Pustules in the cervical region in a teenager

Abstract

A 12-year-old boy consulted for a lesion located in the occipital region of the scalp that extended towards the posterior cervical region and right scapular region, which had been developing for one month. The dermatological examination revealed an erythematous plaque with multiple pustules on its Surface. At the right occipital level, a fluctuating and painful tumor was evident, with purulent secretion on the same plaque described. The pilot traction maneuver was negative. Until that moment, the patient had received multiple treatments with corticosteroids, antibiotics and topical antifungals and oral antibiotics, without response.

A direct mycological examination and culture of the lesion were requested, which was negative, so a skin biopsy of the tumor in the occipital region was performed and sent to Pathology and culture for common germs, mycobacteria and fungi. The histopathological result reported marked involvement and destruction of the hair follicle, and showed moderate edema in the papillary dermis, dense inflammatory infiltrate consisting of lymphocytes, plasma cells and numerous polymorphonuclear neutrophils and eosinophils in the papillary and reticular dermis forming foci of suppuration. No specific microorganisms were observed with the PAS technique.