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Collegium antropologicum, Vol. 34 supplement 2 No. 2, 2010.

Professional paper

Pyostomatitis Vegetans Associated with Inflammatory Bowel Disease – Report of Two Cases

Brankica Mijandrušić-Sinčić ; Division of Gastroenterology, Department of Internal Medicine, University Hospital Center Rijeka, Rijeka, Croatia
Vanja Licul ; Division of Gastroenterology, Department of Internal Medicine, University Hospital Center Rijeka, Rijeka, Croatia
Lari Gorup ; Department of Infectious Diseases, University Hospital Center Rijeka, Rijeka, Croatia
Nada Brnčić ; Department of Infectious Diseases, University Hospital Center Rijeka, Rijeka, Croatia
Irena Glažar ; Department of Oral Medicine and Periodontology, School of Dental Medicine, University of Rijeka, Rijeka, Croatia
Ksenija Lučin ; Department of Pathology, School of Medicine, University of Rijeka, Rijeka, Croatia

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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.

Keywords

pyostomatitis vegetans; inflammatory bowel disease; corticosteroids; azathioprine; adalimumab; infliximab

Hrčak ID:

51675

URI

https://hrcak.srce.hr/51675

Publication date:

20.4.2010.

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