Successful treatment with infliximab and methotrexate of pyostomatitis vegetans associated with Crohn's disease.
A 35-year-old woman with severe fistulizing Crohn's disease presented with pyostomatitis vegetans affecting both the mouth and the vulva. The coalescing pustules transformed within several days into vegetating lesions on areas of inflammation. Microbial assessments revealed no pathogenic agent. Histology showed neutrophilic microabscesses, but no granulomas. Three injections of infliximab and maintenance therapy with methotrexate resulted in rapid and complete regression of both the pyostomatitis vegetans and the Crohn's disease. Infliximab and methotrexate may be a promising treatment for the rare cases of pyostomatitis vegetans associated with Crohn's disease.
Bens
G
G
Departments of Dermatology, Hôpital du Haut-Lévêque, Bordeaux University Hospital, Avenue de Magellan, F-33604 Pessac cedex, Bordeaux, France.
Laharie
D
D
Beylot-Barry
M
M
Vergier
B
B
Noblesse
I
I
Beylot
C
C
Amouretti
M
M
D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D003424:Crohn Disease / Q000150:complications*; D004359:Drug Therapy, Combination; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D000069285:Infliximab; D008727:Methotrexate / Q000627:therapeutic use*; D009061:Mouth Mucosa; D013280:Stomatitis / Q000188:drug therapy* / Q000209:etiology; D014847:Vulvitis / Q000188:drug therapy* / Q000209:etiology
D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D007166:Immunosuppressive Agents; D000069285:Infliximab; D008727:Methotrexate