Pyoderma vegetans developed on chronic leg ulcer.

Pyoderma vegetans is a rare disorder that more commonly affects middle-aged persons, with a male predilection. It is characterized by vegetating lesions that coalescence into a plaque with eroded surface, covered by purulent discharge and crusts. The etiology of this disease is not known with certainty, but it is often associated with bacterial infections in immunocompromised patients. We report the case of a 73-year-old men who presented to the Iasi Dermatology Clinic with a large, irregular, relatively well-defined dermohypodermic ulcer, with infiltrated sclerosing borders, accompanied by pain, with the floor covered in the Northern part by a proliferative, vegetative bleeding area, and the rest by a yellowish secretion and cellular debris, located on the left leg. Bacteriological examination of ulcer secretion identified Pseudomonas aeruginosa. Anatomopathological examination confirmed the development of Pyoderma vegetans on chronic leg ulcer. Under specific treatment for chronic leg ulcer and eradication of infectious focus the outcome was favorable both in terms of trophic ulcer scar- ring and Pyoderma vegetans healing.

[Chilblain lupus in an adolescent]. / Chilblain lupus la adolescent.

Chilblain lupus or lupus pernio is a particular clinical type of cutaneous chronic lupus erythematosus, more frequently met in adults and difficult do diagnose without specific lesions at the level of the face and/or the scalp. The patient B.A., female, aged 16 is hospitalized in the Dermatological Clinic Iasi for some red-to-violaceous plaques, infiltrated, slightly scaling located around the nails and on the hands and legs finger sides. The lesions come up at the age of 13 become even more serious and painful in cold weather, getting better in the warm season when they become slightly pruriginous and are accompanied by a discrete facial erythema in "vespertilio", completely neglected by the patient. The general status was very good during this time, without general manifestations or visceral touches. The clinical diagnosis that was initially suggested, pernio, was afterwards denied by a detailed anamnesis, by laboratory testes (positive antinuclear antibodies, positive anti-double-stranded DNA antibodies) and by the histopathological examination of the biopsy from cutaneous lesions. The introduction of the antimalarial drugs (Plaquenil 200 mg/ day) associated with photoprotective creams, led to cure of cutaneous lesions.