Blastomycosis-like pyoderma

    Article Contributors: 
    Sean Klepper M.D.
    Artur Zembowicz M.D....

    Also known as: superficial granulomatous pyoderma, atypical plaque-like folliculitis in HIV, vegetative pyoderma gangrenosum

    Clinical Features:

    • 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.

    Histologic Features:

    • 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.
    External Links:

    Cases associated with this book:

  • Blastomycosis-like pyoderma
    Author: Artur Zembowicz M.D. Ph.D.

    Conference: Dermpedia Teaching Collection