Pyoderma gangrenosum affecting the mouth

Abstract

<p> <span style="font-size:10pt;font-family:Verdana;">Pyoderma gangrenosum is a rare ulcerative cutaneous disorder commonly associated with systemic diseases such as inflammatory bowel diseases. This paper reports a case of pyoderma gangrenosum affecting the mouth and the skin associated with ulcerative colitis. A Medline search in English literature from 1961 to 2012 revealed only 11 documented cases of pyoderma gangrenosum with oral involvement. Previous reported cases of oral cavity involvement have shown that the most common sites of manifestation are the tongue, palate, and tonsillar fauces. This case emphasizes the importance of including inflammatory bowel diseases and their manifestations in the differential diagnosis of ulcerative lesions in the oral cavity.</span> </p

Oral Pyoderma Gangrenosum: Diagnosis, Treatment and Challenges: A Systematic Review

“…Lesions on the lips can exhibit crusting [16,29]. Supplementary images of oral PG ulcers showing the variety of morphologic features can be visualized in the case reports [5,10,[20][21][22][23]29]. Oral and skin lesions in PG are non-indurated.…”

“…The edges can be elevated and PG ulcers are often bordered by an erythematous or violaceous halo underlining the inflammatory nature of these lesions [21,28]. Certain ulcers are covered by an overlying yellow pseudomembrane, and may express purulent discharge [21,24,29]. Lesions on the lips can exhibit crusting [16,29].…”

“…The base of the lesion can be granular and friable leading to frequent bleeding [14]. The edges can be elevated and PG ulcers are often bordered by an erythematous or violaceous halo underlining the inflammatory nature of these lesions [21,28]. Certain ulcers are covered by an overlying yellow pseudomembrane, and may express purulent discharge [21,24,29].…”

“…Other lesions involved the hard palate, oropharynx, lip, commissure, gingiva, and retromolar area [5,14,16,17,19,20]. Generally, mucosal lesions in the oral cavity were smaller than skin lesions, measuring between 1 and 5 cm in greatest diameter [5,14,18,[21][22][23][24][25][26][27]. As with skin lesions, the onset is rapid and ulcers develop over the course of 4-8 Fig.…”

“…Elevated erythrocyte sedimentation rate (ESR) [5,17,27,29] and C-reactive protein [20][21][22]30] have been observed in cases of oral PG. Blood work can be useful to exclude infectious causes and sexually transmitted diseases (ex.…”