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Inflammatory bowel disease (IBD) has many extraintestinal manifestations. Cutaneous manifestations are usually related to the activity of the bowel disease but may have an independent course. Anyone presenting with IBD should be examined for cutaneous manifestations. Pyoderma gangrenosum is a severe painful ulcerating disease that requires moist wound management and, in the absence of secondary infection, systemic corticosteroids, cyclosporine, or both. Infliximab may also be used. Erythema nodosum is a common cause of tender red nodules of the shins. Management includes leg elevation, NSAIDs, and potassium iodide. Oral manifestations of IBD include aphthous stomatitis, mucosal nodularity (cobblestoning), and pyostomatitis vegetans. Treatment should be directed both at the cutaneous lesions and at the underlying systemic condition.

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2. Rushton DH, Dover R, Sainsbury AW, Norris MJ, Gilkes JJH, Ramsay ID. Why should women have lower reference limits for hemoglobin and ferritin concentrations than men? BMJ 2001;322:1355-7. 3. Waalen J, Felitti V, Beutler E. Hemoglobin and ferritin concentrations in men and women: cross sectional study. BMJ 2002; 325:137. 4. Guyatt GH, Oxman AD, Ali M, William A, Mcllroy W, Patterson C. Laboratory diagnosis of iron deficiency anemia. J Gen Intern Med 1992;7:145-53. 5. Puolakka J. Serum ferritin in the evaluation of iron status in young healthy women. Acta Obstet Gynecol Scand 1980;95: 35-41. 6. Sinclair R. There is no clear association between low serum ferritin and chronic diffuse telogen hair loss. Br J Dermatol 2002;5:982-4.

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