Skin Manifestations of Inflammatory Bowel Disease

Abstract

Inflammatory bowel disease (IBD) is a disease that affects the intestinal tract via an inflammatory process. Patients who suffer from IBD often have diseases that affect multiple other organ systems as well. These are called extraintestinal manifestations and can be just as, if not more debilitating than the intestinal inflammation itself. The skin is one of the most commonly affected organ systems in patients who suffer from IBD. The scientific literature suggests that a disturbance of the equilibrium between host defense and tolerance, and the subsequent over-activity of certain immune pathways are responsible for the cutaneous disorders seen so frequently in IBD patients. The purpose of this review article is to give an overview of the types of skin diseases that are typically seen with IBD and their respective pathogenesis, proposed mechanisms, and treatments. These cutaneous disorders can manifest as metastatic lesions, reactive processes to the intestinal inflammation, complications of IBD itself, or side effects from IBD treatments; these can be associated with IBD via genetic linkage, common autoimmune processes, or other mechanisms that will be discussed in this article. Ultimately, it is important for healthcare providers to understand that skin manifestations should always be checked and evaluated for in patients with IBD. Furthermore, skin disorders can predate gastrointestinal symptoms and thus may serve as important clinical indicators leading physicians to earlier diagnosis of IBD.

Vascularite leucocytoclasique au cours d’une rectocolite ulcéro hémorragique : manifestation cutanée rare. À propos d’une observation exceptionnelle avec revue de la littérature

“…Dansune étude prospectiveréalisée à Lille, 65 %des malades atteints de maladie de Crohn (MC) et 40 %dec eux atteints de RCH présentaient des lésions cutanéo-muqueuses associées à la maladie digestive [ 2,6,7]. On peut classer ces lésions selon leur physiopathologie, en distinguant [6,7] :l es lésions dites «réactionnelles» qui évoluent en général, parallèlement aux poussées digestivesc omme la vascularite leucocytoclasique ;l es lésions granulomateuses qui s'observent uniquement au cours de la MC et ne semblent pas corrélées à l'activité de la maladie ;l es dermatoses associées aux MICI à déterminisme auto immun : épidermolyse bulleuse, psoriasis et les manifestations secondaires aux diverses carences :z inc, fer,a cides gras essentiels… Le diagnostic des manifestations cutanées est le plus souvent clinique ;t outefois, si le tableau est atypique, une biopsie cutanéed oit être réalisée [ 8].…”

“…Les vascularites associées aux MICI sont exceptionnelles [6,7]. La vascularite leucocytoclasique est l'une des rares manifestations cutanées des MICI et survient plutôtaucours de la RCH [2-5, 7, 9].…”

“…La vascularite leucocytoclasique est l'une des rares manifestations cutanées des MICI et survient plutôtaucours de la RCH [2-5, 7, 9]. Superficielle, aveco us ans dépôts d'IgA, elle se présente comme un purpura, parfois associéàdes ulcérations, voire un aspect nécrotique au niveaud es extrémitése td es jambes [7,[9][10][11]. Histologiquement, il existe une atteinte de la paroi des veinules post capillaires avecextravasation d'érythrocytes et leucocytoclasie [10][11][12].…”

Ulcerative colitis associated with vitiligo and IgA deficiency in a young girl

“…Of all the inflammatory bowel diseases, UC is the one most frequently associated with selective IgA deficiency [7,8]. The dermatologic diseases most frequently encountered in IBD patients are pyoderma gangrenosum, hidradenitis suppurativa, lichen planus, rash, secondary amyloidosis [6,9]. It is also possible to encounter a series of autoimmune diseases, such as bullous epidermolysis, vitiligo and/or psoriasis.…”

Gastrointestinal considerations related to youth sports and the young athlete

“…It typically affects the lower extremities, but can occur anywhere on the body. As with EN, PG responds to medical therapy for IBD (4). Primary sclerosing cholangitis (PSC) is a liver disease associated with IBD (5).…”