Facial superficial granulomatous pyoderma

D'Epiro, S; Salvi, Monica; Mattozzi, Carlo; Giancristoforo, Simona; Faina, Valentina; Macaluso, Laura; Luci, Cecilia; Grieco, Teresa; Calvieri, Stefano; Richetta, Antonio Giovanni

doi:10.1111/iwj.12195

Cited by 3 publications

(2 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…All three entities are more frequent in women than men, can present on the breast, and usually manifest with painful purulent lesions (pustules, abscesses) or even ulcers, frequently running a chronic recurrent course [ 1 , 4 , 5 , 23 ]. They share histopathological features of abundant neutrophils and granulomatous inflammation, the latter being diagnostic of IGM, while in PG and HS it is present only in special variants and long-lasting lesions [ 1 , 4 , 18 , 24 ]. Although HS, PG, and IGM are known to be associated with underlying systemic diseases such as inflammatory bowel disease, arthritis, and erythema nodosum [ 5 , 10 , 18 ], we have not found any of them in this patient.…”

Section: Discussionmentioning

confidence: 99%

A Case of Overlapping Clinical Features of Idiopathic Granulomatous Mastitis, Hidradenitis Suppurativa, and Pyoderma Gangrenosum Successfully Treated with Adalimumab

Breznik

Marko²

2022

Case Rep Dermatol

View full text Add to dashboard Cite

A 36-year-old woman with a 6-month history of painful unilateral mammary nodules and abscesses was initially treated by gynecologists under the diagnosis of idiopathic granulomatous mastitis (IGM). IGM is an entity that has not been described in classical dermatological textbooks and is considered a rare inflammatory breast disease assumingly associated with trauma, infection, or autoimmune system manifestations. In this patient, the lesions were refractory to conventional treatment of IGM comprising of surgical incisions, systemic antibiotics, dexamethasone, and methotrexate. At the initial visit to the dermatology department, a working diagnosis of localized hidradenitis suppurativa (HS) of breast was established, and treatment with systemic doxycycline was initiated. After the diagnostic incisional biopsy, the inflamed nodule deteriorated into a painful ulceration, implying a pathergy phenomenon. Histopathological features were consistent with the granulomatous type of pyoderma gangrenosum (PG). Treatment with systemic methylprednisolone and mycophenolate mofetil was unsuccessful. Subsequently, the patient developed nodules in the inguinal and axillary areas, typical for HS. Finally, adalimumab treatment resulted in the complete resolution of all lesions without relapse even after the biologic therapy was discontinued. Although in this case, IGM was not confirmed histopathologically, we noted several etiopathological and therapeutic similarities between IGM, PG, and HS and summarized them in a unique table. Further observations are needed to ascertain the potential associations among the three entities.

show abstract

Section: Discussionmentioning

confidence: 99%

A Case of Overlapping Clinical Features of Idiopathic Granulomatous Mastitis, Hidradenitis Suppurativa, and Pyoderma Gangrenosum Successfully Treated with Adalimumab

Breznik

Marko²

2022

Case Rep Dermatol

View full text Add to dashboard Cite

show abstract

“…Clinical appearance of SGP is usually a sterile, well-defined superficial ulcer with a clean base and no undermining borders most commonly occurring on the trunk and rarely on the face [1,3,[6][7][8]. In contrast to classic PG, SGP typically presents as slowly progressing, more superficial granulomatous lesions and as such has a more favorable prognosis and is not associated with underlying systemic or autoimmune disease [1,3,[6][7][8][9][10][11]. SGP usually resolves with local, topical or intralesional anti-inflammatory or anti-microbial agents and does not require more aggressive systemic immunosuppressive agents that may be required in the treatment PG lesions or GPA, although a handful of cases of more aggressive SGP variants on the face, head, and neck have been reported [9][10][11].…”

Section: Discussionmentioning

confidence: 99%

Granulomatosis and Polyangiitis Presenting as Superficial Granulomatous Pyoderma

Zhang¹,

Roh²,

Patton³

2019

Fortune J Health Sci

View full text Add to dashboard Cite

Superficial granulomatous pyoderma (SGP) is one of four subtypes of pyoderma gangrenosum (PG), an uncommon neutrophilic dermatosis, that presents as superficial, indolent ulcerative nodules or plaques that arise independently from an associated underlying disease [1]. Granulomatosis and polyangiitis (GPA) is a systemic, cytoplasmic ANCA (cANCA) positive vasculitis of small and medium vessels classically presenting with a triad of vascular, pulmonary, and renal complications [2]. We report a case of a limited variant of GPA presenting as SGP in a 57year-old male with multiple nonhealing, painful ulcers on the upper extremities, torso, and neck with histologic features of superficial ulcers with predominantly plasma cell infiltrate consistent with atypical SGP. Over the following year, violaceous ulcers appeared, and a larger wedge biopsy demonstrated sinus tract formation with underlying plasmocytosis with histiocytes and giant cells, neutrophilic inflammation, and focal granuloma formation without vasculitis. The patient developed pulmonary symptoms and fever in the setting of markedly elevated cANCA. A chest CT revealed a lung nodule with fine needle aspiration (FNA) demonstrating acute and granulomatous inflammation but no organisms. Based on compatible clinical and histological findings, the diagnosis of GPA presenting as SGP was established. This case of a variant of GPA initially limited to the integument and mistaken for SGP characterizes the clinical and histopathological presentations of two rare diseases and supports the notion that GPA should be included in the differential diagnosis for SGP even before systemic symptoms and elevated cANCA arise to ensure early diagnosis and treatment.

show abstract

The role of infliximab in the treatment of superficial granulomatous pyoderma of the head and neck

Ibrahim

Bunick

Bhaskar

et al. 2014

Journal of the American Academy of Dermatology

View full text Add to dashboard Cite

Facial superficial granulomatous pyoderma

Cited by 3 publications

References 11 publications

A Case of Overlapping Clinical Features of Idiopathic Granulomatous Mastitis, Hidradenitis Suppurativa, and Pyoderma Gangrenosum Successfully Treated with Adalimumab

A Case of Overlapping Clinical Features of Idiopathic Granulomatous Mastitis, Hidradenitis Suppurativa, and Pyoderma Gangrenosum Successfully Treated with Adalimumab

Granulomatosis and Polyangiitis Presenting as Superficial Granulomatous Pyoderma

The role of infliximab in the treatment of superficial granulomatous pyoderma of the head and neck

Contact Info

Product

Resources

About