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Images in Dermatology
December 18, 2019

Pyodermatitis Pyostomatitis Vegetans

Author Affiliations
  • 1Department of Dermatology, Rabta Hospital, Tunis, Tunisia
JAMA Dermatol. 2020;156(3):335. doi:10.1001/jamadermatol.2019.3515

A man in his 20s presented with a 1-month history of extensive and painful vegetating plaques on the lips and buccal and nasal mucosa. His medical history was notable for Crohn disease treated for the previous 6 years with high doses of sulfasalazine (3000 mg/d). A physical examination revealed multiple friable pustules coalescing into vegetative and erosive plaques with yellow exudate and hemorrhagic crust on the upper and lower labial mucosa. Similar exophytic plaques were noted to involve the nasal mucosa, resulting in complete obstruction of the nostrils and shortness of breath (Figure). The genital mucosa, intertriginous areas, and scalp were spared. General physical examination results and a review of systems were otherwise normal, and findings from laboratory studies were remarkable for peripheral blood eosinophilia. There was no evidence of active gastrointestinal disease at the time of presentation.

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