S11C11aP6a-Bacillary Perifolliculitis

S11C11aP6a-1: The patterns are both granulomatous and suppurative. In the center of the field, the suppurative component is partially cavitated (red arrows outline two suppurative granulomas). There is no continuity with the epidermis. The inflammation begins in the dermis at about the level of the sebaceous glands.

S11C11aP6a-2: An area of suppuration contains prominent giant cells. Green arrows identify a foreign body compatible with extruded follicular contents.

S11C11aP6a-3: To the right, the areas of suppuration contain neutrophils, histiocytes, and multinucleated giant cells. Giant cells have phagocytyzed cellular debris. To the left, the infiltrate is granulomatous. There are numerous tingible bodies.

S11C11aP6a-4: Red arrows identify intra-cellular organisms.

S11C11aP6a-5: The organisms are delicate, gram +, and intra-cellular (cocco-bacillary granulomatous perifolliculitis); the nature of the organism is unknown but, at a histologic level, this type of lesion is fairly common).

 

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