Pyoderma vegetans

Last Updated: 2023-07-07

Author(s): Anzengruber F., Navarini A.

ICD11: 1B7Y

Hallopeau 1898.

Chronic vegetative pyoderma, pyodermites végétantes et verruqueuses, pyodermia chronica papillaris et exulcerans.

Chronic bacterial infection following trivial injuries.

Often occurring in immunocompromised patients.

  • Unknown.
  • Mostly β-haemolytic group A streptococci, sometimes Staphylococcus aureus and Enterobacteriaceae, less frequently Gram-negative germs may also act as triggers.
  • Predisposing factors: Skin lesions, lymphomas, leukaemias, immunosuppressive diseases, alcoholism, malnutrition.

Centrifugally expanding, eventually coin- to palm-sized, livid infiltrates with pustules, necrosis, ulcers (some fistulating), with verrucous, papillomatous smeary secretion. Pus emptying is possible on pressure. In most cases, vegetating pyodermas are solitary lesions; rarely, several may occur. The efflorescences heal with scarring (bridge and pinnacle scars).

V.a. extremities and back of the hand.

Unspecific, epidermal hyperplasia, intra- and subepidermal neutrophilic microabscesses, dermal inflammatory infiltrate.

  • No spontaneous regression.
  • Scarring healing.

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