clobetasol and Stomatitis

Pyostomatitis vegetans (PV) is a rare benign chronic mucocutaneous pustular disorder of unknown etiology, though it is usually associated with chronic inflammatory disease of the bowel-particularly ulcerative colitis. At the oral level PV manifests as an exophytic lesion with an erythematous perimeter and a creamy-yellow surface presenting a friable covering membrane which easily disintegrates, giving rise to the development of small ulcers or superficial erosions. The histology shows epithelial acanthosis and superficial ulceration. The underlying connective tissue exhibits neutrophil and eosinophil infiltration, with miliary abscesses in some cases. The present study describes 2 cases of PV associated with ulcerative colitis. The differential diagnosis should be established with Neumann type pemphigus vegetans, since in both cases the lesions are clinically similar and the histology reveals an important eosinophil response, acanthosis, and the formation of intraepithelial miliary microabscesses. The treatment of PV focuses on control of the disease. In the event the orofacial lesions persist, topical oral drugs such as corticoids, with additional antibiotherapy, multivitamin complexes, and nutritional supplements, can be provided.

Topics: Adult; Anti-Inflammatory Agents; Clinical Protocols; Clobetasol; Colitis, Ulcerative; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Oral Ulcer; Periapical Abscess; Stomatitis

Pyodermatitis-pyostomatitis vegetans is a benign, rare disorder characterized by a pustular eruption in the oral mucosa and vegetating plaques involving the groin and axillary folds. Its association with inflammatory bowel disease is well established. We report the case of a 49-year-old-white man with ulcerative colitis who manifested a vegetating, annular plaque in the left inguinal region of 2 months' duration. Oral examination disclosed an erythematous mucosa with multiple painful pustules involving the labial and gingival mucosa. Histopathologic study demonstrated epidermal hyperplasia and an inflammatory infiltrate composed mostly of neutrophils and eosinophils, grouped into microabscesses within the epidermis and with a bandlike configuration in the upper dermis. Results of direct and indirect immunofluorescence studies were negative. We discuss the differential diagnosis between pyodermatitis-pyostomatitis vegetans and pemphigus vegetans.

Topics: Anti-Inflammatory Agents; Anti-Inflammatory Agents, Non-Steroidal; Carboxymethylcellulose Sodium; Clobetasol; Colitis, Ulcerative; Diagnosis, Differential; Fluorescent Antibody Technique; Humans; Male; Mesalamine; Middle Aged; Mouth Mucosa; Pemphigus; Pyoderma; Stomatitis; Suppuration

Topics: Administration, Topical; Adult; Chronic Disease; Clobetasol; Diagnosis, Differential; Graft vs Host Disease; Hematopoietic Stem Cell Transplantation; Humans; Lichenoid Eruptions; Male; Myelodysplastic Syndromes; Penile Diseases; Stomatitis

Everolimus is used as an immunosuppressant in renal allograft transplant rejection and in metastatic breast cancer treatment. One side effect of everolimus is stomatitis, referred to as mammalian target of rapamycin inhibitor-associated stomatitis. This side effect can affect treatment course and contribute to discontinuation of therapy or dose reduction, previously reported in the treatment of metastatic breast cancer. Here, we present a case of everolimus-associated stomatitis with a novel management method with intralesional triamcinolone that allows for continuous course of everolimus.

Topics: Administration, Topical; Anti-Inflammatory Agents; Clobetasol; Diagnosis, Differential; Everolimus; Female; Gels; Humans; Immunosuppressive Agents; Kidney Transplantation; Middle Aged; Postoperative Complications; Stomatitis

Topics: Aged, 80 and over; Clobetasol; Female; Glucocorticoids; Humans; Mouth Mucosa; Stomatitis; Tongue

The authors describe an 11-year-old boy who had persistent oral lesions that clinically mimicked first-episode herpetic stomatitis. A biopsy revealed noncaseating sterile granulomas. Investigation of the small and large bowels revealed that the child had Crohn's disease. The oral lesions responded favorably to topical steroid therapy. The authors also discuss the range of oral lesions in inflammatory bowel disease and the differential diagnoses.

Topics: Administration, Topical; Anti-Inflammatory Agents; Child; Chronic Disease; Clobetasol; Crohn Disease; Diagnosis, Differential; Glucocorticoids; Humans; Male; Oral Ulcer; Sarcoidosis; Stomatitis