Sean Klepper M.D.
Artur Zembowicz M.D....
Also known as: superficial granulomatous pyoderma, atypical plaque-like folliculitis in HIV, vegetative pyoderma gangrenosum
- An exaggerated inflammatory reaction to bacterial infection, especially Staphylococcus aureus, Pseudomonas aeruginosa and β-hemolytic streptococci.
- Typically affects patients with immunosuppression or lymphoproliferative disorders
- Presents with single to disseminated verrucous plaques with multiple pustules, usually affecting the head and neck, extremities or intertriginous areas
- This disorder typically responds well to antibiotics.
- The causative organism can usually be cultured from the lesions, even if it is not apparent on Gram stain.
- A diffuse mixed inflammatory infiltrate is present in the upper reticular dermis.
- The infiltrate often displays a zonation effect: a central area of neutrophils and a few eosinophils is surrounded by macrophages and giant cells, which are surrounded by a peripheral rim of lymphocytes and plasma cells.
- Pseudoepithelial hyperplasia is often present.
- The inflammation may center on the hair follicles in some cases.