Comparison of Aerobic Bacterial Culture Among Four Veterinary Microbiology Laboratories from Dogs with Superficial Pyoderma.

Bacterial culture and susceptibility are widely used in veterinary medicine to determine the specific bacteria causing infection as well as aid in appropriate antimicrobial selection. Previous studies have shown variable results with culture and susceptibility depending on the laboratory and methodology used. Samples from dogs with superficial pyoderma were obtained to make a homogeneous solution of bacteria. Sample acquisition from this solution was randomized and submitted to four veterinary laboratories for microbial identification and sensitivity. There was fair agreement among the laboratories in identification of a Staphylococcus spp. as well as fair agreement among the laboratories on the same Staphylococcus sp. Very good agreement was noted on identification of methicillin-resistant Staphylococcus spp. Additionally, good to very good agreement was noted on all antimicrobials that were tested across all four laboratories. A difference in turnaround time for sample processing was observed between the laboratories in the present study. Overall, there was mild variability among the laboratory results in this study.

Case Report: Disseminated Vegetating Plaques Occurring over Chronic Recalcitrant Dermatophytosis in an Immunocompromised Patient.

Blastomycosis-like pyoderma (BLP) is an uncommon tissue response possibly to bacterial infection that presents as vegetative skin lesions usually in immunocompromised patients. Staphylococcus aureus is the most frequent pathogen implicated in BLP. Here, we report the case of a 32-year-old man who had ulcerative vegetating lesions on extremities for 3 months over preexisting recalcitrant tinea lesions. The patient was hypertensive with a history of chronic graft rejection after renal transplantation 8 months earlier and was on long-term immunosuppressants. Investigations revealed anemia, mild hyperglycemia, and elevated serum creatinine. Histopathology showed suppurative and fibrosing perifolliculitis with moderate pseudocarcinomatous hyperplasia and the culture of biopsy specimen demonstrated growth of Escherichia coli and Citrobacter koseri. The diagnosis of BLP overlying dermatophytoses was made. The skin lesions improved completely with parenteral antibiotics. Local immune dysregulation by dermatophytoses along with iatrogenic immunosuppression may have favored this rare pyoderma.

Blastomycosis-like pyoderma: A pitfall for the misdiagnosis of squamous cell carcinoma.

Blastomycosis-like pyoderma is a rare cutaneous disease presenting as solitary or multiple verrucous or ulcerated plaques and nodules in a susceptible patient. The diagnostic criteria include characteristic verrucous plaques with pustules and elevated borders, histopathologic findings of pseudoepitheliomatous hyperplasia with abscesses, growth of at least one bacterium in tissue culture, and exclusion of other infectious sources. This report describes a case of a 62-year-old man with poorly controlled type 2 diabetes mellitus who presented with plaques, nodules, and ulcers in both groins and the right ankle. The patient was initially misdiagnosed with multiple squamous cell carcinomas and underwent several operations. A review of the pathology slides revealed pseudoepitheliomatous hyperplasia with multiple dermal abscesses, while repeated wound and tissue cultures were positive for coagulase-negative Staphylococcus. Blastomycosis-like pyoderma was diagnosed. The patient was subsequently treated with culture-guided prolonged antibiotic therapy followed by intralesional steroid injection, which led to gradual resolution of the lesions.

Effects of the clinical severity of disease and concomitant pyoderma on serum acute-phase proteins concentrations in dogs with sarcoptic mange.

BACKGROUND: Information on acute-phase protein (APP) concentrations in dogs with sarcoptic mange (SM) is scarce. OBJECTIVE: To determine the effects of the clinical severity of disease and concomitant pyoderma on serum C-reactive protein (CRP), serum amyloid-A (SAA), haptoglobin (Hp) and ceruloplasmin (Cp) concentrations in dogs with SM. ANIMALS: Forty client-owned dogs with SM (INF group) and 10 healthy control dogs (CON group). MATERIALS AND METHODS: The INF group was divided into three subgroups; Group 1 (mild/moderate), Group 2 (severe) and Group 3 (severe+pyoderma) according to the extent of skin lesions and the presence of concomitant pyoderma. Serum CRP, SAA, Hp and Cp concentrations of all study groups were measured. RESULTS: Serum CRP (P < 0.001), SAA (P < 0.001) and Hp (P = 0.016) concentrations of the INF group were higher than the CON group, with no difference in terms of Cp. A statistical difference was measured between groups 2 and 1 in SAA only. C-reactive protein was found to be significantly higher in dogs with severe SM accompanied by pyoderma (Group 3) when compared with dogs with severe SM (Group 2). The area under the receiver-operating characteristic curves differentiating pyoderma among dogs with severe SM was 0.850 for CRP (P = 0.0001, cut-off value >61.3 mg/L with sensitivity 69.29% and specificity 90.91%). CONCLUSIONS: The unique findings in this were that the SAA serum concentrations are related to the severity of SM and that serum CRP concentrations are effective in detecting the presence of pyoderma in dogs with severe SM.

