A diffuse pustular eruption associated with ulcerative colitis

Abstract

Two patients with 2 yr histories of chronic ulcerative colitis developed, over a 24 to 48 h period, painful pustules involving the skin and oral mucosa. The pustular eruption was associated with a severe exacerbation of the colitis. Culture of the lesions and of the blood failed to reveal an infectious cause for the eruption. Histologic study of a pustule in case 2 revealed suppurative folliculitis. The lesions subsided rapidly in case 1 when i.v. hydrocortisone and i.v. and i.m. antibiotics were administered, and further resolution occurred after colectomy. A similar rapid resolution of the pustules occurred in case 2 after initiation of treatment with i.m. cortisone acetate and antibiotics and with colectomy. This pustular eruption may represent a variant of pyoderma gangrenosum.