Pyostomatitis vegetans (PV) is a rare, chronic mucocutaneous disorder associated 
with inflammatory bowel disease (IBD). Oral lesions of PV are distinct and 
present as multiple white or yellow pustules with an erythematous base that 
coalesce and undergo necrosis to form a typical "snail tracks" appearance. Two 
cases of PV associated with IBD--one with Crohn's disease (CD) and the other 
with ulcerative colitis (UC) are reported. In the first case, adalimumab therapy 
brought the oral and gastrointestinal manifestations to complete remission. In 
the second case, the remission was achieved with systemic steroid therapy, but 
the disease relapsed after therapy discontinuation. Azathioprine was added 
leading to sustained remission of PV. Because of persistent active intestinal 
manifestation of UC, in spite of immunosuppressive therapy, infliximab was 
introduced. With the therapy remission of intestinal manifestation of UC was 
achieved as well. Our cases confirm previously reported good experience with 
immunomodulators and biologics in the treatment of PV. But, before using them we 
have to exclude an infectious etiology of oral lesions.