Indian Journal of Dermatology
  Publication of IADVL, WB
  Official organ of AADV
Indexed with Science Citation Index (E) , Web of Science and PubMed
 
Users online: 2126  
Home About  Editorial Board  Current Issue Archives Online Early Coming Soon Guidelines Subscriptions  e-Alerts    Login  
    Small font sizeDefault font sizeIncrease font size Print this page Email this page


 
Table of Contents 
CASE REPORT
Year : 2010  |  Volume : 55  |  Issue : 4  |  Page : 379-380
Pyoderma vegetans with Ig A deficiency


1 Royal Brisbane Hospital, Brisbane, Australia
2 University of Queensland, Brisbane, Australia

Date of Web Publication4-Jan-2011

Correspondence Address:
Sandeep Kumar
Royal Brisbane Hospital, Herston, Brisbane
Australia
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5154.74556

Rights and Permissions

   Abstract 

A 41-year-old male with known congenital IgA deficiency developed pyoderma vegetans during a subtropical holiday. He responded well to topical treatment with aluminium subacetate.


Keywords: Pyoderma vegetans, IgA deficiency, aluminium subacetate


How to cite this article:
Kumar S, Boyce Z, McKay C, Casey G. Pyoderma vegetans with Ig A deficiency. Indian J Dermatol 2010;55:379-80

How to cite this URL:
Kumar S, Boyce Z, McKay C, Casey G. Pyoderma vegetans with Ig A deficiency. Indian J Dermatol [serial online] 2010 [cited 2019 Oct 23];55:379-80. Available from: http://www.e-ijd.org/text.asp?2010/55/4/379/74556



   Introduction Top


Pyoderma vegetans (PV) is an unusual response to bacterial infection. Most reported cases have been in the setting of immunodeficiency especially HIV-AIDS. We report a case of pyoderma vegetans in a background of IgA deficiency. This was acquired sub-tropically and responded well to topical treatment.


   Case Report Top


A 41-year-old Caucasian male developed multiple, tender, crusted lesions on an erythematous base after a 3-month holiday in southern India. He had no systemic illness other than known IgA deficiency. At the time of presentation, he was on omeprazole and prednisolone prescribed by his general practitioner for these lesions. These lesions had appeared over a 2-week period, having started as small, tender pustules. There was no associated fever, malaise, night sweats, abdominal symptoms, or cough. All family contacts including domestic pets in India remained healthy. Examination revealed a healthy male with multiple lesions [Figure 1] and [Figure 2].There was no lymphadenopathy. Chest examination was within normal limits. Differential diagnoses considered at this stage were cutaneous tuberculosis, leishmaniasis, actinomycosis, PV, and cutaneous amoebiasis. The full blood count indicated to be marginally elevated the white cell count showed a neutrophil predominance. Serology confirmed IgA deficiency. Serology for HIV was negative. Stool microscopy and culture was negative for protozoa/helminths. A chest x-ray showed no abnormalities. Histological examination of tissue showed pseudoepitheliomatous hyperplasia. Swabs were positive for Staphylococcus aureus. Fungal cultures were negative. Cultures were negative for AFB. The patient was treated with aluminium subacetate soaks three times daily. Two weeks after treatment with topical therapy, the lesions had cleared [Figure 3].
Figure 1 :Abdomen of the male showing multiple crusted plaques on an erythematous base (433 × 325 mm, 180 × 180 DPI)

Click here to view
Figure 2 :Close-up view of lesions on an inflamed base (433 × 325 mm, 180 × 180 DPI)

Click here to view
Figure 3 :Healed lesions after aluminium acetate soaks (541 × 406 mm, 72 × 72 DPI)

Click here to view



   Discussion Top


Pyoderma vegetans (PV) is a cutaneous response to bacterial infections - most often staphylococcal and streptococcal. It was originally described by Hallopeau in 1898. [1] Histology is characterized by pseudoepitheliomatous hyperplasia. Cases have been reported on a background of HIV-AIDS; [2],[3],[4] inflammatory bowel disease; [5] lupus nephritis; [6] and mycosis fungoides. [7] Treatment options for PV are curettage, antibiotics, and topical therapies including aluminium subacetate soaks and attention to any underlying systemic illness. In summary, we describe a 41-year-old male with known IgA deficiency in whom PV responded successfully to topical treatment. To our knowledge, an association of PV with IgA deficiency has not been reported in the medical literature.

 
   References Top

1.Hallopeau H. Pyodermite vegetante, ihre Beziehungen zur Dermatitis Herpetiformis and dem Pemphigus vegetans. Arch f Dermatol u Syph 1898;43:289-306.  Back to cited text no. 1
    
2.Ahdoot D, Rickman LS, Haghighi P, Heard WU. Botryomycosis in the acquired immunodeficiency syndrome. Cutis 1995;55:149-52.  Back to cited text no. 2
[PUBMED]    
3.Potekaev NS, Iurin OG, Gorbacheva ZS, Potekaev SN, Pokrovskiĭ VV. Pyoderma vegetans as an early sign of HIV infection. Ter Arkh 1991;63:78-80.  Back to cited text no. 3
    
4.Salvemini JN, Baldwin HE. Botryomycosis in a patient with acquired immunodeficiency syndrome. Cutis 1995;56:158-60.  Back to cited text no. 4
[PUBMED]    
5.Trost LB, McDonnell JK. Important cutaneous manifestations of inflammatory bowel disease. Postgrad Med J 2005;81:580-5.  Back to cited text no. 5
[PUBMED]  [FULLTEXT]  
6.Follows GA, Mathew J, Lucas S, et al. Cutaneous botryomycosis in a patient with lupus nephritis. Nephrol Dial Transplant 1998;13:3200-1.  Back to cited text no. 6
[PUBMED]  [FULLTEXT]  
7.Welch KJ, Burke WA, Park HK. Pyoderma vegetans: association with diffuse T cell lymphoma (large cell type). J Am Acad Dermatol 1989;20:691-3.  Back to cited text no. 7
[PUBMED]    


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

Top
Print this article  Email this article
 
 
  Search
 
  
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Article in PDF (1,530 KB)
    Citation Manager
    Access Statistics
    Reader Comments
    Email Alert *
    Add to My List *
* Registration required (free)  


    Abstract
    Introduction
    Case Report
    Discussion
    References
    Article Figures

 Article Access Statistics
    Viewed2500    
    Printed81    
    Emailed0    
    PDF Downloaded50    
    Comments [Add]    

Recommend this journal