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At least 19 recordsLinked to original sources
PubMed1994

[Pyoderma gangrenosum vegetans. An overview of chronic pyoderma vegetans and pyoderma gangrenosum].

A case simulating extraordinarily extensive chronic vegetating pyoderma revealed itself in its course to be pyoderma gangrenosum. The bacterial flora varied due to a secondary colonization; there was no response to antibiotics but there was to corticosteroid, azathioprine and clofazimine therapy. IgA-paraproteinemia was found. Pyoderma gangrenosum has historically been considered to be a chronic ulcerous pyoderma and is not a disease of bacterial origin. Reviewing the literature available since the turn of this century, chronic vegetating pyoderma is compared with the latter from the viewpoint of clinical features, histopathology, immunology, course and treatment. There are so many convincing parallels between the two conditions that we would like to propose that we stop regarding them as distinct entities and instead view them as parts of a spectrum of the same immunopathological process.

Adult↗
PubMed1997

Aspects of the humoral immune response to Staphylococcus intermedius in dogs with superficial pyoderma, deep pyoderma and anal furunculosis.

Bacterial infection (pyoderma) of the canine skin is largely caused by Staphylococcus intermedius and may be a superficial or deep infection. Pyoderma may be a primary, idiopathic disease or secondary to a range of other dermatological disorders. In this study, the serum concentrations of IgG, IgA, antistaphylococcal IgG and antistaphylococcal IgA were measured by ELISA in normal dogs (n = 22), dogs with idiopathic deep pyoderma (n = 22), atopic dermatitis and superficial pyoderma (n = 24), atopic dermatitis without pyoderma (n = 25), flea bite dermatitis with superficial pyoderma (n = 8), pustular demodicosis (n = 8) and German shepherd dogs with anal furunculosis (n = 28). The serum IgG was significantly increased in dogs with atopy and superficial pyoderma (p < 0.001), and lower than normal in dogs with idiopathic deep pyoderma (p < 0.015). The concentration of serum IgA was significantly lower than normal in dogs with atopy uncomplicated by pyoderma (p < 0.015). The concentration of antistaphylococcal IgG in all clinical sera was significantly elevated (p < 0.001) when compared to normal dogs but concentrations of antistaphylococcal IgA were no greater than in normal dogs. Western blotting analysis for determination of the specificity of serum IgG antistaphylococcal antibody revealed that there were nine major epitopes. Discriminant analysis demonstrated that particular combinations of these epitopes were recognised more frequently by sera from dogs in different clinical groups.

Animals↗
PubMed1998

Comparison of production of Staphylococcus intermedius exotoxin among clinically normal dogs, atopic dogs with recurrent pyoderma, and dogs with a single episode of pyoderma.

OBJECTIVE: To determine whether exotoxin production by Staphylococcus intermedius is an important factor in recurrence of pyoderma in atopic dogs. DESIGN: Prospective clinical study. ANIMALS: 30 client-owned dogs (10 clinically normal dogs, 10 atopic dogs with recurrent pyoderma, and 10 dogs with a single episode of pyoderma). PROCEDURE: Specimens for bacterial culturing were obtained from a pustule or papule of affected dogs or from skin of clinically normal dogs. Staphylococcus intermedius was isolated and processed. Supernatants were analyzed for staphylococcal exotoxins. Types of lesions and severity of pruritus were assessed for each dog. RESULTS: Exotoxins A and C were detected in S intermedius isolated from 1 clinically normal dog. In the atopic group, exotoxin C was isolated from 1 dog, exotoxins A and C were isolated from 1 dog, and exotoxin C and toxic shock syndrome toxin-1 were isolated from 1 dog. Exotoxins were isolated from 2 dogs with a single episode of pyoderma (exotoxin C, 1 dog; exotoxins A and C, 1 dog). Lesion types and severity of pruritus varied greatly among dogs with pyoderma and were not associated with detection of exotoxin or type of exotoxin. CLINICAL IMPLICATIONS: Exotoxins were identified from few isolates of S intermedius, and we did not observe an association between type of lesions or severity of pruritus and detection of exotoxins. Production of exotoxin by S intermedius does not play a role in the recurrent nature of pyoderma in atopic dogs or on type of lesion or severity of pruritus associated with pyoderma.

Animals↗
PubMed1987

Malignant pyoderma or pyoderma gangrenosum of the head and neck?

Malignant pyoderma is a rapidly progressive ulcerating process of unknown origin that predominantly affects the head and neck of young adults. Malignant pyoderma has been considered distinct from pyoderma gangrenosum because of the predominant head and neck location of the ulcers and because the ulcers lack undermining and surrounding erythema. A case of a 22-year-old woman with a severe ulcerative process predominantly affecting the head and neck is described. A review of the literature indicates that malignant pyoderma and pyoderma gangrenosum are almost certainly identical disorders.

Adult↗
PubMed1988

Superficial granulomatous pyoderma: a localized vegetative form of pyoderma gangrenosum.

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.

Abscess↗
PubMed1991

Pyoderma gangrenosum and malignant pyoderma in Nigeria.

Five patients (four black Nigerian males and one Polynesian) with pyoderma gangrenosum (PG) were seen between May 1974 and March 1984, at the Ahmadu Bello University Teaching Hospital, Kaduna, Nigeria. Their age range was 12-42 years (mean 25.6 years). The female expatriate Polynesian patient had PG localized to the upper back while the other four patients had severe and extensive PG lesions. Local cleansing and dressing of the ulcers combined with appropriate systemic antibiotics produced healing in two of these patients. The empirical addition of dapsone and rifampicin led to complete healing in two others, but only transient remission in one patient who, after 22 years of disease activity, died at home from an aggressive and accelerated form of the disease best described as 'malignant pyoderma' gangrenosum.

