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Chronic Cutaneous Bacterial Hypersensitivity Dermopathy: A Second Case and Six Year Evaluation of the First Case

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Abstract:

A case we described and reported 6 years ago as chronic cutaneous granulomatous dermopathy was believed due to bacterial hypersensitivity. We now report a second case with similar features of chronic recurrent indolent inflammatory skin lesions, nondiagnostic skin biopsies, and failure to respond to antibiotics. In the absence of another diagnosis and because of the remarkably similar appearance to the first case, we initiated a therapeutic trial with corticosteroids, which induced a remission. The initial case has now been observed for 6 years, and the patient remains in remission on 5 mg of prednisone on alternate days. The second case was considered consistent with bacterial allergy because of IgG and IgE antibodies against common cutaneous bacteria. As there were no granulomas in the current patient's skin lesions, a new designation, chronic cutaneous bacterial hypersensitivity, has been assigned. The differential diagnosis and criteria for this clinical entity are discussed. Either a remission from prednisone or control with low-dose prednisone may be achieved in this dermopathy, which is both disfiguring and frightening to patients.

Document Type: Research Article

DOI: http://dx.doi.org/10.2500/108854191778879223

Publication date: July 1, 1991

More about this publication?
  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

    The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma.

    Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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