Pyoderma vegetans

Last Updated: 2019-08-26

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

ICD11: -

Hallopeau 1898.

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

Chronic bacterial infection after banal injuries.

Often occurring in immunosuppressed patients.

  • Unknown.

  • Mostly β-hemolytic streptococci of group A, sometimes Staphylococcus aureus and Enterobakteriaceae, more rarely Gram-negative germs can also act as triggers.

  • Predisposition factors: Skin injuries, lymphomas, leukaemias, immunosuppressive diseases, alcoholism, malnutrition. 

Centrifugally expanding, finally coin to palm size, livid infiltrates with pustules, necroses, ulcers (partly fistulizing), with verrucous, papillomatous smeary secretions. A pus emptying is possible on pressure. In most cases, vegetating pyodermias are solitary lesions, rarely more than one can occur. The efflorescences heal scarring (bridge and tip scars).

Especially the extremities and the backs of the hands.

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

  • No spontaneous regression.

  • Narrow healing.

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