Blastomycosis-like pyoderma

Blastomycosis-like pyoderma (also known as Pyoderma Vegetans) is a rare and chronic skin disease that is characterized by vegetative lesions. It was first described in 1898 by dermatologists Hallopeau and Pautrier.

Etiology

The exact cause of blastomycosis-like pyoderma is unknown. However, it is believed to be associated with an underlying immune system disorder or systemic disease, such as inflammatory bowel disease, HIV/AIDS, or cancer. It is not caused by blastomyces dermatitidis, the fungus responsible for blastomycosis, despite the similar name.

Clinical Presentation

Patients with blastomycosis-like pyoderma typically present with large, pustular, vegetative lesions that are often located on the face, neck, and upper extremities. The lesions may be painful and are often accompanied by fever, malaise, and weight loss.

Diagnosis

Diagnosis of blastomycosis-like pyoderma is primarily based on clinical presentation and histopathology. Biopsy of the lesion typically reveals neutrophilic infiltration, acanthosis, and pseudoepitheliomatous hyperplasia. Culture of the lesion is typically negative for fungus or bacteria, which helps to differentiate it from other similar conditions such as blastomycosis or pyoderma gangrenosum.

Treatment

Treatment of blastomycosis-like pyoderma typically involves the use of systemic corticosteroids and immunosuppressive agents such as cyclosporine. Antibiotic therapy is often ineffective, as the condition is not caused by a bacterial infection. In some cases, treatment of the underlying systemic disease can lead to resolution of the skin lesions.

Prognosis

The prognosis for patients with blastomycosis-like pyoderma is variable and largely depends on the severity of the underlying systemic disease. In some cases, the skin lesions can resolve spontaneously, while in others, they can persist for many years.

See Also

• Pyoderma gangrenosum
• Blastomycosis
• Vegetative lesion
• Pseudoepitheliomatous hyperplasia