Metastatic Crohn′s disease of external genitalia

Panackel, Charles; John, Joseph; Krishnadas, D.; Vinayakumar, Kattoor Ramakrishnan

doi:10.4103/0019-5154.43207

Cited by 18 publications

(20 citation statements)

References 17 publications

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“…The evolution of MCD can be unpredictable and sometimes refractory to medical treatment, although cases with spontaneous healing have also been reported (20). An established standard therapy for MCD remains underwhelming due to the lack of randomized control studies and definite guidelines (6,(20)(21). In the literature, the initial management of MCD is medical, including topical antibiotics and topical, oral, or intralesional steroids (3), oral antibiotics (most commonly ciprofloxacin and metronidazole) (16,22), sulfasalazine, and immunosuppressive agents such as azathioprine and cyclosporine (2,16,(21)(22).…”

Section: Discussionmentioning

confidence: 99%

Metastatic vulvar Crohn’s disease preceding intestinal manifestations: a case report and short review

Kyriakou¹,

Gkermpesi²,

Thomopoulos³

et al. 2019

Acta Dermatovenerologica Alpina Pannonica Et Adriatica

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Crohn's disease (CD) is a multi-systemic chronic granulomatous inflammatory disease with a constellation of extraintestinal manifestations affecting various organs, including the skin. Metastatic CD (MCD), defined as granulomatous lesions of the skin occurring at sites separate from the gastrointestinal (GI) tract in patients affected with CD, is the least common cutaneous manifestation, and it is occasionally the primary manifestation of the disease. It may precede any symptoms from the GI tract by months or even years, and it often remains undiagnosed. We present the case of a 42-year-old woman with a rare cutaneous manifestation of MCD involving the external genitalia. The cutaneous lesions of the mons pubis and vulva preceded GI manifestations of CD by 2 years. The patient was treated with azathioprine, oral steroids, and antibiotics. Reduction of the cutaneous nodules, discharge, and erythema was achieved, accompanied by relief of GI symptoms. Response to treatment was maintained during a follow-up of 6 months. In MCD, involvement of the external genitalia is exceedingly rare, with few documented cases in the literature. The integration of clinical information, microscopic findings, and exclusion of other cutaneous granulomatous processes is necessary in order to accurately diagnose this rare dermatologic entity and provide an opportunity for successful therapeutic intervention.

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Section: Discussionmentioning

confidence: 99%

Metastatic vulvar Crohn’s disease preceding intestinal manifestations: a case report and short review

Kyriakou¹,

Gkermpesi²,

Thomopoulos³

et al. 2019

Acta Dermatovenerologica Alpina Pannonica Et Adriatica

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“…The cutaneous findings tend to occur more often with Crohn's disease that involves the large bowel. This is different from gastrointestinal-only Crohn's disease where the small bowel, primarily the terminal ileum, is most commonly affected [11, 12, 17, 20–23]. …”

Section: Clinical Presentationmentioning

confidence: 99%

Metastatic Crohn’s Disease: An Approach to an Uncommon but Important Cutaneous Disorder

Aberumand

Howard

2017

BioMed Research International

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Objective. To provide physicians with a clinical approach to metastatic Crohn's disease (MCD). Main Message. Metastatic Crohn's disease, defined as skin lesions present in areas noncontiguous with the gastrointestinal tract, is the rarest cutaneous manifestation of Crohn's disease. MCD lesions vary in morphology and can arise anywhere on the skin. MCD presents equally in both sexes and across age groups. Cutaneous findings may precede, develop concurrently with, or follow gastrointestinal involvement. A detailed history and thorough physical examination including a full-skin exam may help to exclude other dermatoses, as MCD can mimic other common disorders. A biopsy is required for a definitive diagnosis. Treatment options for MCD remain underwhelming due to the lack of randomized control studies and varying responses of reported therapeutic methods. Topical, intralesional, and systemic corticosteroids, antibiotics, traditional immunosuppressants, and surgery have shown mixed results. Recently, biologics have shown promise, even with refractory cases of MCD. Conclusion. MCD is an important cutaneous manifestation of this inflammatory disorder. Although a rare entity, early recognition can provide opportunity for successful therapeutic intervention.

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“…We describe two further cases of young adult men presenting with lymphoedematous disease [8,10]. Cutaneous manifestations of Crohn's disease are common, occurring in up to 44% of patients [3]. MCD affecting any site represents a small fraction of this number, and prevalence of overall is currently unknown.…”

Section: Discussionmentioning

confidence: 97%

“…Patients with phimosis have been found to have unsuspected foci of MCD at circumcision [8,9]. There are varied descriptions of nodules, plaques, fistulating disease, and severe lymphoedema [3][4][5][6][7][8][9]. MCD can precede, coincide with, or occur after the diagnosis of bowel disease [10,11].…”

Section: Introductionmentioning

confidence: 99%

Metastatic Crohn’s disease of the penis: two cases

et al. 2011

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Metastatic Crohn's disease is a rare inflammatory process that is non-contiguous from the bowel. It can affect the penis and is variable in presentation and onset in relation to bowel symptoms. It has been treated with oral, topical, systemic, and surgical therapies. We describe our experience with two cases of penile metastatic Crohn's disease and their management in comparison with other cases described in the literature. Both our patients were of the lymphoedematous type and had sexual and voiding dysfunction. They were treated with topical and intra-lesional steroids and circumcision after unsuccessful systemic treatments.

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Metastatic Crohn′s disease of external genitalia

Cited by 18 publications

References 17 publications

Metastatic vulvar Crohn’s disease preceding intestinal manifestations: a case report and short review

Metastatic vulvar Crohn’s disease preceding intestinal manifestations: a case report and short review

Metastatic Crohn’s Disease: An Approach to an Uncommon but Important Cutaneous Disorder

Metastatic Crohn’s disease of the penis: two cases

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