Blastomycosis-like pyoderma (pyoderma vegetans) responding to antibiotics and topical disodium chromoglycate

Background. Blastomycosis-like pyoderma is a disorder of uncertain etiology that has been described in association with a variety of underlying conditions, including inflammatory and neoplastic pathologic conditions and in association with a primary immunodeficiency state. The response to therapy, antibiotics in particular, is said to be variable or poor. Methods. We examined two patients with blastomycosis-like pyoderma in whom no underlying pathologic or immunologic abnormalities were found. We treated them with antibiotics according to bacterial resistance tests. In the second case topical disodium chromoglycate was added. Results. Treatment cleared or markedly improved the lesions. Conclusions. Antibiotic treatment guided by susceptibility tests is recommended. The addition of topical disodium chromoglycate may be useful.