A case of pyostomatitis vegetans as an initial symptom of ulcerative colitis

  • SUZUKI Toyonori
    Department of Dentistry and Oral Surgery, Azabu Kitami Triology Hospital
  • FUJITA Atsushi
    Department of Dentistry and Oral Surgery, Azabu Kitami Triology Hospital
  • MATSUDA Kohei
    Department of Dentistry and Oral Surgery, Azabu Kitami Triology Hospital
  • KAKUGUCHI Wataru
    Department of Dentistry and Oral Surgery, Azabu Kitami Triology Hospital
  • KOBAYASHI Ichizo
    Department of Dentistry and Oral Surgery, JR Sapporo Hospital
  • SHINDO Masanobu
    Department of Oral Pathology and Biology, Department of Oral Pathobiological Science, Graduate School of Dental Medicine, Hokkaido University

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Other Title
  • 潰瘍性大腸炎の初期症状として出現した増殖性化膿性口内炎の1例
  • カイヨウセイ ダイチョウエン ノ ショキ ショウジョウ ト シテ シュツゲン シタ ゾウショクセイ カノウセイ コウナイエン ノ 1レイ

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Abstract

A case of pyostomatitis vegetans as an initial symptom of ulcerative colitis is reported. A 16-year-old girl with no history of systemic disease was referred to our department because of oral pain. Miliary pustules with a cobblestone appearance and a partial ulcer were found in the bilateral maxillary gingiva and the left mandibular gingiva. Treatment with topical corticosteroids had no effect on the oral lesions. We recommended that the patient sought medical consultation because of fever, diarrhea, and hematochezia. She was given a diagnosis of ulcerative colitis and was prescribed mesalazine by a physician. After treatment, the fever, diarrhea, and hematochezia resolved. On the other hand, the oral lesion expanded and involved the entire mucosa of the mouth. Histopathological examination revealed that the lesion was suppurative inflammation with ulcer formation, diagnosed as pyostomatitis vegetans. Immediately after the systemic administration of corticosteroids began, the oral mucosal lesion resolved.

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