Adalimumab-Induced Pyodermatitis-Pyostomatitis Vegetans (PPV) in Ulcerative Colitis: A Rare Dermatological Dilemma

Ulcerative colitis (UC), a chronic inflammatory disease affecting the rectum and colon, is commonly managed using immunosuppressants and biologics, including adalimumab. However, adalimumab administration can lead to dermatological complications, notably pyostomatitis vegetans, in UC patients. This study presents a unique case of pyostomatitis vegetans that developed in a UC patient following initiation of adalimumab therapy. The primary challenge lies in accurately differentiating between adalimumab-induced pyostomatitis vegetans and the dermatological manifestations associated with UC. Precise identification of the origin of pyostomatitis vegetans is crucial for appropriate clinical intervention. We report an exceptional case involving an 82-year-old female patient who presented with rectal discharge and a deteriorating overall condition. She had a prior diagnosis of UC and subsequently developed pyostomatitis vegetans after commencing adalimumab therapy. Treatment with adalimumab was discontinued in favor of topical corticosteroid administration, resulting in favorable outcomes. This study emphasizes the rarity of pyostomatitis vegetans, particularly in the context of adalimumab usage, underscoring the critical need for heightened vigilance in the clinical management of such occurrences.