Pyodermatitis vegetans responding to rifampicin and clindamycin

Pyodermatitis vegetans, or pyoderma vegetans (PDV), is a rare inflammatory cutaneous disease characterized by well-circumscribed, exudative vegetating plaques with elevated margins affecting the face, scalp, intertriginous regions, and, less often, the trunk and distal extremities.1, 2, 3 PDV is sometimes present in association with oral lesions termed, pyostomatitis vegetans (PSV).2,3 PDV is known to be correlated with gastrointestinal disorders, particularly inflammatory bowel disease (IBD).4, 5, 6 Other diseases reported in association with PDV include T-cell lymphoma, chronic myeloid leukemia, liver diseases, malnutrition, HIV infection, and primary immunodeficiency disorders.5 Multiple topical and systemic medications have been described to treat PDV with varying efficacies.6 We report on a case of PDV in a patient with Crohn's disease treated with a combination of rifampicin and clindamycin with good results.