Pyodermatitis-pyostomatitis vegetans of the eyelids case report and review of the literature.
OBJECTIVE
To present the first reported case of eyelid involvement in pyodermatitis-pyostomatitis vegetans (PDPSV) leading to the diagnosis of ulcerative colitis, and to review the literature.


METHODS
Interventional case report.


METHODS
A 29-year-old man presented with a 4-week history of severe bilateral upper and lower eyelid margin ulceration and pustules unresponsive to topical and systemic broad-spectrum antibiotic treatment. Further questioning revealed the existence of skin and oral lesions.


METHODS
Clinical course, histological findings, and response to treatment.


RESULTS
The histological and immunofluorescence studies were suggestive of PDPSV. Colonoscopy showed significant chronic active ulcerative colitis. Treatment with systemic steroids and sulfasalazine resulted in complete resolution of eyelid, oral, and skin lesions. However, stopping the steroids resulted in recurrence of eyelid and oral lesions and required recommencement of treatment.


CONCLUSIONS
It is important to be familiar with this pustular skin condition, as correct diagnosis may lead to the diagnosis of inflammatory bowel disease. Although periocular involvement is probably rare, the combined typical skin and oral lesions and the characteristic histological and immunofluorescence tests should suggest the correct diagnosis.
Leibovitch
Igal
I
Oculoplastic & Orbital Division, Department of Ophthalmology & Visual Sciences, Royal Adelaide Hospital, University of Adelaide, Adelaide, Australia. leiboigal5@yahoo.com.au
Ooi
Colin
C
Huilgol
Shyamala C
SC
Reid
Cathy
C
James
Craig L
CL
Selva
Dinesh
D
D000328:Adult; D003093:Colitis, Ulcerative / Q000175:diagnosis* / Q000188:drug therapy; D003113:Colonoscopy; D005141:Eyelid Diseases / Q000175:diagnosis* / Q000188:drug therapy; D005499:Folliculitis / Q000175:diagnosis* / Q000188:drug therapy; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D011239:Prednisolone / Q000627:therapeutic use; D011711:Pyoderma / Q000175:diagnosis* / Q000188:drug therapy; D013280:Stomatitis / Q000175:diagnosis* / Q000188:drug therapy
D005938:Glucocorticoids; D011239:Prednisolone