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

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.

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

Autor: Brankica Mijandrušić-Sinčić - ; Division of Gastroenterology, Department of Internal Medicine, University Hospital Center Rij



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