Metastatic Crohn's disease: an underestimated entity.
Crohn's disease
clinical presentation
extraintestinal
metastatic
perianal
skin involvement
therapy
Journal
Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG
ISSN: 1610-0387
Titre abrégé: J Dtsch Dermatol Ges
Pays: Germany
ID NLM: 101164708
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
received:
15
09
2020
accepted:
28
01
2021
pubmed:
8
5
2021
medline:
19
8
2021
entrez:
7
5
2021
Statut:
ppublish
Résumé
Cutaneous metastatic Crohn's disease (MCD) is a rare but challenging dermatologic manifestation of Crohn's disease. It is histologically defined as the presence of non-caseating granulomas at skin sites separated from and non-contiguous to the gastrointestinal tract. Cutaneous metastatic Crohn's disease should be distinguished from the much more frequent contiguous cutaneous manifestations of Crohn's disease that present at perianal or, less common, peristomal sites with direct extension from the intestine to the adjacent skin. Versatile clinical presentation and the fact that occurrence can predate the initial diagnosis of Crohn's disease may lead to misdiagnosis, delayed treatment and underreporting. As case numbers are small and randomized controlled studies on management are lacking, the therapeutic approach remains challenging and is often unsatisfactory. We here performed a systematic literature search identifying 264 published pediatric and adult cases of MCD and additionally report three of our own cases. Our review summarizes clinical characteristics, putative etiopathology, histologic findings, differential diagnoses and treatment options for MCD.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
973-982Informations de copyright
© 2021 The Authors. Journal der Deutschen Dermatologischen Gesellschaft published by John Wiley & Sons Ltd on behalf of Deutsche Dermatologische Gesellschaft.
Références
Bender-Heine A, Grantham JT, Zaslau S et al. Metastatic Crohn disease: a review of dermatologic manifestations and treatment. Cutis 2017; 99: E33-e40.
Palamaras I, El-Jabbour J, Pietropaolo N et al. Metastatic Crohn’s disease: a review. J Eur Acad Dermatol Venereol 2008; 22: 1033-43.
Schrodt BJ, Callen JP. Metastatic Crohn’s disease presenting as chronic perivulvar and perirectal ulcerations in an adolescent patient. Pediatrics 1999; 103: 500-2.
Kurtzman DJ, Jones T, Lian F et al. Metastatic Crohn’s disease: a review and approach to therapy. J Am Acad Dermatol 2014; 71: 804-13.
Parks AG, Morson BC, Pegum JS. Crohn’s disease with cutaneous involement. Proc R Soc Med 1965; 58: 241-2.
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.
Teixeira M, Machado S, Lago P et al. Cutaneous Crohn’s disease. Int J Dermatol 2006; 45: 1074-6.
Ploysangam T, Heubi JE, Eisen D et al. Cutaneous Crohn’s disease in children. J Am Acad Dermatol 1997; 36: 697-704.
Emanuel PO, Phelps RG. Metastatic Crohn’s disease: a histopathologic study of 12 cases. J Cutan Pathol 2008; 35: 457-61.
Hackzell-Bradley M, Hedblad MA, Stephansson EA. Metastatic Crohn’s disease. Report of 3 cases with special reference to histopathologic findings. Arch Dermatol 1996; 132: 928-32.
Moschen AR, Tilg H, Raine T. IL-12, IL-23 and IL-17 in IBD: immunobiology and therapeutic targeting. Nat Rev Gastroenterol Hepatol 2019; 16: 185-96.
Lang N, Hartschuh W, Enk A, Toberer F. Metastatic Crohn’s disease: a diagnostic and therapeutic challenge. J Dtsch Dermatol Ges 2015; 13: 571-4.
Salvaggio HL, Graeber KE, Clarke LE et al. Mucocutaneous granulomatous disease in a patient with Hermansky-Pudlak syndrome. JAMA Dermatol 2014; 150: 1083-7.