By Gary M. White, MD

Pyostomatitis vegetans (PV) is a rare, debilitating disorder of the oral mucosa often found in association with inflammatory bowel disease (IBD), most commonly ulcerative colitis but also Crohn's disease. Cutaneous pustular lesions may be associated and have been termed pyodermatitis (vegetans).


Pustules studded along the gingiva are typical. They are said to resemble snail tracks. Lesions are friable and easily lead to erosions. Involvement of the lips, hard and soft palate, vestibule, buccal mucosa and tonsils are also common.

Vegetating plaques in the scalp, face, axilla and groin are characteristic of pyodermatis.


Topical and/or systemic steroids are often first line therapy. Strict control of the IBD helps prevent or treat the PV as well. In one report pyostomatitis vegetans responded quickly and dramatically to treatment with 0.1% tacrolimus ointment. Dapsone, azathioprine, mycophenolate mofetil, cyclosporine and infliximab have all been used with some success. Biologic agents may be employed to treat both the IBD and PV.


A 58-year-old man presented with “white lesions that looked like pus” on the labial gingiva. The lesions peeled off during tooth brushing, without causing any discomfort. The patient also complained of bloody diarrhea for the past several months. Complete colonoscopy was performed and the diagnosis of Crohn's disease was made. Ann Gastroenterol. 2013; 26(2): 187.

A 27-year-old man with Crohn disease developed pustular lesions on the gums and skin. The condition was controlled with prednisone and dapsone. Ann Dermatol. 2015 Oct; 27(5): 624–625


Homepage | FAQs | Use of Images | Contact Dr. White

It is not the intention of to provide specific medical advice, diagnosis or treatment. only intends to provide users with information regarding various medical conditions for educational purposes and will not provide specific medical advice. Information on is not intended as a substitute for seeking medical treatment and you should always seek the advice of a qualified healthcare provider for diagnosis and for answers to your individual questions. Information contained on should never cause you to disregard professional medical advice or delay seeking treatment. If you live in the United States and believe you are having a medical emergency call 911 immediately.