A 41-year-old man visited our clinic because of vegetating plaques resembling pemphigus vegetans on his sacral and perianal areas. He had also suffered from acne conglobata since adolescence. A biopsy specimen taken from the perianal area showed marked acanthosis, exocytosis, and inflammatory infiltrates in the dermis, but no acantholysis. Direct and indirect immunofluorescent tests were negative for anti-intercellular antibodies. Bacterial cultures from the lesions showed many different types of organisms. We diagnosed the case as pyoderma vegetans and discussed the relationship between pyoderma vegetans and other pyoderma.
Fujita M, Okamoto S