Crohn's Disease of the Vulva

Complication of Crohn's disease on the vulva treated as a Bartholin's gland abscess: A case report

“…6 Vulva involvement has been reported without active bowel symptoms. 7 Fistulas were common, but there were non-ulcerative lesions, such as condylomatous changes. 6 Rectovaginal fistulas have been reported at the post-episiotomy site after 1 year.…”

Clinical Spectrum of Vulva Metastatic Crohn’s Disease

“…In another case, reported by Kingsland and Alderman, clobetasol 17-propionate cream applied three times daily significantly reduced pain but did not change the appearance of vulvar MCD lesions. Subsequent treatment with metronidazole 400 mg twice daily for 3 months resulted in resolution and remission of disease for at least 1 year [5].…”

“…Intertriginous lesions classically present as knife-like ulcerations while lesions on the arms and legs may present as nodules or lichenoid papules [4]. Once diagnosed, MCD is often recalcitrant to therapy; a combination of systemic agents including corticosteroids, azathioprine, mycophenolate mofetil, infliximab, and metronidazole, as well as surgery, and even hyperbaric oxygen therapy may be necessary [5][6][7][8]. We describe three cases of MCD involving the vulva and perianal area which initially presented as vulvar pain.…”

Common and unusual urogenital Crohn’s disease complications: spectrum of cross-sectional imaging findings

“…Sometimes gynecological complaints precede the diagnosis of the chronic inflammatory bowel disease, therefore persistent, unexplained genital abnormalities should raise suspicion of underlying CD [27,28]. Direct extension of fistulizing transmural intestinal disease to the pelvic organs is the usual mechanism, whereas rarely ''metastatic'' CD occurs in the perineum and external genitalia separated from the bowel.…”

“…7). Conversely, ''metastatic'' CD refers to vulvar involvement noncontiguous to the gastrointestinal tract: reported in both adults and children, this very rare entity may precede or coexist with intestinal manifestations and represents a challenging diagnosis and a possibly unrecognized cause of vulvar pain [27,28,31,32]. Inflammatory changes including vulvar skin and subcutaneous thickening with T2-weighted hyperintense signal and positive contrast enhancement, sometimes fistulas or abscess cavities are exquisitely depicted by MRI (Fig.…”