Crohn's disease of the vulva—two further cases

Lavery, H.A.; Pinkerton, John; Sloan, Joanna B.

doi:10.1111/j.1365-2133.1985.tb02091.x

Cited by 27 publications

(13 citation statements)

References 6 publications

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“…The most commonly described histological finding in the literature is noncaseating granulomas, 8,11,[13][14][15]18,26,[32][33][34][36][37][38] which more than 90% of biopsies disclose. In our series, only 38% of patient biopsies had noncaseating granulomatous inflammation, a finding associated with a range of clinical signs, including ulcers, vulvar swelling, and exophytic lesions, consistent with what appears in prior reports.…”

Section: Discussionmentioning

confidence: 99%

“…Direct extension involves contiguous disease expansion from the bowel to the vulva, eg, as with fistulae. [11][12][13] Metastatic CD has been defined as granulomatous inflammation of the skin that is not contiguous with the GI tract. [5][6][7][14][15][16][17] Although the literature documents both forms of vulvar CD, more than 90% of the published cases depict noncaseating granulomas in noncontiguous sites.…”

Section: Discussionmentioning

confidence: 99%

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Vulvar Manifestations of Crohn's Disease

Foo

Papalas

Robboy

et al. 2011

The American Journal of Dermatopathology

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Crohn's disease is an inflammatory bowel disorder with several well-known extraintestinal manifestations, such as erythema nodosum, uveitis, and arthritis. Less commonly observed are vulvar manifestations, which have primarily been discussed in case reports or small case series. These cases generally highlight patients with histopathology limited to noncaseating granulomas. As these histological findings are identified in bowel biopsies from only approximately 50% of patients with gastrointestinal Crohn's disease, there is likely an under-recognition and underdiagnosis of vulvar lesions as Crohn's disease manifestations. We describe the largest case series to date involving patients with vulvar Crohn's disease, discuss the varied clinical presentations, and describe the histopathological findings, which include noncaseating granulomas, ulcerations, lymphatic lesions, and even dysplasia and carcinoma. Our findings underscore the importance of keeping vulvar Crohn's disease on the differential diagnosis when faced with a range of vulvar symptoms and suggest that regular gynecological surveillance in patients with Crohn's disease may be of benefit.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Vulvar Manifestations of Crohn's Disease

Foo

Papalas

Robboy

et al. 2011

The American Journal of Dermatopathology

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“…Individual usage of tacrolimus 0.1% OD has also been found to be safe and effective in treating MCD [59]. Other noteworthy efficacious treatment options for MCD include tetracycline hydrochloride ointment [60], mesalamine 800 mg three times daily with prednisone 80 mg/day [61], and intralesional triamcinolone [4]. Recurrence may take place with any of the above treatment modalities.…”

Section: Treatmentmentioning

confidence: 99%

Metastatic Crohn’s Disease: An Approach to an Uncommon but Important Cutaneous Disorder

Aberumand

Howard

2017

BioMed Research International

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Objective. To provide physicians with a clinical approach to metastatic Crohn's disease (MCD). Main Message. Metastatic Crohn's disease, defined as skin lesions present in areas noncontiguous with the gastrointestinal tract, is the rarest cutaneous manifestation of Crohn's disease. MCD lesions vary in morphology and can arise anywhere on the skin. MCD presents equally in both sexes and across age groups. Cutaneous findings may precede, develop concurrently with, or follow gastrointestinal involvement. A detailed history and thorough physical examination including a full-skin exam may help to exclude other dermatoses, as MCD can mimic other common disorders. A biopsy is required for a definitive diagnosis. Treatment options for MCD remain underwhelming due to the lack of randomized control studies and varying responses of reported therapeutic methods. Topical, intralesional, and systemic corticosteroids, antibiotics, traditional immunosuppressants, and surgery have shown mixed results. Recently, biologics have shown promise, even with refractory cases of MCD. Conclusion. MCD is an important cutaneous manifestation of this inflammatory disorder. Although a rare entity, early recognition can provide opportunity for successful therapeutic intervention.

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“…Injection of steroids into the lips (no more than 1 ml/cm of an aqueous solution of triamcinolone acetonide 10 mg/ml with 1–2% xylocaine hydrochloride [20, 25]) might be helpful but, if it decreases the swelling, it does not represent a curative therapy [8, 20, 25] and it is painful [8, 25]. In all cases, in the literature, surgical excision was proposed but should remain a last resort in such a recurrent disease [4, 6, 16, 17]. …”

Section: Discussionmentioning

confidence: 99%

“…For instance, in the literature, the indurated swelling of the labia majora is frequently described as erythematous and asymmetrical as in our case. However, it is most often associated with ulcerations [2, 4, 12, 13, 15, 16, 17], sometimes with a ‘knife cut’ sign (the tendency for linear fissures to develop within intertriginous folds) [18]. Flesh-tinted papules or nodules, pustular eruption [5, 12, 13, 17] and satellite adenopathy [17] are other reported vulvar lesions associated with Crohn’s disease.…”

Section: Discussionmentioning

confidence: 99%

Granulomatous Vulvitis, Granulomatous Cheilitis: A Single Diagnosis?

Thiriar

Deroux²,

Dourov³

et al. 1998

Dermatology

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We report two cases of labial swelling (oral and vulvar) with a granulomatous histology in patients with a history of Crohn’s disease. The differential diagnosis of granulomatous vulvitis and cheilitis, as well as the symptomatology and treatment of vulvar and oral Crohn’s disease are further discussed. To our knowledge, reported cases of vulvar and oral Crohn’s disease are quite scarce in the literature, but the disease might be underdiagnosed. We hope to contribute to an earlier recognition and a better management of the vulvar and oral mucocutaneous lesions of Crohn’s disease.

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Crohn's disease of the vulva—two further cases

Cited by 27 publications

References 6 publications

Vulvar Manifestations of Crohn's Disease

Vulvar Manifestations of Crohn's Disease

Metastatic Crohn’s Disease: An Approach to an Uncommon but Important Cutaneous Disorder

Granulomatous Vulvitis, Granulomatous Cheilitis: A Single Diagnosis?

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