engleski

A case of pyostomatitis vegetans associated with ulcerative colitis

This was a case of PV that progressed into extra-oral presentation (pyodermatitis vegetans) and got secondarily infected. This most probably occurred because systemic steroids were initially prescribed in dosage not sufficient to control UC, and yet sufficient for immunosuppression. The valuable time was lost because of differential diagnosis that was attributed to oral reaction to sulpha drug. It is very hard to be sure between the two even in the case of histological finding consistent with PV, as one of reported adverse reactions to 5-ASA is, so called, “pustuloderma toxica”. Its histological finding seems to resemble the one of PV, although it has never been described on the oral mucosa. As both entities are rather rare, body of literature and personal experience both in oral medicine and GE specialists is rather sparse. Taking all these into account, plus the fact that it is expected for young patient’s parents to become anxious about lack of immediate response, making them prone to “doctor shopping”, cases such as this should be dealt with open-mindedly in good cooperation between all involved specialties, but the most responsible and knowledgeable in the diagnostic process of oral lesions is oral medicine specialist.

pyostomatitis vegetans; ulcerative colitis

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