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Pemphigus vegetans type hallopeauL10.1
Synonym(s)
Hallopeau-type pemphigus vegetans; pyoderma vegetans; Pyodermites végétante Hallopeau-Feulard; pyodermite végétante; Pyodermite végétante de Hallopeau
HistoryThis section has been translated automatically.
Hallopeau, 1898
DefinitionThis section has been translated automatically.
Suppurative variant of pemphigus vulgaris with formation of papillomatous growths in the eroded areas. S.a. Pemphigus vegetans, type Neumann. Pyostomatitis vegetans is assumed by some authors to be a minimal variant.
EtiopathogenesisThis section has been translated automatically.
Variant of pemphigus vulgaris (autoantibodies against desmoglein 1, 3), occasionally triggered by ACE inhibitors. Also described in the context of malignant underlying diseases.
LocalizationThis section has been translated automatically.
Mainly intertrigines, capillitium, stem, genitals, oral mucosa.
Clinical featuresThis section has been translated automatically.
Initially, yellowish-purulent pustules and flabby blisters appear, which after bursting turn into foetal smelling vegetation on eroded ground. Frequently reddened, hyperkeratotic, erosive or encrusted plaques with growth tendency and deep, wrinkle-like relief (especially on the capillitium).
HistologyThis section has been translated automatically.
Particularly prominent is a pronounced acanthosis with intraepithelial, neutrophilic and eosinophilic infiltrates, which become denser in places like abscesses, with eosinophilic spongiosis and acantholysis.
Differential diagnosisThis section has been translated automatically.
Complication(s)This section has been translated automatically.
Bacterial superinfection.
TherapyThis section has been translated automatically.
- Glucocorticoids such as prednisone (e.g. Decortin) initially 60-120 mg/day and azathioprine (e.g. Imurek) 50-150 mg/day. Glucocorticoid maintenance dose below the Cushing's threshold. Successes with acitretin (neotigason) have been described. See also pemphigus vulgaris.
- Alternatively, soft X-ray therapy or intralesional injection of glucocorticoids such as triamcinolone (e.g. Volon A/Scandicain 1:2) can be considered. In the case of erosions, baths with disinfectant additives such as potassium permanganate (light pink), drying local therapy with Lotio alba, if necessary with 2-5% Clioquinol R050. Antibiotic or antimycotic additives may also be considered for external treatment, possibly in combination with glucocorticoid-containing creams or emulsions with hydrocortisone (Hydro-Wolff, Hydrogalen, R120) or triamcinolone acetonide (Triamgalen).
Operative therapieThis section has been translated automatically.
The papillomatous growths can be removed surgically.
LiteratureThis section has been translated automatically.
- Gerharz M, Stadler R (1987) Pemphigus vegetans of the Hallopeau type. Detection of pemphigus antibodies with direct and indirect immunofluorescence. dermatologist 38: 371-374
- Hallopeau FH (1898) Nouvelle étude sur une forme pustuleuse et bulleuse de la maladie de Neumann, dite pemphigus végétans Annales de dermatologie et syphiligraphie (Paris) 9: 969
- Hashizume H et al (1993) Epidermal antigens and complement-binding anti-intercellular antibodies in pemphigus vegetans, Hallopeau type. Br J Dermatol 129: 739-743
- Jansen T et al (2001) Pemphigus vegetans. A historical perspective. dermatologist 52: 504-509
- Neumann HA et al (1980) Pyodermite vegetante of Hallopeau. Arch Dermatol 116: 1169-1171
- Ngo JT et al (2012) Pemphigus vegetans associated
withintranasal cocaine abuse. J Cutan Med Surg 16:344-349 - Steiner A et al (1985) Pemphigus vegetans (Hallopeau) with eosinophilic cancellous bone - a successful retinoid therapy. dermatologist 36: 356
- Virgili A et al (1992) Sudden vegetation of the mouth. Pemphigus vegetans of the mouth (Hallopeau type). Arch Dermatol 128: 398-399, 401-402
Ngo JT et al (2012) Pemphigus vegetans associated
withintranasal cocaine abuse. J Cutan Med Surg 16:344-349