Necrotizing vasculitis secondary to disseminated histoplasmosis simulating pyoderma gangrenosum

Vinicki, Juan Pablo; Tiraboschi, Iris Nora; Fernandez, Daniel; Dubinsky, Diana; Laborde, Hugo Armando; Nasswetter, G

doi:10.1093/rheumatology/ket174

Cited by 3 publications

(3 citation statements)

References 4 publications

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“…Pyoderma gangrenosum‐like ulcers are uncommon in disseminated histoplasmosis. These may occur as a result of direct infection with Histoplasma 3 or as necrotizing vasculitis secondary to disseminated infection 4 . Bone involvement is also extremely rare, manifesting as carpal tunnel syndrome, septic arthritis, or osteomyelitis.…”

Section: Figurementioning

confidence: 99%

Disseminated histoplasmosis presenting as pyoderma gangrenosum‐like ulcers in an apparently immunocompetent patient: multiple red herrings presenting a diagnostic challenge

et al. 2020

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Section: Figurementioning

confidence: 99%

Disseminated histoplasmosis presenting as pyoderma gangrenosum‐like ulcers in an apparently immunocompetent patient: multiple red herrings presenting a diagnostic challenge

et al. 2020

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“…Other conditions that may share similar clinical features with PG are vasculitis such as Wegener’s granulomatosis, 77,78 Behçet’s disease 67,79 and antiphospholipid syndrome 80,81 ; apart from these, there are skin cancer manifestations, including squamous cell carcinoma, 82 cutaneous lymphoma, 83,84 and metastatic carcinoma. Moreover, even many infectious diseases such as cellulitis, necrotizing fasciitis, 85,86 herpetic ulcers, 87,88 atypical mycobacterial infections, 89 cutaneous tuberculosis, 90 leishmaniasis, sporotrichosis, 91 cryptococcosis, 92,93 histoplasmosis, 94,95 mucormycosis, 96 blastomycosis, 97 and ecthyma gangrenosum 98 have to be considered. Finally, it is important to mention factitious skin ulcers, 99 which belong to Munchausen syndrome, iatrogenic ulcers caused by drug injections and bites of spiders or other insects.…”

Section: Differential Diagnosismentioning

confidence: 99%

Pyoderma Gangrenosum: A Current Problem as Much as an Unknown One

Vallini

Andreini

Bonadio

2017

The International Journal of Lower Extremity Wounds

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Pyoderma gangrenosum (PG) is a rare neutrophilic inflammatory skin disease, characterized by recurrent skin ulcers, which in almost 50% of cases are associated with systemic autoimmune disorders, including rheumatoid arthritis, chronic hepatitis, inflammatory bowel disease, paraproteinemias and hematological malignancies. A systematic search of literature for PG was carried out using the PubMed, Embase, and Google Scholar databases for the purpose of this review and 2780 articles were retrieved up to February 2017. Inflammation represents the predominant aspect of the disease, but its pathophysiological mechanisms are not completely clear yet, since there are many studies showing only one or more isolated findings of the disease. The goal of PG treatment is to reduce inflammation in order to promote ulcer healing by minimizing side effects of therapy. Several systemic and local treatments are available, but the lack of large randomized double-blind studies results in an absence of a uniform therapeutic standard: thus, more clinical studies are required in order to make head-to-head comparisons between combination and single-drug therapies and to identify specific combination therapies for distinctive clinical patterns of PG.

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“…Northern Argentina is hyperendemic for H. capsulatum; like Brazil, it has a number of tools for PDH detection. Although perhaps not routine in all laboratories, these include the use of serology, immunoblotting techniques [77], and PCR [41, 78]. Research using molecular assays to expedite diagnosis is ongoing [79].…”

Section: Endemic Regions and Resourcesmentioning

confidence: 99%

Diagnostic Methods for Histoplasmosis: Focus on Endemic Countries with Variable Infrastructure Levels

Scheel

Gómez

2014

Curr Trop Med Rep

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Diagnosis of histoplasmosis remains challenging in resource-limited regions where HIV/AIDS is epidemic and histoplasmosis is endemic. Early and rapid detection of histoplasmosis is essential to preventing morbidity and mortality, yet few diagnostic options are available in low-resource areas of the world. The aim of this review is to provide an overview of the current status of the diagnosis of histoplasmosis, including an update on recent developments and utilization of new technologies. We discuss the specific diagnostic challenges faced in endemic regions, emphasizing the need for greater availability and standardization of rapid diagnostics for this endemic and neglected disease. While significant progress has been made in the development of new methods, clinical utility must be established by means of formal and extensive clinical studies.

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Necrotizing vasculitis secondary to disseminated histoplasmosis simulating pyoderma gangrenosum

Cited by 3 publications

References 4 publications

Disseminated histoplasmosis presenting as pyoderma gangrenosum‐like ulcers in an apparently immunocompetent patient: multiple red herrings presenting a diagnostic challenge

Disseminated histoplasmosis presenting as pyoderma gangrenosum‐like ulcers in an apparently immunocompetent patient: multiple red herrings presenting a diagnostic challenge

Pyoderma Gangrenosum: A Current Problem as Much as an Unknown One

Diagnostic Methods for Histoplasmosis: Focus on Endemic Countries with Variable Infrastructure Levels

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