Complement deposits in inflammatory bowel disease

Veloso, Tavarela

doi:10.1016/0016-5085(90)91209-o

Cited by 7 publications

(5 citation statements)

References 2 publications

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“…The most common site is the pretibial or shin area, but the knees, ankles, arms, or trunk can also be affected (Levine and Burakoff, 2011). Direct immunofluorescence of EN lesions reveal perivascular deposits of immunoglobulins and complement, suggesting that the pathogenesis of reactive cutaneous manifestation of IBD is due to the abnormal immunological response of common antigens between bowel bacteria and skin (Veloso, 1990; Fava and Danese, 2011; Khor et al, 2011). EN lesions have been noted to be correlated with the underlying disease activity and worsened with colitis flares (Timani and Mutasim, 2008).…”

Section: Reactive Cutaneous Manifestations Of Ibdmentioning

confidence: 99%

Skin Manifestations of Inflammatory Bowel Disease

2012

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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.

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Section: Reactive Cutaneous Manifestations Of Ibdmentioning

confidence: 99%

Skin Manifestations of Inflammatory Bowel Disease

2012

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“…2 Histological examination of the lower dermis in these patients may reveal a moderate lymphohistiocytic infiltrate, and direct immunofluorescence for immunoglobulins and complement may reveal perivascular deposits. 16 Erythema nodosum lesions usually respond to treatment with corticosteroids, but severe or refractory cases may require infliximab therapy. 17…”

Section: Erythema Nodosummentioning

confidence: 99%

Skin complications associated with inflammatory bowel disease

Veloso

2004

Aliment Pharmacol Ther

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Summary Cutaneous manifestations are well‐recognized complications of Crohn's disease and ulcerative colitis. The incidence of these manifestations varies widely but, at the time of diagnosis, the mean incidence is around 10%. During the course of the disease, a great variety of skin lesions may develop, many of which are secondary to granulomatous cutaneous disease, reactive skin eruptions, nutritional deficiency and other associated conditions. The disorders that are directly related to the inflammatory process of Crohn's disease include perianal and peristomal ulcers and fistulae, metastatic Crohn's disease and oral granulomatous lesions. Histologically, the features are similar to those found in the inflamed bowel. These lesions usually respond to treatment of the underlying intestinal disease. The most common forms of reactive skin eruption are erythema nodosum and pyoderma gangrenosum. Certain subsets of patients are more susceptible to the development of erythema nodosum; in a previous report from our group, erythema nodosum was seen mainly in females, and in patients with colonic involvement and/or arthritis. This manifestation tends to occur during the first 2 years of the clinical course of the disease and may recur in approximately one‐half of cases. Infliximab is highly effective in healing refractory lesions of erythema nodosum and pyoderma gangrenosum. Manifestations that are secondary to nutritional deficiency or associated conditions include acrodermatitis enteropathica, psoriasis and autoimmune disorders. For most of the cutaneous manifestations, the primary therapeutic target remains the bowel. Early aggressive therapy can minimize severe complications and maintenance treatment may prevent some devastating consequences.

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“…42 In the case of pyoderma investigators stress a heightened expression of pro-inflammatory cytokines: IL8, IL16, IL17, tumor necrosis factor (TNF)-alpha. 43 As usual, the influence of a permissive HLA expression is invoked: B15 has been associated to development of erythema nodosum; 44 TRAF3IP2 an intermediate of the inflammatory response and possibly a driver of IL17, has been summoned for both erythema and pyoderma. 45 Unfortunately, a drug acting specifically against IL17 resulted efficacious against rheumatic and cutaneous inflammatory disorders, but a trigger for IBD reaction and new-onset.…”

Section: Skin Manifestationsmentioning

confidence: 99%

The gut and the inflammatory bowel diseases inside-out: extra-intestinal manifestations

Ribaldone

Pellicano

Actis

2020

Minerva Gastroenterol Dietol

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An increasing deal of attention is being conveyed on the extra-intestinal manifestations of inflammatory bowel diseases (IBD). We compiled the present review in an attempt to upgrade the accuracy of the classification of such polymorphic entities. We focused on three patterns. First, the conventional extra-intestinal manifestations localized to bone and joints, to the eye, to the biliary tree and to the skin. Second, the so-called IBD-like syndromes accompanied by bone marrow-derived anomalies of innate or acquired immunity. Third, specific disorders of the skin and of the lungs. The extra-intestinal manifestations are thought to derive from an altered gut permeability, the release of cross-reacting antigens, and subsequent peripheral inflammation; T helper 17 cells boosted by a polymorphic interleukin 23 circuitry would be the main effectors of this chain. Inflammatory bowel disease-like pictures would derive from inborn errors of the immune response causing undue inflammation home to the gut. Monogenic IBD belong to this subset, and are of specific pediatric interest. Psoriasis, chronic obstructive pulmonary disease, and IBD are all inflammatory disorders of the barrier organs: skin, lungs, and gut. The demonstration that specific antigen hyper-or hyporesponsiveness raised at any of the three districts can modulate the response of the other two sites, has led to the innovative concept of a system-wide mucosal immunological organ. An improved knowledge of these entities has not only a speculative importance, but can also bear a clinical impact, insofar as the extra-intestinal manifestations prove often more disabling than the underlying IBD itself.

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Complement deposits in inflammatory bowel disease

Cited by 7 publications

References 2 publications

Skin Manifestations of Inflammatory Bowel Disease

Skin Manifestations of Inflammatory Bowel Disease

Skin complications associated with inflammatory bowel disease

The gut and the inflammatory bowel diseases inside-out: extra-intestinal manifestations

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