Chronic ulcerative vegetative pyoderma: causes, symptoms, diagnosis, treatment

Chronic ulcerative vegetative pyoderma is a deep form of pyoderma caused by streptococcal and staphylococcal infections. It occurs in people of any age. Development of the disease is promoted by severe immunodeficient conditions, leading to a decrease in the body's defenses, and a violation of the normal functional state of the skin.

Symptoms of chronic ulcerative vegetative pyoderma. The disease develops on the site of pustules or folliculitis. The lesion is slightly elevated and sharply delimited from the surrounding healthy skin, a bluish-red color, a soft consistency, an oval shape. On the surface of such a plaque there is an ulcer with uneven undercut edges, sluggish granulation and serous-purulent dense plaque (ulcer form). Over time, the bottom of the ulcer defect is covered by vegetations with an unpleasantly smelling serous-purulent discharge (ulcerative-vegetative form). The skin around the lesion is inflamed, follicular and perifollicular superficial pustules can be seen on it, sometimes merging into continuous lesions. Skin and pathological process can spread to the periphery (serpiginous form), capturing new areas of the skin. The disease is accompanied by soreness and restriction of movement in the limbs. When the process is regressed at the center of a peptic defect, the vegetation is flattened, the separated one stops. Healing occurs by scar formation. Foci can be single and multiple.

Histopathology. Dystrophic changes in the epidermis and chronic inflammation in the dermis with foci of granulomatous structure, necrosis and abscess formation are noted. Among the cells of the infiltrate, lymphocytes, fibroblasts with an admixture of neutrophils, eosinophils and plasma cells predominate.

Differential diagnosis. The disease should be distinguished from warty and colliquative skin tuberculosis, deep mycoses (blastomycosis, sporotrichosis).

Treatment of chronic ulcerative vegetative pyoderma. It is necessary to determine the sensitivity of the microorganism to antibiotics and prescribe antibiotic therapy. Effective sispres (ciprofloxacin), which is prescribed for 500 mg (children - 250 mg) 2 times a day for one week. To conduct antibiotic therapy should be connected immunomodulators, corticosteroids, vitamin preparations. To potentiate the effect of antibiotics, it is recommended to use 2 mg of phloenzyme 3 times a day. In order to increase the nonspecific resistance of the body and increase the production of alpha and gammainterferon use proteflasite (20 drops 2 times a day). On ulcers impose proteolytic enzymes, 5% dermatol ointment, creams and ointments containing antibiotics and corticosteroids (gentriderm, triderm, etc.). The effectiveness of therapy increases with the connection of a helium-neon laser.

[1], [2], [3], [4], [5], [6], [7]