Focal injection of vancomycin combined with surgical debridement-dermatoplasty in the treatment of pseudo-epitheliomatous granuloma.
BACKGROUND
Pseudo-epitheliomatous granuloma (PEG) can occur in some small skin wounds with secondary infections resulting from improper treatments. It is difficult to heal and can easily relapse.


OBJECTIVE
This study explores the clinical and pathological characteristics of PEG and effective treatments.


METHODS
Tissue specimens of PEG obtained from 11 patients (age range: 2-67 years) were sent for microbial examination and histological observation. The local lesions were treated by focal injection of vancomycin combined with surgical debridement-dermatoplasty.


RESULTS
The diagnosis of PEG was based on histological examination, which revealed long epithelial peduncle encapsulated granulation tissue-like honeycomb in which more vessels, macrophages, lymphocytes and mast cells and less extracellular matrix were distributed. Bacteria such as Staphylococcus aureus, Bacillus pyocyaneus, ethylene-type Streptococcus, stool Streptococcus and F-citric acid Bacillus were found in the microbial culture of the specimens. They were tolerant to celbenin but sensitive to vancomycin. PEG could be cured by focal application of vancomycin combined with free skin or skin flap after thorough debridement. The relapse of PEG could be prevented by the therapy.


CONCLUSIONS
Focal injection of vancomycin combined with surgical debridement-dermatoplasty is an effective therapy for PEG.
Jiang
Du-yin
DY
Institute of Tissue Engineering of Shandong University, 247 Bei Yuan Road, Jinan 250033, PR China. jdybs2@vip.163.com
Fu
Xiao-bing
XB
Zong
Xian-lei
XL
Chen
Bi
B
Wang
Ji-chang
JC
Shan
Fei
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001419:Bacteria / Q000187:drug effects / Q000302:isolation & purification; D002056:Burns / Q000150:complications; D002648:Child; D002675:Child, Preschool; D003646:Debridement; D005260:Female; D006099:Granuloma / Q000382:microbiology / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007271:Injections, Intradermal; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012871:Skin Diseases / Q000150:complications; D016038:Skin Transplantation; D014640:Vancomycin / Q000627:therapeutic use*; D014945:Wound Healing / Q000187:drug effects; D014946:Wound Infection / Q000150:complications; D055815:Young Adult
D000900:Anti-Bacterial Agents; D014640:Vancomycin