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2016, Number 4

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Dermatología Cosmética, Médica y Quirúrgica 2016; 14 (4)

Facial Pustulosis: Study of 400 Patients. A New Dermatological Disease?

Peral RME, Ruíz JM

Language: Spanish
References: 24
Page: 262-269
PDF size: 276.70 Kb.


ABSTRACT

Background: facial pustulosis is a chronic infection of the skin that may be related to Arcanobacterium pyogenes. It affects the face especially the peripheral areas. Characterized lesions are pustules, abscesses and scars in advanced stages.
Objective: to demonstrate that in patients diagnosed and treated previously as acne, lesions are not exclusive of acne vulgaris, but of facial pustulosis.
Methodology: a longitudinal, observational and retrospective study of 400 patients was carried out from October 1997 to December 2008. Age ranged from six months to 79 years. All the patients underwent microbiological aerobic and anaerobic cultures and antibiogram with the MicroScan method.
Results: of the 400 patients studied, 52.5% were female and 47.5% males. Ninety percent had 30 days to two years of evolution, and the dermatosis was localized in the face. Pustules were predominated, but papules, abscesses and scars were also observed. Sixty percent of the patients had pain at the site of the lesions. Patients had received topical treatment with benzoyl, peroxide, retinoic acid, erythromycin and clindamycin, and systemic treatment with tetracycline, erythromycin, clindamycin, and sulfamethoxazole with trimethoprim, referring only improvement or no response.
Conclusions: in this study, Arcanobacterium pyogenes was isolated in papulo-pustular lesions previously diagnosed and treated without success as acne, which can correspond to a secondary infection by the bacteria of pre-existing acne, or it could be a new endemic entity in the region.


REFERENCES

  1. Arenas R. Acné vulgar, en Dermatología. Atlas, diagnóstico y tratamiento, México, Mc Graw Hill, 2004, pp. 25-28.

  2. Webster GF. The pathophysiology of acne, Cutis 2005; 76(2 Suppl): 4-7.

  3. Bialecka A, Kasprowicz A, Kaszycki P y Marcinkiewicz J. Characteristics of the Propionibacterium sp strains isolated from acne patients, Med Dosw Mikrobiol 2004; 56(1): 79-92.

  4. Rodríguez-Cavallini E y Vargas-Dengo P. Etiología bacteriana y susceptibilidad a antibióticos en pacientes con acné, Rev Biomed 2004; 15: 101-6.

  5. Cunliffe WJ y Harald PM. Acné. Diagnóstico y tratamiento, LatinComm, 2003, fasc. 1, pp. 29-37.

  6. Cohen RJ, Shannon BA, McNeal JE et al. Propionibacterium acnes associated with inflammation in prostatectomy specimens: a possible link to cancer evolution?, J Urol 2005; 173(6): 1969-74.

  7. Perry A y Lambert P. Propionibacterium acnes: infection beyond the skin, Expert Rev Anti Infect Ther 2011; 9(12): 1149-56.

  8. McDowell A, Valanne S, Ramage G et al. Propionibacterium acnes types I and II represent phylogenetically distinct groups, J Clin Microbiol 2005; 43(1): 326-34.

  9. Bojar RA y Holland KT. Acne and Propionibacterium acnes, Clin Dermatol 2004; 22(5): 375-9.

  10. Amaru R, Nieto R, Miranda L y Andia T. Flora bacteriana, sensibilidad antibiótica y factores en acné vulgar grados III y IV, Hospital Antonio Lorena del Cusco, Situa 2006; 10(20).

  11. Hermida A, Romero P, Cabarcos M y Treviño M. A propósito de un caso de neumonía por Arcanobacterium pyogenes, An Med Interna 2004; 21: 334-6.

  12. Jost BH, Post KW, Songer JG y Billington SJ. Isolation of Arcanobacterium pyogenes from the porcine gastric mucosa, Vet Res Commun 2002; 26(6): 419-25.

  13. Portas TJ y Bryant BR. Morbidity and mortality associated with Arcanobacterium pyogenes in a group of captive blackbuck (Antilope cervicapra), J Zoo Will Med 2005; 36(3): 570.

  14. Lavin S, Ruiz-Bacarán M, Marco I et al. Foot infections associated with Arcanobacterium pyogenes in free-living fallow deer (Dama dama), J Wildt Dis 2004; 40(3): 607-11.

  15. Hesselink JW. Hypertrophic osteopathy in a dog with a chronic lung abscess, J Am Vet Med Assoc 1990; 196(5): 760-2.

  16. Billington SJ, Post KW y Jost BH. Isolation of Arcanobacterium (Actinomyces) pyogenes from cases of feline otitis external and canine cystitis, J Vet Invest 2002; 14(2): 159-62.

  17. Gómez-Mateos J, Ubeda A, Florez C y León E. Endocarditis por Arcanobacterium pyogenes: primer caso en Europa, Enferm Infecc Microbiol Clin 2009; 27(4): 249-54.

  18. Norenberg D, Bigley DV, Virata RL y Liang GC. Corynebacterium pyogenes septic arthritis with plasma cell sinovial infiltrate and monoclonal gammopathy, Arc Intern Med 1978; 138(5): 810-1.

  19. Levy CE, Pedro RJ, Von Nowakonski A et al. Arcanobacterium pyogenes sepsis in farmer, Brazil, Emerg Infect Dis 2009; 15(7): 1131-2, doi: 10.3201/ eid1507.081072.

  20. Kavitha K, Latha R, Udayashankar C et al. Tres casos de infección por Arcanobacterium pyogenes asociado a los tejidos blandos, Med Microbiol 2010; 59(Pt. 6): 736-9.

  21. Kotrajaras R, Buddhavudhikrai P, Sukroongreung S y Chanthravimol P. Endemic leg ulcers caused by Corynebacterium pyogenes in Thailand, Int J Dermatol 1982; 21(7): 407-9.

  22. Gahrn-Hansen B y Frederiksen W. Human infections with Actinomyces pyogenes (Corynebacterium pyogenes), Diagn Microbiol Infect Dis 1992; 15(4): 349-54.

  23. Kotrajaras R y Tagami H. Corynebacterium pyogenes. Its pathogenic mechanism in epidemic leg ulcers in Thailand, Int J Dermatol 1987; 26(1): 45-50.

  24. Montgomery J. The aerobic bacteriology of infected skin lesions in children of the Eastern Highlands Province, PNG Med J 1985; 28(2): 93-103.




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