title: Pyostomatitis vegetans and its relation to inflammatory bowel disease, pyoderma gangrenosum, pyodermatitis vegetans, and pemphigus.
abstract: Pyostomatitis vegetans (PSV) is an intraoral pustular eruption considered by most authors to represent the mucous analogous of cutaneous pyoderma gangrenosum and its vegetating presentations (pyodermatitis vegetans). A strong correlation of PSV with inflammatory bowel disease (IBD) is well documented. The histopathology of PSV lesions usually reveals acanthosis, and neutrophils and/or eosinophils infiltration with intraepithelial or subepithelial abscesses; acantholysis is present in some cases. We studied four patients with IBD that presented oral lesions suggestive of PSV. Two male and two female patients were included. The histopathology of oral lesions of two patients revealed findings typical for PSV. The other two patients showed findings typical for pemphigus vulgaris (PV), although the course of their symptoms paralleled that of the bowel disease. Our findings may suggest that pustular lesions in patients with IBD can be a presentation of both PSV and PV; adequate diagnosis is required because clinical presentation is very similar.
authors.affiliation: Department of Dermatology, Medical School, University of São Paulo, São Paulo, Brazil. mentanico@hotmail.com
authors.forename: Marcello M S
authors.initials: MM
authors.lastname: Nico
authors.forename: Thais P
authors.initials: TP
authors.lastname: Hussein
authors.forename: Valeria
authors.initials: V
authors.lastname: Aoki
authors.forename: Silvia V
authors.initials: SV
authors.lastname: Lourenço
mesh_terms: D000051:Acantholysis / Q000473:pathology; D000328:Adult; D003092:Colitis / Q000175:diagnosis*; D003176:Complement C3 / Q000032:analysis; D004804:Eosinophils / Q000473:pathology; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology; D009504:Neutrophils / Q000473:pathology; D010392:Pemphigus / Q000175:diagnosis*; D011350:Proctocolitis / Q000175:diagnosis; D011711:Pyoderma / Q000175:diagnosis*; D017511:Pyoderma Gangrenosum / Q000175:diagnosis*; D013280:Stomatitis / Q000175:diagnosis* / Q000473:pathology
chemical_list: D003176:Complement C3; D007074:Immunoglobulin G