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Pleomorphic, Variably Acid-fast Bacteria in an Adult Patient With Disabling Pansclerotic Morphea
Alan R. Cantwell, Jr, MD;
Joyce E. Jones;
Dan W. Kelso
Arch Dermatol. 1984;120(5):656-661.
Abstract
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• Disabling pansclerotic morphea (DPM) is a rare variant of scleroderma, characterized by immunologic abnormalities and peripheral blood eosinophilia. Sclerodermatous skin specimens from a 24-year-old woman with DPM were studied for the presence of acid-fast bacteria in bacteriologic culture and in microscopic sections. On three of four occasions, a highly pleomorphic organism was cultured from the skin lesions. Detailed bacteriologic investigations indicated that the microbe had unstable and vacillating morphologic characteristics and peculiar acid-fast properties. The organism could be identified as Staphylococcus epidermidis, but it also had stages of growth with morphologic forms more characteristic of a Corynebacterium-like or actinomycetelike microbe. Variably acid-fast coccoid forms, and variably eosinophilic- and basophilic-staining coccoid forms were observed in vivo. The morphologic forms observed in vivo were similar in appearance to some of the growth forms of the microbe observed in vitro, suggesting that such an organism might be implicated to the pathogenesis of DPM.
(Arch Dermatol 1983;120:656-661)
Author Affiliations
From the Department of Dermatology, Kaiser Foundation Hospital, and the Southern California Permanente Medical Group, Los Angeles (Dr Cantwell); the Division of Laboratory Animal Medicine, the University of California at Los Angeles (Ms Jones), and the Central Diagnostic Laboratories of California, Tarzana (Mr Kelso).
Footnotes
Accepted for publication March 15, 1983.
Reprint requests to the Department of Dermatology, Southern California Permanente Medical Group, 4900 Sunset Blvd., Los Angeles, CA 90027 (Dr Cantwell).
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