title: Pyostomatitis vegetans associated with inflammatory bowel disease--report of two cases.
abstract: Pyostomatitis vegetans (PV) is a rare, chronic mucocutaneous disorder associated with inflammatory bowel disease (IBD). Oral lesions of PV are distinct and present as multiple white or yellow pustules with an erythematous base that coalesce and undergo necrosis to form a typical "snail tracks" appearance. Two cases of PV associated with IBD--one with Crohn's disease (CD) and the other with ulcerative colitis (UC) are reported. In the first case, adalimumab therapy brought the oral and gastrointestinal manifestations to complete remission. In the second case, the remission was achieved with systemic steroid therapy, but the disease relapsed after therapy discontinuation. Azathioprine was added leading to sustained remission of PV. Because of persistent active intestinal manifestation of UC, in spite of immunosuppressive therapy, infliximab was introduced. With the therapy remission of intestinal manifestation of UC was achieved as well. Our cases confirm previously reported good experience with immunomodulators and biologics in the treatment of PV. But, before using them we have to exclude an infectious etiology of oral lesions.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, University Hospital Center Rijeka, Rijeka, Croatia. brankica.sincic@medri.hr
authors.forename: Brankica
authors.initials: B
authors.lastname: Mijandrusić-Sincić
authors.forename: Vanja
authors.initials: V
authors.lastname: Licul
authors.forename: Lari
authors.initials: L
authors.lastname: Gorup
authors.forename: Nada
authors.initials: N
authors.lastname: Brncić
authors.forename: Irena
authors.initials: I
authors.lastname: Glazar
authors.forename: Ksenija
authors.initials: K
authors.lastname: Lucin
mesh_terms: D000328:Adult; D003093:Colitis, Ulcerative / Q000150:complications*; D003424:Crohn Disease / Q000150:complications*; D005260:Female; D005928:Glossitis / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D012074:Remission Induction; D013256:Steroids / Q000627:therapeutic use; D013280:Stomatitis / Q000188:drug therapy / Q000209:etiology*; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D013256:Steroids