective, including penicillin, doxycycline, and ciprofloxacin (Cipro). If an outbreak of anthrax is suspected, the antibiotic of choice is ciprofloxacin, until it is known whether the anthrax strain is resistant to any of the other usual antibiotics. Because spores may take up to 60 days to germinate, the length of treatment is usually 60 days. Cutaneous anthrax is treated with oral antibiotics (pills). In the event of a bio-terrorist attack, the National Pharmaceutical Stockpile is available to supplement and help provide antibiotics should a shortage occur.

There are two primary modes of prevention of anthrax. For individuals who have been truly exposed to anthrax (but have no signs and symptoms of the disease), preventive antibiotics may be offered, such as ciprofloxacin, penicillin, or doxycycline, depending on the particular strain of anthrax. Vaccination has also been developed and is given in a 6-dose series. This vaccine is mandated for all U.S. military personnel. It is currently not available, nor is it recommended, for use in the general public.

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All information is intended for reference only. Please consult your physician for accurate medical advices and treatment. Copyright 2005,, all rights reserved. Last update: July 18, 2005