Pyodermatitis vegetans after total colectomy

Abstract

Pyostomatitis–pyodermatitis vegetans (PPV) is a rare dermatological manifestation of inflammatory bowel disease, characterized by erythematous, vesiculopustular, exudative, annular, and/or vegetating plaques over the intertriginous regions that may precede or appear at the same time as the mucosal lesions. Systemic corticosteroids, dapsone, sulfasalazine, azathioprine, cyclosporine, and subtotal/total colectomy are the most common treatment options. A 16-year-old male patient presented to our outpatient clinic with a four months history of thickly crusted erosions on his trunk, back, and lower extremity. He had ulcerative colitis for four years and total colectomy was done seven months ago. Clinical and histopathological examination of his lesions were consistent with pyostomatitis vegetans. Although subtotal/total colectomy has been reported as a treatment option for PPV, lesions reappeared three months after total colectomy in our patient.

Pyodermatitis vegetans responding to rifampicin and clindamycin

“…Multiple previous studies have considered PDV as a clinical marker for IBD activity and recommended that a total/subtotal colectomy is a therapeutic option for complete remission of symptoms 3 , 6 , 13 . However, in 2015, Uzunçakmak et al 9 reported on a case of PDV developed shortly after a total colectomy and discontinuation of systemic corticosteroid 9 . Here we report a first presentation of PDV 3 years after total colectomy in a patient with Crohn's disease.…”

“…Previous reports have indicated that PDV is frequently associated with IBD in 70% of cases, and up to 100% in a recent cohort study 1, 2, 3, 4 , 6 , 8 . PDV commonly affects adults in the third decade of life with a male/female ratio of 3:1 3 , 9 . The etiology of PDV is still unknown.…”

Pyodermatitis-Pyostomatitis Vegetans: A Cutaneous Clue for Crohn’s Disease

“…They are used as systemic, intralesional, and topical treatments depending on disease severity. All the cases reviewed that used corticosteroids achieved clearance, however relapse was common when tapering [1][2][3][4][6][7][8][9][10][11][12][13]. Other systemic treatments for PPV include dapsone, azithromycin,…”