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Blastomycosis-like pyoderma: successful treatment with low-dose acitretin
Roland T D Nguyen1, Graeme L Beardmore
1Greenslopes Private Hospital, Greenslopes, Queensland, Australia. rolandtdnguyen@hotmail.com
The Australasian Journal of Dermatology
|April 22, 2005
Summary
Blastomycosis-like pyoderma on sun-damaged skin is rare. Low-dose oral acitretin effectively treated two patients resistant to antibiotics.
Area of Science:
- Dermatology
- Infectious Diseases
Background:
- Blastomycosis-like pyoderma is a rare bacterial skin infection.
- It typically presents as verrucous plaques with purulent discharge.
- Sun-damaged skin is an unusual site for this condition.
Observation:
- Two elderly patients presented with blastomycosis-like pyoderma on sun-damaged skin.
- One patient had multiple painful nodules and plaques; the other had a solitary plaque.
- Histopathology revealed pseudoepitheliomatous hyperplasia and dermal suppuration.
Findings:
- Bacterial cultures identified Staphylococcus aureus in one patient and Prevotella and Corynebacterium species in the other.
- Fungal and mycobacterial investigations were negative.
- Neither patient responded to oral doxycycline.
Implications:
- This case series suggests blastomycosis-like pyoderma can occur on sun-damaged skin.
- Low-dose oral acitretin appears to be an effective treatment option for refractory cases.
- Further research is warranted to understand the role of sun damage in this condition.