title: [Pyogenic granuloma revealing fistula and deep infection: five cases].
abstract: BACKGROUND
  Pyogenic granuloma, or botryomycosis, occurring after minor injury or scratching with a septic implement, is a rapidly growing benign inflammatory vascular tumour, often involving the skin or mucous membrane. We report 5 unusual cases of pyogenic granuloma revealing fistula tracking to foreign bodies such as a pace-maker or orthopaedic material, and deep infectious sites with fistula.
  
  
  METHODS
  This retrospective study included 5 men of average age 72.2 years over a period of 22 years (between 1981 and 2003). Clinical images were recorded and a diagnosis of botryomycosis was confirmed in all patients by histological analysis. Four patients presented suppuration. The time from initial clinical signs to diagnosis, presence of traumatic events, screening for microscopic organisms, response to systemic antibiotic therapy, recurrence and clinical features of botriomycosis were analysed.
  
  
  RESULTS
  All patients presented botryomycosis with fistula and suppuration revealing deep bone infection and in one patient, pace maker infection. Complete resolution of the lesions occurred after excision of foreign material and prolonged systemic antibiotic therapy.
  
  
  CONCLUSIONS
  We report the first series of botryomycosis revealed by fistula and showing deep infectious disease. Pyogenic granuloma is a well-known but rarely reported dermatologic condition.
authors.affiliation: Service de Dermatologie CHU Dupuytren, 2, avenue Martin-Luther-King, 87000 Limoges.
authors.forename: A
authors.initials: A
authors.lastname: Sparsa
authors.forename: J-M
authors.initials: JM
authors.lastname: Bonnetblanc
authors.forename: C
authors.initials: C
authors.lastname: Roux
authors.forename: C
authors.initials: C
authors.lastname: Pinet
authors.forename: V
authors.initials: V
authors.lastname: Loustaud-Ratti
authors.forename: S
authors.initials: S
authors.lastname: Boulinguez
authors.forename: F
authors.initials: F
authors.lastname: Labrousse
authors.forename: E
authors.initials: E
authors.lastname: Vidal
authors.forename: C
authors.initials: C
authors.lastname: Bedane
mesh_terms: D000368:Aged; D017577:Cutaneous Fistula / Q000175:diagnosis / Q000209:etiology*; D017789:Granuloma, Pyogenic / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012871:Skin Diseases / Q000150:complications* / Q000175:diagnosis