Hyperinflammatory Proliferative (Blastotnycosis‐like) Pyodermas: Review, Mechanisms, and Therapy

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Abstract
Some sites of chronic localized infection have a vigorous granulocytic inflammatory response and develop marked tissue proliferation. This is most common in patients with poor nutrition, halogen ingestion or foreign bodies. The granulocytes release connective tissue‐activating peptides which cause fibroblast proliferation and ground substance formation. The dermal papillae enlarge and support a larger germinative cell volume, producing pseudoepitheliomatous hyperplasia. Hypertrophic granulation tissue or “proud flesh” appears to be a similar phenomenon without the epithelial component. In a milder physiologic range this phenomenon probably accounts for the term “laudable pus.”

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