Crohn’s disease initiated with extraintestinal features

Abstract

Crohn’s disease (CD) is a multifactorial, chronic immune-mediated disorder. The oral cavity is involved in 0.5% to 20% of the patients with CD. Oral manifestations of CD are sometimes nonspecific and can be overlooked by the clinicians. These manifestations may precede intestinal symptoms and can serve as indicators for early diagnosis. To increase awareness and to contribute to the standard intervention, here we report a paediatric case with persistent idiopathic swelling of the lower lip and perianal fistula. Microscopic examinations revealed multiple non-necrotising granulomas with chronic inflammation, oedema and lymphangiectasia. The patient was treated with metronidazole 500 mg and ciprofloxacin 500 mg twice a day for one month. The perioral lesions were managed with topical 0.03% tacrolimus and oral prednisone 10 mgtwice a day for one month, followed by a tapered regimen of 10 mg/day for another month. The patient’s symptoms improved without full remission at the 6-month follow-up.

Early diagnosis and treatment of perianal Crohn's disease in a 1‐year‐old infant: Case report and review of literature

“…11 Approximately 10% of pediatric patients newly diagnosed with CD may have perianal fistulas and/or abscesses. 12 A good history should be taken, and perianal lesions are less often brought to attention. Our patient presented with perianal abscesses 27 days after onset, exhibiting signs of dehydration, pale dry skin, periorbital pitting edema, mouth ulcers, and severe diaper rash.…”

“…Approximately 10% of pediatric patients newly diagnosed with CD may have perianal fistulas and/or abscesses 12 . A good history should be taken, and perianal lesions are less often brought to attention.…”

Difficult and complicated oral ulceration: an expert consensus guideline for diagnosis

“…The final diagnosis of Crohn’s disease depends on colonoscopy, gastrointestinal biopsy, and gastrointestinal CT scan. 7 And diagnosis of granulomatous vasculitis is made by combination of nasal lesion, chest CT, urine routine, and antineutrophil cytoplasmic antibodies. 8 , 9

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Manifestações orais e maxilofaciais da doença de Crohn: uma revisão integrativa

“…Consiste no alargamento crônico dos lábios com presença de fissuras perpendiculares, rachaduras ou, ainda, crostas no vermelho do lábio (Figura 2). Pode acometer apenas um ou ambos lábios, com ou sem extensão para regiões periorais, sem presença de sintomatologia dolorosa (Chang et al 2019;Jajam, Bozzolo, and Niklander 2017;Tan et al 2016).…”