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.
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Gara S, Souissi A, Mokni M. Pyodermatitis Pyostomatitis Vegetans. JAMA Dermatol. 2020;156(3):335. doi:10.1001/jamadermatol.2019.3515
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: