HistoryThis section has been translated automatically.
Hallopeau 1898; Nanta and Bazex 1937
DefinitionThis section has been translated automatically.
Chronic, therapy-resistant pyoderma, which can occur after banal injuries. Frequently occurring in immunocompromised patients or as a consequence of a therapy-resistant leg ulcer.
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PathogenThis section has been translated automatically.
Mostly beta-hemolytic Group A Streptococci or Staphylococcus aureus. More rarely, Gram-negative germs or a mixed flora are the triggers (Molodoi AD et al. 2015).
EtiopathogenesisThis section has been translated automatically.
Defects of humoral or cellular immunity, predisposing local factors, virulent pathogens, infection of an underlying skin lesion
LocalizationThis section has been translated automatically.
Located mainly on the extremities, especially on the lower legs, the backs of the feet and hands.
Clinical featuresThis section has been translated automatically.
Peripherally expanding, spongy, livid-red infiltrates with numerous pustules and fistulas; initially a screen-like aspect. Later development of differently sized, smearily covered ulcers with arch-shaped margins. Occasionally, superimposed, verrucous epithelial proliferates are also formed with evacuation of a serous-purulent secretion under pressure. The foci can become as large as the palm of the hand. Often this form of pyoderma develops as a vegetative single focus. Multiple occurrence is possible.
With adequate wound management, healing takes place with the formation of irregularly configured scars. Also bridge and tip scars.
Differential diagnosisThis section has been translated automatically.
External therapyThis section has been translated automatically.
Consistent wound management (Note: in the case of chronic pyoderma of this kind, the cause is often inadequate nursing management).
Ointment dressings with disinfectant additives such as polyvidon iodine ointment(e.g. Betaisodona ointment).
Internal therapyThis section has been translated automatically.
- Agent of choice for β-hemolytic streptococci is benzylpenicillin (penicillin G) dosage 10 million IU over 10 days. Alternatively erythromycin (e.g. erythrocin) 3 times/day 500 mg p.o., doxycyclin (e.g. Doxy Wolff) 2 times/day 100 mg p.o.
- For staphylococcal infections cephalosporins such as cefuroxime (e.g. Elobact 2 times/day 250 mg p.o. or Flucloxacillin (e.g. Staphylex Kps.) 3-4 times/day 0.5-1.0 g p.o.
Progression/forecastThis section has been translated automatically.
Note(s)This section has been translated automatically.
The vegetative (bacterial) pyoderma must be distinguished from the aetiologically unexplained clinical picture of Pyoderma gangraenosum, which may be complicated by other organ manifestations (e.g. paraproteinemia, polycythaemia vera, ulcerative colitis, etc.).
Some authors list the chancery pyoderma as an independent clinical picture. Clinically and therapeutically, however, this clinical picture differs only slightly from chronic vegetative pyoderma.
LiteratureThis section has been translated automatically.
- Aksu Çerman A et al (2016) Pyoderma Vegetans Misdiagnosed as Verrucous Carcinoma.
At J Dermatopathol 38:148-50.
- Bianchi L et al (2001) Pyoderma vegetans and ulcerative colitis. Br J Dermatol 144: 1224-1227
- Hallopeau H (1898) Pyodermite vegetante, its relationship to dermatitis herpetiformis and pemphigus vegetans. Arch Dermatol Syph (Vienna) 43: 289-306
- Hornstein OP et al. (1984) Pluriorificative vegetative pyoderma with T-cell defect. dermatologist 35: 132-137
- Molodoi AD et al(2015) Pyoderma vegetans developed on chronic leg ulcer.
Rev Med Chir Soc Med Nat Iasi 119:107-111.
- Rieder JM et al. (2004) Pyoderma vegetans of the penis. J Urol 171: 354
Incoming links (11)Chronic vegetative pyoderma; Dispensing pyoderma; Dock8 deficiency; Papillomatosis cutis carcinoides; Pyoderma, chronic vegetative; Pyodermia chronica papillaris et exulcerans; Pyodermites végétantes et verruqueuses; Quinolinol sulphate monohydrate solution 0,1 % (nrf 11.127.); Tuberculosis cutis verrucosa; Tuberculosis fungosa serpiginosa; ... Show all
Outgoing links (24)Actinomycosis; Antibiogram; Antibiotics; Basal cell carcinoma (overview); Bromoderm; Cefuroxime; Cephalosporins; Doxycycline; Erythromycin; Flucloxacillin; ... Show all
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