eMedicine Specialties > Dermatology > Bacterial Infections

Pyoderma Vegetans: Follow-up

Author: Robert A Schwartz, MD, MPH, Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, UMDNJ-New Jersey Medical School
Coauthor(s): Justin Brown, MD, Dermatologist, The Dermatology Group
Contributor Information and Disclosures

Updated: Apr 22, 2009

Follow-up

Further Outpatient Care

Numerous treatment options are available for pyoderma vegetans (PV), with mixed results, and these different therapies should be tried if initial therapy fails.

Prognosis

With therapy, the prognosis is good, although this may prove untrue in the face of associated medical conditions, such as HIV, diffuse T-cell lymphoma, and CML, which must be properly addressed.

Miscellaneous

Medicolegal Pitfalls

The main medical pitfall is clinically misdiagnosing this rare condition. Pyoderma vegetans (PV) is easily confused with pemphigus vegetans and deep fungal infections. The clinical manifestations and pathohistology are similar for both pyoderma vegetans and pemphigus vegetans, but immunofluorescence testing is useful in differentiating between the 2 conditions. In patients in whom inflammatory bowel disease does not coexist, pyoderma vegetans has a good prognosis with therapy. In contrast, pemphigus vegetans has a poor prognosis without the continuous use of immunosuppressive drugs. Additionally, because pyoderma vegetans is sometimes a cutaneous sign of cancer, misdiagnosis can be a serious medicolegal issue.

 


More on Pyoderma Vegetans

Overview: Pyoderma Vegetans
Differential Diagnoses & Workup: Pyoderma Vegetans
Treatment & Medication: Pyoderma Vegetans
Follow-up: Pyoderma Vegetans
Multimedia: Pyoderma Vegetans
References
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References

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Further Reading

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Keywords

pyoderma vegetans, blastomycosis-like pyoderma, blastomycosislike pyoderma, mycosis-like pyoderma, mycosislike pyoderma

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Contributor Information and Disclosures

Author

Robert A Schwartz, MD, MPH, Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, UMDNJ-New Jersey Medical School
Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and Sigma Xi
Disclosure: Nothing to disclose.

Coauthor(s)

Justin Brown, MD, Dermatologist, The Dermatology Group
Justin Brown, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Society for MOHS Surgery, and Sigma Xi
Disclosure: medicis Honoraria Review panel membership; triax Honoraria Review panel membership

Medical Editor

Julie C Harper, MD, Assistant Program Director, Assistant Professor, Department of Dermatology, University of Alabama at Birmingham
Julie C Harper, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Stiefel Honoraria Speaking and teaching; Allergan Honoraria Speaking and teaching; Intendis Honoraria Speaking and teaching; Coria Honoraria Speaking and teaching; Sanofi-Aventis Honoraria Speaking and teaching

Pharmacy Editor

David F Butler, MD, Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic
David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Managing Editor

Van Perry, MD, Assistant Professor, Department of Medicine, Division of Dermatology, University of Texas Health Science Center
Van Perry, MD is a member of the following medical societies: American Academy of Dermatology and American Society for Laser Medicine and Surgery
Disclosure: Nothing to disclose.

CME Editor

Catherine Quirk, MD, Clinical Assistant Professor, Department of Dermatology, Brown University
Catherine Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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