Histopathologic Features of Superficial Granulomatous Pyoderma

Abstract

Study of the histopathologic pattern of 28 cases of superficial granulomatous pyoderma demonstrated an ulcerative, verrucous pyoderma of the superficial dermis. Focal abscesses in the subepidermis or dermis were juxtaposed with granuloma formation and plasma cell inflammation. Hemorrhage and granulation tissue were present. The clinical lesions are indolent, and this feature is confirmed by chronic inflammatory elements, including sinus tract formation and focal fibrosis. Superficial granulomatous pyoderma must be added to the histologic differential diagnosis of the vegetative and ulcerative granulomas: blastomycosis, tuberculosis verrucosa cutis, and bromoderma.

Superficial Granulomatous Pyoderma: A Case Report of Two Japanese Patients and Clinical Comparison with Foreign Patients

“…Central cribriform scars and sinus tracts may be recognized.The lesions tended to occur on the sites of trauma, including those of surgical treatment.They tend to occur on the trunk rather than on the extremities in contrast to classic PG. This characteristic pattern of GP was diagnosed as SGP (1) (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). In parallel, 13 cases of SGP including our patients have been reported in Japan (15)(16)(17)(18)(19).…”

Superficial Granulomatous Pyoderma: A Case in an 11-Year-Old Girl and Review of the Literature

“…Superficial granulomatous pyoderma is a rare entity that has features similar to PG but differs from classic PG in that it has slower disease progression, often characteristic distinguishing histopathologic findings, and general absence of associated comorbid conditions. Superficial granulomatous pyoderma lesions typically appear singly and are more granulomatous, clean, and superficial than those in PG (3). Pathergy is common, but in general, SGP has a favorable prognosis with conservative treatment and usually does not require systemic immunosuppressive agents.…”

“…Involvement of prior surgical sites has also been described, consistent with the pathergy that can be seen in this disorder (1,2,5,12). Although some patients have been described to have multiple lesions (1,14,17,18), SGP, in contrast to PG, usually presents as a single lesion that enlarges slowly and has a superficial granulomatous clean base with vegetative borders (3).…”

Case 3

“…Histological examination in conjunction with close clinico‐pathological correlation is usually sufficient to make the diagnosis and the histological appearances are described as being characteristic of the condition although this has been questioned 5 . In a study of 28 cases, 6 there was a consistent pattern of subepidermal granulomata surrounding sterile neutrophil microabscesses with an outer layer of lymphocytes and plasma cells. Histiocytes and giant cells were frequent, as was haemorrhage.…”