Vulvar superficial granulomatous pyoderma successfully treated with dapsone

Panés-Rodríguez, A.; Arregui-Murua, M.A.; Gutiérrez-Támara, P.; Borja-Consigliere, H.A.; Rodríguez-Pérez, Irene; Tuneu-Valls, A.

doi:10.1111/ced.13017

Cited by 2 publications

(3 citation statements)

References 7 publications

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Section: Discussionmentioning

confidence: 99%

“…In addition to compatible biopsy findings, definitive diagnosis of SGP relies on clinical presentation and course of disease [1,8]. Clinical appearance of SGP is usually a sterile, well-defined superficial ulcer with a clean base and no undermining borders most commonly occurring on the trunk and rarely on the face [1,3,[6][7][8]. In contrast to classic PG, SGP typically presents as slowly progressing, more superficial granulomatous lesions and as such has a more favorable prognosis and is not associated with underlying systemic or autoimmune disease [1,3,[6][7][8][9][10][11].…”

Section: Discussionmentioning

confidence: 99%

“…Clinical appearance of SGP is usually a sterile, well-defined superficial ulcer with a clean base and no undermining borders most commonly occurring on the trunk and rarely on the face [1,3,[6][7][8]. In contrast to classic PG, SGP typically presents as slowly progressing, more superficial granulomatous lesions and as such has a more favorable prognosis and is not associated with underlying systemic or autoimmune disease [1,3,[6][7][8][9][10][11]. SGP usually resolves with local, topical or intralesional anti-inflammatory or anti-microbial agents and does not require more aggressive systemic immunosuppressive agents that may be required in the treatment PG lesions or GPA, although a handful of cases of more aggressive SGP variants on the face, head, and neck have been reported [9][10][11].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Granulomatosis and Polyangiitis Presenting as Superficial Granulomatous Pyoderma

Zhang¹,

Roh²,

Patton³

2019

Fortune J Health Sci

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Superficial granulomatous pyoderma (SGP) is one of four subtypes of pyoderma gangrenosum (PG), an uncommon neutrophilic dermatosis, that presents as superficial, indolent ulcerative nodules or plaques that arise independently from an associated underlying disease [1]. Granulomatosis and polyangiitis (GPA) is a systemic, cytoplasmic ANCA (cANCA) positive vasculitis of small and medium vessels classically presenting with a triad of vascular, pulmonary, and renal complications [2]. We report a case of a limited variant of GPA presenting as SGP in a 57year-old male with multiple nonhealing, painful ulcers on the upper extremities, torso, and neck with histologic features of superficial ulcers with predominantly plasma cell infiltrate consistent with atypical SGP. Over the following year, violaceous ulcers appeared, and a larger wedge biopsy demonstrated sinus tract formation with underlying plasmocytosis with histiocytes and giant cells, neutrophilic inflammation, and focal granuloma formation without vasculitis. The patient developed pulmonary symptoms and fever in the setting of markedly elevated cANCA. A chest CT revealed a lung nodule with fine needle aspiration (FNA) demonstrating acute and granulomatous inflammation but no organisms. Based on compatible clinical and histological findings, the diagnosis of GPA presenting as SGP was established. This case of a variant of GPA initially limited to the integument and mistaken for SGP characterizes the clinical and histopathological presentations of two rare diseases and supports the notion that GPA should be included in the differential diagnosis for SGP even before systemic symptoms and elevated cANCA arise to ensure early diagnosis and treatment.

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