A case of pyogenic granuloma in pustular psoriasis

Abstract

This is a case report of mutiple pyogenic granuloma in a patient with pustular psoriasis. A 67-year-old male patient presented with recurrent erythematous pustules on the trunk and extremities for 4 years, recurrence with multiple papular nodules on the neck, back, axilla, and bilateral cubital fossa for 1 week. There were generalized erythematous pustules on the whole body, and large flakes of erosions on the back of the neck, back, double armpits. After the pustules ruptured, there were a lots of maculopapular rashes and nodules above the erosions, ranging in size from mung bean to peanut kernel, and these lesions bled easily when squeezed. The histopathologic examination: consistent with pustular psoriasis with multiple granulomatous changes. Special staining: D-PAS staining, hexamine silver staining, acid-fast staining and Gram staining were all negative. Treatment: we gave him oral administra of Avia Capsuls and QingDi capsules for his pustular psoriasis, and intravenous clindamycin based on drug sensitivity results. Other adjuvant treatments included potassium permanganate soution hydro-therapy, UVB-phototherapy, for the multiple pyogenic granulomas, we first used electrocautery to remove the papules and nodules on his left arm, but the patient refused this therpy as was so painful, so we just gave him some Lincomycin Hydrochloride and Lidocaine Hydrochioride Gel and XiTu Spray smeared on the multiple pyogenic granulomas aftre hydro-therapy for the remaining skin lesions. All the Papules and nodules subsided after one month. Recently, pustular psoriasis still had localized recurrence on his trunk and limbs, and the pyogenic granuloma has not recurred so far. The patient is still being followed up regularly.

Keywords

• pustular psoriasis
• multiple pyogenic granulomas
• infection
• erosion surface