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Skin conditions in patients with inflam­matory bowel diseases


Authors: K. Jůzlová;  M. Krásová;  J. Hercogová
Authors‘ workplace: Dermatovenerologická klinika 2. LF UK a Nemocnice Na Bulovce, Praha
Published in: Gastroent Hepatol 2017; 71(1): 40-48
Category:
doi: https://doi.org/10.14735/amgh201740

Idiopatické střevní záněty (IBD –  inflam­matory bowel diseases) se mohou manifestovat také na kůži. U Crohnovy nemoci (CD –  Crohn’s disease) lze kožní projevy zaznamenat až u 22– 44 % pacientů a patří tak mezi nejčastější extraintestinální manifestaci nemoci. Ke kožním projevů IBD řadíme specifické změny, které mají stejný histopatologický obraz jako CD, dále reaktivní změny s odlišným histopatologickým obrazem, mezi které patří erythema nodosum, pyoderma gangrenosum či aftózní stomatitida, a asociované choroby jako je psoriáza, atopická dermatitida nebo hidradenitis suppurativa. U pa­cientů s IBD se také setkáváme s problematikou dermatóz v okolí stomie, vzácněji pak dermatóz z malabsorpce či malnutrice.

Overview

Inflammatory bowel diseases (IBD) may also manifest on the skin. Skin manifestation can occur in 22–44% of patients with Crohn’s disease (CD) and it is the most common extraintestinal manifestation of CD. Specific lesions, reactive lesions, and associated diseases are among the skin manifestations of CD. Specific lesions have the same histopathological findings as CD. Erythema nodosum, pyoderma gangrenosum, and aphthous stomatitis are among the reactive lesions of CD and each presents a different histopathological picture. Psoriasis, atopic dermatitis, and hidradenitis suppurativa are also diseases associated with CD. Peristomal dermatitis and dermatosis due to malabsorption and malnutrition are another issue in CD patients. Dermatosis caused by IBD treatment is another important problem in patients with IBD. Skin side-effects can occur in 20% patients undergoing biological treatment. The most common dermatosis in these patients is atopic dermatitis, paradoxical reactions, and bacterial skin diseases, such as pyoderma. A paradoxical reaction is defined as the induction or exacerbation of a disease by a drug(s) approved for the disease. In the case of skin manifestations, it is not always necessary to withdraw the prescribed drug. Given the relatively high occurrence of diverse skin reactions in patients suffering from IBD, close cooperation between gastroenterologists and dermatologists is highly recommended.

Key words:
inflammatory bowel diseases – skin manifestations – psoriasis – atopic dermatitis – skin neoplasms – infection

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

 Submitted:
20. 1. 2017

Accepted:
26. 1. 2017


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Labels
Allergology and clinical immunology Dermatology & STDs Paediatric dermatology & STDs Paediatric gastroenterology Paediatric pneumology Gastroenterology and hepatology Surgery Pneumology and ftiseology General practitioner for adults

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