clobetasol and Pyoderma

Pyodermatitis-pyostomatitis vegetans is a benign, rare disorder characterized by a pustular eruption in the oral mucosa and vegetating plaques involving the groin and axillary folds. Its association with inflammatory bowel disease is well established. We report the case of a 49-year-old-white man with ulcerative colitis who manifested a vegetating, annular plaque in the left inguinal region of 2 months' duration. Oral examination disclosed an erythematous mucosa with multiple painful pustules involving the labial and gingival mucosa. Histopathologic study demonstrated epidermal hyperplasia and an inflammatory infiltrate composed mostly of neutrophils and eosinophils, grouped into microabscesses within the epidermis and with a bandlike configuration in the upper dermis. Results of direct and indirect immunofluorescence studies were negative. We discuss the differential diagnosis between pyodermatitis-pyostomatitis vegetans and pemphigus vegetans.

Topics: Anti-Inflammatory Agents; Anti-Inflammatory Agents, Non-Steroidal; Carboxymethylcellulose Sodium; Clobetasol; Colitis, Ulcerative; Diagnosis, Differential; Fluorescent Antibody Technique; Humans; Male; Mesalamine; Middle Aged; Mouth Mucosa; Pemphigus; Pyoderma; Stomatitis; Suppuration

Blastomycosis-like pyoderma (BLP) is a rare reactive skin disease that is most commonly caused by bacterial infection. Herein we present a case of BLP arising in lichen planus, a chronic inflammatory disease. We propose Wolf's isotopic response, or the appearance of a new skin disease at the site of an existing and unrelated disease, as the underlying molecular mechanism responsible for this unusual physical presentation. It is important that clinicians recognize atypical morphologies such as BLP, which mimics squamous cell carcinoma both clinically and pathologically. These similarities highlight the need for a tissue diagnosis to identify infectious etiologies and rule out malignancy when BLP is suspected. J Drugs Dermatol. 2018;17(2):233-235.

Topics: Aged; Anti-Inflammatory Agents; Blastomycosis; Clobetasol; Humans; Lichen Planus; Male; Pyoderma

An 80-year-old Caucasian female with rheumatoid arthritis and recurrent atypical bullous pyoderma gangrenosum is described. There was no evidence of any underlying myeloproliferative disorder. Rapid healing occurred in response to oral minocycline hydrochloride and topical clobetasol propionate.

Topics: Administration, Cutaneous; Administration, Oral; Aged; Aged, 80 and over; Clobetasol; Female; Humans; Minocycline; Pyoderma; Recurrence; Skin Diseases, Vesiculobullous