Vesiculopustular eruption of ulcerative colitis

Many cutaneous disorders that have been described in association with ulcerative colitis (UC), including certain pustular eruptions, probably represent early, evolving lesions of pyoderma gangrenosum (PG). Several nonspecific, often poorly delineated pustular eruptions apparently unrelated to pyoderma gangrenosum have also been reported to occur with ulcerative colitis. A patient had an evanescent, vesiculopustular eruption with a course paralleling that of his UC. Histologic examination of biopsy material from the skin revealed intraepidermal and subcorneal neutrophilic abscess formation and a mixed dermal, perivascular inflammatory cell infiltrate with notable sparing of the follicles. An IgG deposition in a bandlike pattern was identified at the dermoepidermal junction by direct immunofluorescence microscopy. This vesiculopustular eruption may represent a distinct entity or another case or variant of similar pustular eruptions previously described in association with UC.