Pyoderma: Difference between revisions

Revision as of 14:22, 20 November 2014

1/100,000 people per year in US, primarily 40s-50s yoa
Dysfunction of activated neutrophils
>50% associated with systemic disease:
- IBD
- Polyarthritis, sero-negative and -positive
- Leukemia
- Less commonly psoriatic arthritis, OA, RA, spondyloarthopathy, hepatitis, PBC, myelomas, SLE, Sjogren

Extracutaneous manifestations (due to sterile neutrophilic infiltrates)
- Culture-negative pulmonary infiltrates most common
- CV, CNS, GI, eyes, liver, spleen, bones, LNs
Features
- Initial lesion - bite-like, small, red papule or pustule (many patients attribute spider bite)
- Changes into larger, ulcerative lesion
- Two primary variants:
  - Classic ulcerative form - usually on legs, deep ulceration, violaceous border along ulcer bed
  - Superficial, atypical form - hands/forearms/face, vesiculopustular
- Less common variants: 1) Peristomal pyoderma, 2) Genital pyoderma (must differentiate from STI), 3) Pyostomatitis vegetans (intraoral)

Papules
- Insect bites
- Scabies
- Seabather's eruption
- Cercarial dermatitis (Swimmer's Itch)
Macular
- Chikungunya
Sub Q Swelling and Nodules
Ulcers
- Tropical pyoderma
- Leishmaniasis
- Mycobacterium marinum
- Buruli ulcer
- Dracunculiasis (Guinea Worm disease)
Linear and Migratory Lesions
- Cutaneous larvae migrans
- Photodermatitis

See also domestic U.S. ectoparasites

Authors:

@@ Line 9: / Line 9: @@
 ==Clinical Features==
+*Extracutaneous manifestations (due to sterile neutrophilic infiltrates)
+**Culture-negative pulmonary infiltrates most common
+**CV, CNS, GI, eyes, liver, spleen, bones, LNs
+*Features
+**Initial lesion - bite-like, small, red papule or pustule (many patients attribute spider bite)
+**Changes into larger, ulcerative lesion
+**Two primary variants:
+***Classic ulcerative form - usually on legs, deep ulceration, '''violaceous''' border along ulcer bed
+***Superficial, atypical form - hands/forearms/face, vesiculopustular
+**Less common variants: 1) Peristomal pyoderma, 2) Genital pyoderma (must differentiate from STI), 3) Pyostomatitis vegetans (intraoral)
 ==Differential Diagnosis==