Year 2023 / Volume 115 / Number 3
Letter
A diagnostic challenge: chronic cutaneous ulcers as an isolated clinical finding in metastatic Crohn’s disease

146

DOI: 10.17235/reed.2022.8995/2022

Leticia Pérez-Santiago, Alejandro García-Vázquez, José Martín-Arévalo, Coral Cózar Lozano, Vicente Pla Martí, David Moro Valdezate, Stephanie Anne García Botello, David Casado Rodrigo, Alejandro Espí Macías,

Abstract
Metastasic Crohn disease (MCD) is the most uncommon cutaneous manifestation of Crohn disease. The actual incidence is not clear. There are fewer than 200 cases described in the literature. We report a case of 21 years-old girl that came to our emergency care with large exudative ulcers in the inguinal folds, the vulva, the perianal region and the popliteal fossae. Histopathological examination of the ulcers revealed a non-caseating granulomatous inflammation with abundant multinucleated giant cells and intense lymphocytic infiltrate. Colonoscopy, contrast study of the small bowel and video capsule endoscopy were carried out without evidence of digestive disease. High potency topical steroids (betamethasone 0,5mg/gr twice daily) and 300mg intravenous Infliximab were initiated as the initial line therapy and the ulcers began to heal. We report this case to highlight the presence of cutaneous ulcers without intestinal disease in a young non-pediatric woman as the unique manifestation of the disease.
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References
1. Schneider SL, Foster K, Patel D, Shwayder T. Cutaneous manifestations of metastatic Crohn's disease. Pediatr Dermatol. 2018 Sep;35(5):566-574. doi: 10.1111/pde.13565. Epub 2018 Jun 28. PMID: 29952016
2. Siroy A, Wasman J. Metastatic Crohn disease: a rare cutaneous entity. Arch Pathol Lab Med 2012; 136: 329–32.
3. Aberumand B, Howard J, Howard J. Metastatic Crohn’s disease: an approach to an uncommon but important cutaneous disorder. Biomed Res Int. 2017;2017:8192150.
4. Babak A, et al. Metastatic Crohn’s Disease: An Approach to an Uncommon but Important Cutaneous Disorder. BioMed Research International. 2017;1-6.
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Citation tools
Pérez-Santiago L, García-Vázquez A, Martín-Arévalo J, Cózar Lozano C, Pla Martí V, Moro Valdezate D, et all. A diagnostic challenge: chronic cutaneous ulcers as an isolated clinical finding in metastatic Crohn’s disease. 8995/2022


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Publication history

Received: 08/06/2022

Accepted: 30/06/2022

Online First: 06/07/2022

Published: 07/03/2023

Article revision time: 16 days

Article Online First time: 28 days

Article editing time: 272 days


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