Crohn's Disease of the Vulva*

Abstract

Summary Cutaneous ulceration has only recently been recognized as a complication of Crohn's disease. It usually occurs in the perineum in continuity with Crohn's disease of the anus. A case is presented of metastatic ulceration of the anterior vulva in a patient with Crohn's disease.

Multicentric Cutaneous Crohn's Disease: A Case Report and Review of Literature

“…Over t he years a further 21 patients (1 1 m a les and 12 fe males) wit h 'metastatic' Crohn's disease have been described. The age range has been from In most cases the race of the patient has not been specified, but there have been at least o ne C hinese (5) and two black patients ( 6,7) . C uta neous les io n s ha ve bee n repo rted on widespread areas of the body.…”

“…Nodules (9,(11)(12)18) have also been frequently described. Edema or induration (5,19), plaques (1 3), vesicles (1 3 ), papules (1 2,14), and 'granulomatous' lesions (8) have been described less frequently. O n e pa tie n t presen ted wi th a n erysipelas-like lesion of the face ( 14).…”

“…Histologically all cases have shown noncaseating, sarcoid-like granulomas. In some cases the granulomas were close ly related to de rma l o r su bcutaneous blood vessels (11 ,12, 18), while in others they were present rando m I y th ro ugh o ut the de rmis (5,7,9,14,17,20) or in both the dermis and the subcutis (13,14,19,2 1).…”

Vulvar inflammation as a manifestation of Crohn's disease

“…While localized surgical excision has low success rates due to frequent localized recurrence of vulvar lesions and suboptimal wound healing, vulvectomy has been described as a radical, yet more defi nitive treatment option. [3,[16][17][18] Our patient was treated with a two-week course of oral antibiotic therapy (clindamycin and ciprofloxacin), as well as continued immunotherapy with methotrexate. At a follow-up visit, the patient's primary care physician noted scarring and deformity of the left vulva; there was no evidence, however, of active infl ammation or recurrent infection.…”

Annual review of surgery 1973

“…More and more examples of associated skin ulceration are being reported, which may involve the perineal area, the region around a colostomy or ileostomy, or metastatic foci elsewhere over the body. A patient with Crohn's disease affecting the anterior part of the vulva is reported by Ansell and Hogbin (1973). Involvement of the right ureter in the inflammatory mass of terminal ileal Crohn's is reviewed by Steigmann (1973).…”