Remission of refractory metastatic Crohn's disease achieved with dapsone

Remission of refractory metastatic Crohn's disease achieved with dapsone IntroductionMetastatic Crohn's disease (MCD) is a rare manifestation of Crohn's disease (CD) defined by the presence of necrotizing granulomatous skin lesions in areas anatomically separated from the affected bowel sites. In adults it is frequently seen in patients already diagnosed with CD, while in children it can be the first manifestation. It is important to highlight that the skin manifestations are not correlated with the severity of CD and that surgical resection of the affected bowel site does not guarantee resolution of MCD. So far there is no solid evidence to recommend any treatment in MCD. It usually has a chronic course with exacerbations and remissions, and therapy is often unsuccessful. Even though spontaneous resolution of MCD has been described, it is infrequent and unpredictable.Case reportWe report the case of an 82‐year‐old woman who was diagnosed with Crohn's disease 20 years ago when she suffered from abdominal pain, weight loss, severe diarrhea, and gastrointestinal bleeding. A total proctocolectomy with colostomy was performed, whose biopsy showed patchy involvement, transmural inflammation, and granulomas, thus confirming the diagnosis of Crohn's disease. She presented a 2‐year history of painful lesions on her groin, genital region, and gluteal cleft, with exacerbations and partial remissions. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png International Journal of Dermatology Wiley

Remission of refractory metastatic Crohn's disease achieved with dapsone

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Publisher
Wiley
Copyright
International Journal of Dermatology © 2018 International Society of Dermatology
ISSN
0011-9059
eISSN
1365-4632
D.O.I.
10.1111/ijd.13885
Publisher site
See Article on Publisher Site

Abstract

IntroductionMetastatic Crohn's disease (MCD) is a rare manifestation of Crohn's disease (CD) defined by the presence of necrotizing granulomatous skin lesions in areas anatomically separated from the affected bowel sites. In adults it is frequently seen in patients already diagnosed with CD, while in children it can be the first manifestation. It is important to highlight that the skin manifestations are not correlated with the severity of CD and that surgical resection of the affected bowel site does not guarantee resolution of MCD. So far there is no solid evidence to recommend any treatment in MCD. It usually has a chronic course with exacerbations and remissions, and therapy is often unsuccessful. Even though spontaneous resolution of MCD has been described, it is infrequent and unpredictable.Case reportWe report the case of an 82‐year‐old woman who was diagnosed with Crohn's disease 20 years ago when she suffered from abdominal pain, weight loss, severe diarrhea, and gastrointestinal bleeding. A total proctocolectomy with colostomy was performed, whose biopsy showed patchy involvement, transmural inflammation, and granulomas, thus confirming the diagnosis of Crohn's disease. She presented a 2‐year history of painful lesions on her groin, genital region, and gluteal cleft, with exacerbations and partial remissions.

Journal

International Journal of DermatologyWiley

Published: Jan 1, 2018

References

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