Pyodermatitis-pyostomatitis vegetans: a case report and systematic review focusing on oral involvement.

Autor: Chrcanovic BR; Department of Oral and Maxillofacial Surgery and Oral Medicine, Faculty of Odontology, Malmö University, Carl Gustafs väg 34, Malmö, SE-214 21, Sweden. bruno.chrcanovic@mau.se., Martins-Chaves RR; Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil., Pontes FSC; Department of Oral Pathology, João de Barros Barreto University Hospital, Universidade Federal do Pará, Belém, Brazil., Fonseca FP; Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil., Pontes HAR; Department of Oral Pathology, João de Barros Barreto University Hospital, Universidade Federal do Pará, Belém, Brazil., Gomez RS; Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Jazyk: angličtina
Zdroj: Oral and maxillofacial surgery [Oral Maxillofac Surg] 2024 Sep; Vol. 28 (3), pp. 1405-1414. Date of Electronic Publication: 2024 Mar 12.
DOI: 10.1007/s10006-024-01234-1
Abstrakt: Background: Pyodermatitis-pyostomatitis vegetans (PPV) is a rare mucocutaneous disease characterized by multiple pustules and it is considered a marker for inflammatory bowel disease (IBD). The oral manifestations of this condition are referred to as pyostomatitis vegetans (PSV).
Purpose: To investigate which features could help in establishing the diagnosis of PSV, with or without cutaneous lesions, based on information retrieved from all cases of PSV described in the literature. A case of PV from the authors was also included in the analysis.
Methods: An electronic search was undertaken, last updated in August 2022. Inclusion criteria included publications reporting cases of PSV, with the diagnosis confirmed by the pathological examination of oral or skin lesions, and presence of IBD.
Results/conclusions: Sixty-two publications with 77 cases of PSV and an associated IBD were included. Features that are helpful in establishing the diagnosis of PSV are snail track appearance of oral lesions, an associated IBD (which is not always symptomatic), evidence of intraepithelial clefting on microscopic examination of oral lesions, and peripheral blood eosinophilia. A gold standard for the management of PSV does not exist and high-level evidence is limited. There is no established therapeutic protocol for PSV and management primarily consists of topical and/or systemic corticosteroids, antirheumatic drugs (sulfasalazine, mesalazine), monoclonal antibody (infliximab, adalimumab) immunosuppressives (azathioprine, methotrexate), antibiotics (dapsone), or a combination of these. The risk of recurrence of oral lesions is considerable when the medication dose is decreased or fully interrupted.
(© 2024. The Author(s).)
Databáze: MEDLINE
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