Periporitis staphylogenes and multiple sweat gland abscesses: causes, symptoms, diagnosis, and treatment

Periporitis staphylogenes and multiple sweat gland abscesses, also known as pseudofurunculosis, is a suppurative inflammation of exocrine sweat glands.


Causes

The pathogen is mainly staphylococcus aureus. Patients are invaded through sweat glands, mostly induced by excessive sweating in summer, also secondary to eczema. Malnutrition and unclean skin are also one cause.


Signs and Symptoms

Periporitis staphylogenes and multiple sweat gland abscesses often occurs with miliaria rubra, more common in hot seasons, mainly in children and parturients, especially malnourished or debilitating children, mostly in the forehead, neck, back, and buttocks. Some small pustules occur initially in the sweat pores, developing into pea sized to chestnut sized sharply demarcated hard nodules, with round top, with bright red or purplish red surface, with tenderness. The nodules quickly suppurate and soften, forming abscesses, with undulation when pressed. Yellowish green sticky pus is discharged after rupture of abscesses, healing after incrustation, persisting for 5 - 7 days. Sometimes new lesions occur after old lesions subside. Symptoms can be naturally reduced after atmospheric temperature drops, and generally obvious systemic symptoms are absent. However, when numerous subcutaneous abscesses are present, fever, lymphadenitis, and sometimes sepsis can occur.


Histopathology

Purulent inflammation and abscess formation in the connective tissue around the sweat ducts and the eccrine sweat glands are visible. Abscesses in the deep dermis, surrounded by epithelioid cells and monocytes, with neutrophils in the center can be seen. Agglomerated Gram-positive cocci can be seen in Gram staining.


Diagnosis

On the basis of clinical findings, such as onset in summer, mostly in the head of children, diagnosis is not difficult.


Treatment

Strengthened nutrition, clean skin, and ventilation of the room should be performed to promote the smooth discharge of sweat and prevent miliaria. Antibiotics can be used as appropriate. Incision and drainage can be selected if necessary.