Bilateral Auricular Blastomycosis-like Pyoderma: A Rare Presentation Histologically Misinterpreted as Squamous Cell...

Area of Science:

• Dermatology
• Pathology
• Microbiology

Background:

• Blastomycosis-like pyoderma (BLP) is a rare chronic inflammatory dermatosis.
• It presents with vegetative and verrucous plaques, often colonized by Staphylococcus aureus.
• BLP is frequently misdiagnosed as squamous cell carcinoma (SCC) or other dermatoses due to similar clinical and histopathological features.

Purpose of the Study:

• To report an unusual case of bilateral auricular BLP.
• To review and summarize existing literature on BLP.
• To discuss the potential association between BLP and systemic inflammatory conditions.

Main Methods:

• Clinicopathological reassessment of a patient with bilateral auricular BLP.
• Microbiological cultures to identify bacterial colonization.
• Comprehensive literature review of previously reported BLP cases.

Main Results:

• The patient's condition, initially misdiagnosed as SCC, was confirmed as BLP.
• Histopathology revealed pseudoepitheliomatous hyperplasia, neutrophilic microabscesses, and inflammatory infiltrate.
• Staphylococcus aureus was identified, guiding effective antimicrobial therapy.
• Literature review summarized clinical, histopathological, microbiological, and therapeutic data for BLP.

Conclusions:

• Accurate diagnosis of BLP requires integrating clinical, histological, and microbiological findings.
• BLP may be associated with systemic inflammatory conditions and immune dysregulation.
• Increased awareness of BLP's diverse presentations is crucial to avoid misdiagnosis and ensure appropriate management.