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Unusual presentation of pyostomatitis vegetans and its management
  1. Conor O'Gorman1,
  2. Sophia Smyth2 and
  3. Amanda Willis3
  1. 1Specialty Registrar in Oral Medicine, Belfast Health and Social Care Trust, Belfast, UK
  2. 2Undergraduate Dental Student, Queens University Belfast, Belfast, UK
  3. 3Senior Clinical Lecturer and Consultant in Oral Medicine, Queens University Belfast / Belfast Health & Social Care Trust, Belfast, UK
  1. Correspondence to Dr Amanda Willis; a.willis{at}


A man in his early 50s was referred to the oral medicine clinic regarding a 6-month history of ulceration affecting the palate and gingivae. Intra-oral examination revealed multiple friable pustules on a background of erythema affecting the gingival sulci and ‘snail-track’ like ulceration affecting the palate. Histopathological analysis of the gingivae revealed features in keeping with a diagnosis of pyostomatitis vegetans (PV). Although he did not report any gastrointestinal symptoms, the patient was referred to gastroenterology and underwent colonoscopy and small bowel series examination. Colonic biopsies showed no features to suggest a diagnosis of inflammatory bowel disease (IBD). In 11 years since diagnosis of PV, the patient still shows no signs or symptoms suggestive of IBD. This case highlights a rare occurrence of PV without IBD, but emphasises the importance of appropriate referral to relevant medical specialities based on clinical and histopathological findings.

  • Dentistry and oral medicine
  • Medical management

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  • Contributors COG, SS and AW were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content. COG and AW gave final approval of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.