Adult↗
PubMedDate not supplied

Comparative evaluation of cefadroxil and cephalexin in children and adolescents with pyodermas. Cefadroxil Once Daily Pyoderma Study Group.

This randomized, multicenter study compared the safety and efficacy of cefadroxil with that of cephalexin for the treatment of pyodermas in children and adolescents (1-18 years of age). Cefadroxil was given as a single oral daily dose of 30 mg/kg, and cephalexin 30 mg/kg/day was given in two divided doses. The maximum daily dose for both drugs was 1 gm, and treatment was administered for 10 days. Clinical and bacteriologic evaluations were made on days 4 or 5 during therapy and 2 to 4 days after therapy was completed. Of the 462 patients enrolled in the study, 156 patients in the cefadroxil group and 133 patients in the cephalexin group were evaluable. Staphylococcus aureus (56% of isolates) and Streptococcus pyogenes (39% of isolates) were isolated most frequently. The bacteriologic response was statistically greater in the patients treated with cefadroxil than in those treated with cephalexin (96% versus 89%; P = 0.042). A satisfactory clinical response was reported in 147 (94%) cefadroxil-treated patients and 122 (92%) cephalexin-treated patients (P = 0.476). The overall effective response to treatment was significantly higher with cefadroxil than with cephalexin (94% versus 86%; P = 0.024). Compliance with 9 or 10 days of therapy was similar in both treatment groups, although there was a difference between the two treatment groups with respect to completion of medication regimen: 95% of patients taking cefadroxil once daily--versus 65% of patients taking cephalexin twice daily--took 100% of their medication (P < 0.0001). Adverse events were infrequent and mild. The results of this study demonstrate that once-daily cefadroxil offers greater bacteriologic eradication and a better overall effective response than twice-daily cephalexin for the treatment of pyodermas caused by gram-positive pathogens in children and adolescents.

Adolescent↗
PubMed2002

Skin ulcers misdiagnosed as pyoderma gangrenosum.

BACKGROUND: Pyoderma gangrenosum is a diagnosis of exclusion, and the misdiagnosis of pyoderma gangrenosum can result in substantial complications in patients who have other causes of severe cutaneous ulceration. METHODS: We reviewed the charts of 240 patients with a diagnosis of pyoderma gangrenosum who were evaluated at our institution from 1975 through 2000, including 157 consecutive patients treated for presumed pyoderma gangrenosum from 1984 through 1992. We also reviewed the English-language literature. RESULTS: Ninety-five patients (49 from our institution and 46 described in the literature) had skin ulcers with a clinical resemblance to pyoderma gangrenosum. The final diagnoses were vascular occlusive or venous disease, vasculitis, cancer, primary infection, drug-induced or exogenous tissue injury, and other inflammatory disorders. Of the 95 patients studied, 64 had been treated for pyoderma gangrenosum for a median of 10 months (range, 3 to 180). These 64 included 15 of the 157 consecutive patients treated for pyoderma gangrenosum at our institution (10 percent). Of the ulcers in the 64 patients treated for pyoderma gangrenosum, it was clear that those in 23 patients (36 percent) did not respond to treatment directed at pyoderma gangrenosum, those in 8 (12 percent) were exacerbated by such treatment, and those in 15 (23 percent) improved with such treatment. CONCLUSIONS: The misdiagnosis of pyoderma gangrenosum is not uncommon and exposes patients to risks associated with its treatment. A thorough evaluation is required in all patients suspected of having pyoderma gangrenosum in order to rule out alternative diagnoses.

Arterial Occlusive Diseases↗
PubMed1999

Clinico-bacteriological study of pyodermas in children.

One hundred cases of pyodermas in children were investigated clinically and bacteriologically. Nasal and throat swabs from all cases were subjected to bacteriological examination. Most of the children (42%) were in the 1-4 year age group. The majority (58%) belonged to lower socio-economic groups with poor standards of hygiene. A history of over-crowding was obtained from 87% of cases, 82% were undernourished. Most of the children (68%) reported during the hot and humid months of June, July, August, and September. Primary pyodermas were observed in 72% of the children, and secondary pyodermas in 28%. Impetigo was the commonest primary pyoderma (48.61%); among secondary pyodermas, infected scabies was noted predominantly (42.86%). The face and legs were more commonly involved. Bacteriological cultures from pyoderma lesions revealed a single microorganism in the majority of the patients (84%). Staphylococcus aureus was isolated in pure culture from 48% and pure beta-hemolytic streptococci from 36%. A combination of both was obtained from 16%. No other organism was isolated from any case. A similar pattern was also observed in cultures from the nose and throat. Only 46 out of the 64 strains (84.3%) of Staphylococcus aureus isolated from pyoderma were typable. The majority (39.1%) showed a mixed pattern of phages; the second commonest was the non-allocated phage type (30.4%). Nasal flora had more of the non-allocated phage type (50%); two out of the three strains (66.6%) isolated from the throat showed a mixed pattern. All the strains of beta hemolytic streptococci, isolated either from lesions of pyoderma, nose, or throat belonged to group A. Staphylococcus aureus and showed a high sensitivity to netilmycin (100%), ofloxacin (98.4%), amoxycillin/clavulanic acid (96.9%), ciprofloxacin (89.1%) and gentamycin (84.4%) but a high resistance to penicillin (85.9%). A greater correlation was noted between nasal flora and organisms causing pyodermas. A change in the pattern of organisms causing pyodermas in children and their antibiotic sensitivities in this part of the globe has been observed in this study. The role of endogenous nasal and throat flora in the causation of pyodermas has also been highlighted.

Anti-Bacterial Agents↗