Hypodermitis sclerodermiformis and unusual acid-fast bacteria

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Abstract
Two patients with localized, chronic, painful, scleroderma-like lesions of the lower part of the leg associated with venous stasis are described. This type of lesion was termed hypodermitis sclerodermiformis and the literature pertinent to this entity is reviewed. Skin biopsy material was studied for the presence of acid-fast microbes. In both cases, Fite-Faraco-stained tissue sections contained many acid-fast coccoid and giant microbial forms suggestive of transitional L forms. Culture of the lesion in both cases was positive for Staphylococcus epidermidis. Until the cause is fully clarified, the search for acid-fast bacteria appears warranted in forms of pseudoscleroderma such as hypodermitis sclerodermiformis.

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