HistoryThis section has been translated automatically.
Hallopeau 1898; Nanta and Bazex 1937
DefinitionThis section has been translated automatically.
Increasingly rarely used, only vaguely defined term for a "chronic, fistulating, peripherally progressive, therapy-resistant pyoderma", which may occur after trivial injuries and then develops a momentum of its own. Such chronic, also fistulating pyodermas are mainly found in immunocompromised patients. Such vegetating skin suppurations can also occur in the wake of a therapy-resistant leg ulcer. The distinction from pyoderma gangraenosum appears to be "fluid", especially since the occurrence of vegetating pyoderma has been described in ulcerative colitis in the same way as pyoderma gangraenosum ( Bianchi L et al. 2001).
You might also be interested in
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.
Localized mainly on the extremities, especially on the lower legs.
Clinical featuresThis section has been translated automatically.
Peripherally expanding, spongy, livid-red nodules with numerous pustules and fistulas; initially sieve-like aspect. Later, formation of ulcers of different sizes, covered with grease, with arcuate borders. Occasionally, superimposed, verrucous epithelial proliferates with discharge of a serous-purulent secretion on pressure. The foci can be as large as the palm of the hand. Frequently, this form of pyoderma develops as a vegetating single focus. However, multiple occurrences are possible. Such forms of pyoderma have been described, for example, in necrobiosis lipoidica or in radiation scars, i.e. in pre-damaged bradydrophic tissues.
With adequate wound management, healing occurs with the formation of irregularly configured scars. Also bridge and pinnacle 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.
- Alexis A et al (2005) Off-label dermatologic uses of anti-TNF-a therapies. J Cutan Med Surg 9: 296-302
- Aksu Çerman A et al (2016) Pyoderma vegetans misdiagnosed as verrucous carcinoma. Am J Dermatopathol 38:148-50.
- Antonelli E et al (2021) Dermatological manifestations in inflammatory bowel diseases. J Clin Med 10:364.
- Barrick CJ et al (2019) Necrobiosis lipoidica with superimposed pyoderma vegetans. Cutis 103:44-45.
- Bianchi L et al (2001) Pyoderma vegetans and ulcerative colitis. Br J Dermatol 144:1224-1247
- Bianchi L et al (2001) Pyoderma vegetans and ulcerative colitis. Br J Dermatol 144: 1224-1227
- Hallopeau H (1898) Pyodermite vegetante, its relations to dermatitis herpetiformis and pemphigus vegetans. Arch Dermatol Syph (Vienna) 43: 289-306
- Hornstein OP et al (1984) Pluriorificial vegetative pyoderma in T-cell deficiency. Dermatol 35: 132-137
- Molodoi AD et al.(2015) Pyoderma vegetans developed on chronic leg ulcer.
- Rev Med Chir Soc Nat Iasi 119:107-111.
- Rieder JM et al (2004) Pyoderma vegetans of the penis. J Urol 171: 354
- Shanavas S et al (2019) Pyoderma vegetans of the perineum in the setting of Ulcerative Colitis. ACG Case Rep J 6:e00170.
- Yu SX et al (2020) Nasal mucosa pyoderma vegetans associated with ulcerative colitis: A case report. World J Clin Cases 8:4953-4957.
Incoming links (12)Chronic vegetative pyoderma; Dispensing pyoderma; Dock8 deficiency; Papillomatosis cutis carcinoides; Pyoderma, chronic vegetative; Pyoderma gangraenosum; Pyodermia chronica papillaris et exulcerans; Pyodermites végétantes et verruqueuses; Quinolinol sulphate monohydrate solution 0,1 % (nrf 11.127.); Tuberculosis cutis verrucosa; ... Show all
Outgoing links (24)Actinomycosis; Antibiogram; Antibiotics; Basal cell carcinoma (overview); Bromoderm; Cefuroxime; Cephalosporins; Doxycycline; Erythromycin; Flucloxacillin; ... Show all
Please ask your physician for a reliable diagnosis. This website is only meant as a reference.