Ann Dermatol.  2011 Aug;23(3):365-368. 10.5021/ad.2011.23.3.365.

Blastomycosis-like Pyoderma with Good Response to Acitretin

• Lee YS
• Jung SW
• Sim HS
• Seo JK
• Lee SK

• KMID: 2171931
• DOI: http://doi.org/10.5021/ad.2011.23.3.365

Abstract

Blastomycosis-like pyoderma is a rare, vegetating skin lesion that is an unusual exaggerated tissue reaction possibly to prolonged primary or secondary bacterial infection. We report a case of blastomycosis-like pyoderma in a man with Down syndrome, diabetes mellitus and hypothyroidism who responsed poorly to conventional therapies, including antibiotics and correction of predisposing factors for a long time, but experienced dramatic improvement after 3 months of acitretin treatment.

Keyword

Acitretin; Blastomycosis-like pyoderma

MeSH Terms

Acitretin
Anti-Bacterial Agents
Bacterial Infections
Diabetes Mellitus
Down Syndrome
Hypothyroidism
Pyoderma
Skin
Acitretin
Anti-Bacterial Agents

Figure

• 

  Fig. 1 (A) Lichenified verrucous plaques with hemorrhagic ulcers on both ankles and right foot dorsum. (B) Close up view.

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  Fig. 2 (A) Histologic examination shows hyperkeratosis, pseudoepitheliomatous hyperplasia and dense inflammatory infiltrates in upper dermis (H&E, ×40). (B) The magnified view shows papillary dermal microabscess and neutrophil exocytosis (H&E, ×200). (C) Periappendageal dense mixed inflammatory infiltration of plasma cells and a few eosinophils (H&E, ×200).

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  Fig. 3 The verrucous skin lesion improved after 3 months to the treatment with acitretin.

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