Pyostomatitis vegetans (PV) is a rare disorder that affects the oral mucosa. It is currently classified as a pustular dermatosis.
Oral findings:
(1) erythema of the oral mucosa
(2) multiple yellowish or whitish pustules which are often painful and friable
(3) superficial erosions or ulcers may develop after a pustule rupture, with or without "snail tract" fissures
(4) mucosal cobblestoning or vegetations may develop
Other findings:
(1) concurrent pyodermatitis vegetans may be present
(2) eosinophilia
(3) exclusion of other causes (negative bacterial cultures, negative immunofluorescence, etc)
Biopsy of an early lesion shows intraepithelial or subepithelial microabscesses with neutrophils and eosinophils.
Many patients with PV will have an inflammatory bowel disease (either Crohn's disease or ulcerative colitis), but not all. PV may appear months or years before there is evidence of the inflammatory bowel disease.
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