minocycline and Granuloma

We report a case of cutaneous atypical mycobacteriosis in a 12-year-old healthy girl due to Mycobacterium avium. The cutaneous symptoms were three well-defined subcutaneous nodules on both buttocks and on the posterior surface of the left thigh. One had a fistulous opening on the skin surface. Histopathological examination revealed epithelioid cell granulomas surrounded by dense lymphocytic infiltration and acid-fast bacteria were seen with modified periodic acid-carbol fuchsin staining. Using Ogawa's medium at 37 degrees C, acid-fast bacteria were isolated from the biopsied specimen and identified by the DNA-DNA hybridization method as Mycobacterium avium. In drug susceptibility test, these were resistant to all antituberculous drugs. Oral administration of minocycline 100 mg/day for two months had little effect on the two remaining lesions, which were therefore excised. Based upon reported cases of Mycobacterium avium complex, we considered that our pediatric patient with multiple intradermal or subcutaneous nodules on the buttocks and the thigh exhibited the characteristic symptoms of M. avium infection.

Topics: Administration, Oral; Anti-Bacterial Agents; Antitubercular Agents; Buttocks; Child; Coloring Agents; Cutaneous Fistula; DNA, Bacterial; Drug Resistance, Microbial; Female; Granuloma; Humans; Lymphocytes; Minocycline; Mycobacterium avium; Mycobacterium avium-intracellulare Infection; Periodic Acid; Phenols; Rosaniline Dyes; Skin Diseases, Bacterial; Tetracycline Resistance; Thigh

Propionibacterium acnes (P. acnes) is a commensal bacterium indigenous to the skin. Previous reports have suggested that infection with P. acnes causes sarcoidosis, a systemic granulomatous disease. We present the case of a 63-year-old woman who developed subcutaneous nodules. A skin biopsy revealed necrotizing vasculitis and noncaseating granulomas, which are characteristic of sarcoidosis. Immunohistostaining revealed a P. acnes skin infection, which led to the diagnosis of sarcoidosis. Minocycline treatment resolved the infection and improved the patient's symptoms. We herein report a case in which immunohistochemistry was useful in the diagnosis of sarcoidosis.

Topics: Anti-Bacterial Agents; Antibodies, Monoclonal; Biopsy; Female; Granuloma; Humans; Immunohistochemistry; Japan; Middle Aged; Minocycline; Propionibacterium acnes; Sarcoidosis; Treatment Outcome; Vasculitis

Topics: Anti-Bacterial Agents; Anti-Inflammatory Agents; Biopsy; Buttocks; Dermal Fillers; Diagnosis, Differential; Dimethylpolysiloxanes; Female; Granuloma; Humans; Injections, Subcutaneous; Liposarcoma; Lost to Follow-Up; Middle Aged; Minocycline; Skin Ulcer; Thigh; Triamcinolone

Mycobacterium W (Mw) vaccine has been found to be effective in the treatment of leprosy and warts. Despite increasing use of Mw immunotherapy, data on its safety is limited. We report a series of eight patients who developed persisting injection site granulomatous reaction following Mw immunotherapy and were successfully treated with minocycline. Eight patients with persistent nodular swelling at the site of Mw injections were identified. Seven of them had received Mw immunotherapy for cutaneous warts and one for verrucous epidermal nevus. The lesions were firm, erythematous, succulent, non-tender nodules confined to the sites of Mw vaccine injections. In 6 of these patients nodules also involved the previously injected areas. Skin biopsy from all patients showed eosinophil rich inflammation admixed with histiocytes and lymphocytes. In addition granulomas were seen in all with septal and nodular panniculitis in four patients. Broken and granular acid-fast bacilli were identified in two cases. All patients were treated with oral minocycline 100 mg/day for a mean of 9 weeks and showed good clinical response. Granulomatous reaction is a rare but significant adverse effect of Mw immunotherapy at cosmetically and functionally imperative sites. Oral minocycline appears to be effective therapy in this situation.

Topics: Administration, Oral; Adolescent; Adult; Anti-Bacterial Agents; Bacterial Vaccines; Drug Administration Schedule; Female; Granuloma; Humans; Immunotherapy; Male; Middle Aged; Minocycline; Mycobacterium Infections, Nontuberculous; Skin Diseases, Bacterial; Time Factors; Treatment Outcome

Topics: Anti-Bacterial Agents; Breast; Female; Granuloma; Humans; Middle Aged; Minocycline; Pyoderma; Skin Ulcer

Granulomatous rosacea is a variant of rosacea that may present similar to other granulomatous diseases. We present the case of a 45-year-old woman with a 2-year history of facial erythema with multiple papules and pustules on the cheeks, chin, and glabella. The patient responded to minocycline, resulting in healing 6 months without residual scarring. This patient's clinical and histological presentation and treatment outcome are to our assessment consistent with granulomatous rosacea. However, other clinically and histologically related entities will be discussed. These entities include, but are not limited to, perioral dermatitis, granulomatous periorificial dermatitis, lupus miliaris disseminatus faciei, facial afro-caribbean eruption syndrome, and sarcoidosis.

Topics: Dermatitis, Perioral; Diagnosis, Differential; Facial Dermatoses; Female; Granuloma; Humans; Middle Aged; Minocycline; Remission Induction; Rosacea; Skin Diseases, Papulosquamous; Tuberculoma

Topics: Anti-Infective Agents; Drug Therapy, Combination; Granuloma; Humans; Leprostatic Agents; Leprosy; Minocycline; Ofloxacin; Rifampin; Tetracycline

Histopathological activity was assessed in the skin tissue of 13 skin-smear negative, borderline tuberculoid leprosy patients after administration of a single dose of ROM (rifampin 600 mg, ofloxacin 400 mg and minocycline 100 mg) therapy. Biopsies taken just before therapy showed Mycobacterium leprae to be present in eight cases. After 6 months, only three showed granulomatous lesions and others showed only resolving or inactive lesions. Acid-fast bacilli (AFB) persisted in the nerves of three cases. At the end of 12 months, granulomas persisted in 2 out of 13 (15%) patients. No bacilli, however, were detected in any of them at the end of 12 months. This study demonstrated that 12 months after a single dose of ROM granuloma cleared in 85% of the patients and AFB were absent in all of them.

Topics: Adolescent; Adult; Child; Child, Preschool; Female; Granuloma; Humans; Leprosy, Lepromatous; Male; Minocycline; Ofloxacin; Rifampin; Skin

Topics: Adult; Anti-Bacterial Agents; Anti-Infective Agents; Dapsone; Drug Monitoring; Granuloma; Histiocytes; Humans; Leprostatic Agents; Leprosy, Borderline; Leprosy, Tuberculoid; Lymphocytes; Male; Minocycline; Ofloxacin; Recurrence; Rifampin

Five patients attended the accident and emergency (A&E) department with fish tank granuloma caused by an infection with Mycobacterium marinum. All patients had forearm symptoms which were initially misdiagnosed. They were later recognised by the presence of superficial cutaneous lesions in a sporotrichotic distribution. Definitive diagnosis was confirmed by the histological appearances of a biopsy and or culture of the organism. All patients responded to oral minocycline and had uncomplicated recoveries once the diagnosis was established. A&E doctors need to be aware of the possible diagnosis of fish tank granuloma especially when treating forearm infections which have been resistant to antibiotics.

Topics: Adult; Aged; Anti-Bacterial Agents; Female; Granuloma; Hobbies; Humans; Male; Middle Aged; Minocycline; Mycobacterium Infections, Nontuberculous; Mycobacterium marinum; Occupational Diseases

Topics: Adult; Anti-Bacterial Agents; Granuloma; Humans; Male; Minocycline; Mycobacterium Infections, Nontuberculous; Mycobacterium marinum

Superficial granulomatous pyoderma, recently described as a variant of pyoderma gangrenosum, would be better termed pathergic granulomatous cutaneous ulceration as the seven previously described cases, as well as our own two cases, have significant dermal involvement histologically and heal with scarring. In contrast to pyoderma gangrenosum, lesions of superficial granulomatous pyoderma respond to less toxic anti-inflammatory agents.

Topics: Adult; Chronic Disease; Dapsone; Diagnosis, Differential; Granuloma; Humans; Male; Minocycline; Pyoderma; Recurrence; Skin Ulcer

Topics: Adult; Facial Dermatoses; Female; Granuloma; Humans; Minocycline; Rosacea

Twenty-five patients had superficial ulcerative and vegetative pyoderma with granulomatous histologic findings. Healing occurred without systemic corticosteroid therapy in all but three patients. All patients had clinical pyoderma gangrenosum. In five patients the lesion occurred after surgery of the skin. Histopathologic study of 40 biopsy specimens showed focal neutrophilic abscesses of the papillary dermis, often with peripheral palisading histiocytes and foreign-body giant cells. Pseudoepitheliomatous, vegetative hyperplasia and sinus tract formation were observed frequently. All patient had massive areas of plasmacytosis, and 13 had eosinophils. Granulation tissue, hemorrhage, and fibrosis were additional features in some areas. Foreign material in the lesions was considered unimportant, except in one patient with a starch granuloma. Therapy with local corticosteroids, minocycline, tetracycline, or sulfa drugs resulted in healing in 15 patients. We believe that we have identified a localized, limited form of chronic superficial pyoderma gangrenosum with verrucous and ulcerative lesions and a granulomatous histologic appearance that represents a unique pattern of this disease in some patients.

Topics: Abscess; Adolescent; Adrenal Cortex Hormones; Adult; Aged; Child; Female; Gangrene; Granuloma; Humans; Male; Middle Aged; Minocycline; Pyoderma; Skin Ulcer

Two patients with Mycobacterium marinum infections from home tropical fish aquariums are presented herein. Both patients showed dramatic improvement with minocycline therapy. In vitro susceptibility results also confirmed minocycline, doxycycline, and tetracycline efficacy using disc diffusion and dilution methods.

Topics: Adult; Arm; Female; Granuloma; Hand; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Minocycline; Mycobacterium; Mycobacterium Infections; Tetracyclines

Atypical acid-fast infections are not infrequent in the Gulf Coastal region. The development of erythematous papules within three or four weeks after aquatic exposure deserves such consideration. Deeper tissues may also become involved. This should signal a caution when considering the use of corticosteroid injections in such a suspicious lesion. Inasmuch as hypertrophic scar formation at a site of trauma must be considered in the differential diagnosis, it is important to secure histopathologic examination prior to treatment. While a surgical approach has been required for the most part, oral administration of minocycline hydrochloride has brought about healing in the patients reported herein. This article deals with only three cases. However, response was complete and without recurrence in each. Such therapy is recommended prior to the use of more drastic procedures.

Topics: Adult; Fingers; Granuloma; Hand; Humans; Male; Middle Aged; Minocycline; Mycobacterium Infections; Skin Diseases, Infectious; Swimming; Tetracyclines