Conclusions - The unique findings in this were that the SAA serum concentrations are related to the severity of SM and that serum CRP concentrations are correlated with the presence of pyoderma in dogs with severe SM. Contexte - Les informations sur les concentrations de protéines de phase aiguë (APP) chez les chiens atteints de gale sarcoptique (SM) sont rares. Objectif - Déterminer les effets de la gravité clinique de la maladie et de la pyodermite concomitante sur les concentrations sériques de protéine C-réactive (CRP), d'amyloïde-A (SAA), d'haptoglobine (Hp) et de céruloplasmine (Cp) chez les chiens atteints de SM. Animaux - Quarante chiens de propriétaires atteints de SM (groupe INF) et 10 chiens témoins sains (groupe CON). Matériels et méthodes - Le groupe INF a été divisé en trois sous-groupes ; Groupe 1 (léger/modéré), Groupe 2 (sévère) et Groupe 3 (sévère + pyodermite) selon l'étendue des lésions cutanées et la présence de pyodermite concomitante. Les concentrations sériques de CRP, SAA, Hp et Cp de tous les groupes d'étude ont été mesurées. Résultats - Les concentrations sériques de CRP (P < 0,001), SAA (P < 0,001) et Hp (P = 0,016) du groupe INF étaient supérieures à celles du groupe CON, sans différence en termes de Cp. Une différence statistique a été mesurée entre les groupes 2 et 1 en SAA uniquement. La protéine C-réactive s'est avérée significativement plus élevée chez les chiens atteints de SM sévère accompagnée de pyodermite (groupe 3) par rapport aux chiens atteints de SM sévère (groupe 2). L'aire sous les courbes caractéristiques de fonctionnement du récepteur différenciant la pyodermite chez les chiens atteints de SM sévère était de 0,850 pour la CRP (P = 0,0001, valeur seuil > 61,3 mg/L avec une sensibilité de 69,29 % et une spécificité de 90,91 %). Conclusions - Les résultats uniques dans ce cas étaient que les concentrations sériques de SAA sont liées à la gravité de la SM et que les concentrations sériques de CRP sont corrélées à la présence de pyodermite chez les chiens atteints de SM sévère.

Introducción- la información sobre las concentraciones de proteína de fase aguda (APP) en perros con sarna sarcóptica (SM) es escasa. Objetivo- determinar los efectos de la gravedad clínica de enfermedad y pioderma concomitante en las concentraciones de proteína C reactiva (CRP) sérica, amiloide-A sérica (SAA), haptoglobina (Hp) y ceruloplasmina (Cp) en perros con SM. Animales - Cuarenta perros de propietarios particulares con SM (grupo INF) y 10 perros de control sanos (grupo CON). Materiales y métodos - El grupo INF se dividió en tres subgrupos; Grupo 1 (leve/moderada), Grupo 2 (grave) y Grupo 3 (grave+pioderma) según la extensión de las lesiones cutáneas y la presencia de pioderma concomitante. Se midieron las concentraciones séricas de CRP, SAA, Hp y Cp de todos los grupos de estudio. Resultados- las concentraciones séricas de CRP (P < 0,001), SAA (P < 0,001) y Hp (P = 0,016) del grupo INF fueron más altas que las del grupo CON, sin diferencias en términos de Cp. Se observó una diferencia estadística entre los grupos 2 y 1 en SAA solamente. Se encontró que la proteína C reactiva era significativamente más alta en perros con SM severa acompañada de pioderma (Grupo 3) en comparación con perros con SM severa (Grupo 2). El área bajo las curvas de características operativas del receptor que diferencian la pioderma entre perros con SM grave fue de 0,850 para CRP (P = 0,0001, valor de corte >61,3 mg/l con sensibilidad del 69,29 % y especificidad del 90,91 %). Conclusiones- los hallazgos únicos en esto estudio fueron que las concentraciones séricas de SAA están relacionadas con la gravedad de la SM y que las concentraciones séricas de CRP están correlacionadas con la presencia de pioderma en perros con SM grave.

Contexto - São escassas as informações sobre as concentrações de proteínas de fase aguda (PFA) em cães com sarna sarcóptica (SS) são escassas. Objetivo - Determinar os efeitos da gravidade da doença e a piodermite concomitante nas concentrações de proteína C-reativa (PCR), amiloide sérico A (ASA), haptoglobina (Hp) e ceruloplasmina (Cp) em cães com SS. Animais - Quarenta cães de clientes com SS (grupo INF) e 10 cães controle saudáveis (grupo CON). Materiais e métodos - O grupo INF foi dividido em três subgrupos; Grupo 1 (leve/moderado), Grupo 2 (grave), Grupo 3 (grave + piodermite) de acordo com a extensão das lesões cutâneas e a presença de piodermite concomitante. As concentrações séricas de PCR, ASA, Hp e Cp, foram mensuradas. Resultados - As concentrações séricas de PCR (P < 0,001), ASA (P < 0,001) e Hp (P = 0,016) no grupo INF foram maiores que no grupo COM, sem diferenças em termos de Cp. Mensurou-se a diferença estatística entre os grupos 2 e 1 no ASA apenas. A proteína C-reativa foi significativamente maior em cães com SS grave com piodermite (Grupo 3) quando comparado com cães com SS grave (Grupo 2). A área sob as curvas características de operação do receptor que diferenciam piodermite entre cães com SS grave foi 0,850 para a PCR (P = 0,0001, valor de corte > 61,3 mg/L com sensibilidade de 69,29% e especificidade de 90,91%). Conclusões - Os achados mais singulares deste estudo foram de que as concentrações séricas de ASA são relacionadas à severidade da SS e que as concentrações séricas de PCR são correlacionadas com a presença de piodermite em cães com SS grave.

Incidence of Vesicobullous and Erosive Disorders of Neonates: Where and How Much to Worry?

OBJECTIVE: To analyse the incidence of dermatoses in neonates, stress the importance of simple noninvasive diagnostic procedures with perspective to actual need of active intervention. METHODS: Forty four neonates with vesicobullous lesions in Departments of Dermatology and Pediatrics were evaluated with respect to diagnosis, required treatments and follow ups. RESULTS: Of the total 44 neonates, 29 were boys and 15 girls. Low birth weight (weight at birth less than 2,500 g as per WHO criteria) was seen in 19 neonates. Of the infectious dermatoses, most common were pyodermas. Four cases (9%) were diagnosed to be of staphylococcal pyoderma and impetigo and two cases each of Group A Streptococcal impetigo and neonatal tinea faciei (4.5% each), one case each of neonatal candidiasis, neonatal varicella/chickenpox and scabies (2.3% each) were seen. Of the transient skin lesions, erythema toxicum neonatorum was commonest of all, being seen in 18 neonates (41%), followed by four cases (9%) of miliaria crystallina, three cases of neonatal acne (6.8%) and two cases of sucking blisters (4.5%) and one case each of transient neonatal pustular melanosis, epidermolysis bullosa simplex, incontinentia pigmentii, eosinophilic pustular folliculitis, pemphigus vulgaris and neonatal herpes simplex (2.3% each) were enrolled in this study (Fig. 1). Fig. 1 Piechart showing percentage and number of neonates with different diagnostic profiles in the study CONCLUSIONS: Certain specific considerations have to be born in mind while evaluating and managing neonatal dermatoses. Care has to be instituted to identify accurately infectious diseases and distinguish them from benign transient neonatal dermatoses. Some disorders first manifesting during the neonatal period may also represent harbingers of potential problems during adulthood. Finally, treatment modalities are instituted taking in account the actual diagnosis and judging if the treatment really is required or not.

A perplexing case of superficial granulomatous pyoderma with sporotrichoid-like distribution.

Superficial granulomatous pyoderma (SGP) is a rare pyoderma gangrenosum (PG) variant that differs from classic PG in that the ulcers tend to be more superficial, lack a rapidly advancing border, and are not typically associated with an underlying systemic disease. The ulcers are most commonly painless and located on the trunk, with a clean granulating base. They generally do not show undermining but may have a vegetative border. Lesions usually respond well to either topical or intralesional corticosteroids with complete healing. The classic histopathologic finding is a "three-layer granuloma" in the superficial dermis consisting of central neutrophilic inflammation and necrosis, a surrounding layer of histiocytes and multinucleated giant cells, and an outer most layer of plasma cells and eosinophils. Herein, we present a unique case of SGP with sporotrichoid-like distribution on the lower extremity.

Two-Year Delayed Healing of an Endovascular Access Site Related to an Unusual Etiology.

In this case report, the authors describe a patient who underwent an endovascular abdominal aortic aneurysm repair complicated by more than a 2-year delay in healing of the left inguinal fold access site. Providers initially suspected a chronic infection or foreign body reaction, but eventually the patient was diagnosed with superficial granulomatous pyoderma. Once the correct etiology was determined and appropriate treatment begun, the access site healed within 3 weeks.

Granuloma aséptico facial idiopático: revisión actualizada de las dificultades diagnósticas y terapéuticas / Idiopathic Facial Aseptic Granuloma: Updated Review of Diagnostic and Therapeutic Difficulties

El granuloma aséptico facial idiopático (GAFI) es una patología específica de la edad pediátrica caracterizada por la aparición de nódulos rojizos asintomáticos en la región facial. Su etiopatogenia es aún motivo de discusión, aunque la literatura actual orienta a que se encontraría dentro del espectro de la rosácea infantil. Tiene una evolución crónica pero benigna, y hay publicaciones que documentan la resolución espontánea de las lesiones en menos de un año. A pesar de no tener un tratamiento bien definido, se prefiere que sea conservador y se eviten las intervenciones agresivas

Idiopathic facial aseptic granuloma is a pediatric skin condition involving asymptomatic reddish nodules. The etiology and pathogenesis is still under discussion, although the literature tends to place this condition within the spectrum of childhood rosaceas. The clinical course is chronic but benign, and cases have been reported to resolve spontaneously in less than a year. Even though no well-defined treatment has emerged, a conservative approach that avoids aggressive therapies is preferred