Vitiligo and Crohn's Disease in Children

Pashankar, Dinesh S.; Prendiville, Julie; Israel, David M.

doi:10.1097/00005176-199902000-00029

Cited by 8 publications

(5 citation statements)

References 9 publications

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“…Accordingly, the increased associated occurrence of other autoimmune disorders, mainly thyroid disease, supports this theory [7]. Concomitant occurrence with inflammatory bowel disease has been rarely reported [8]. This fact is usually explained to be due to immunologic mechanisms, but whether the association is significant or merely due to chance is an open question.…”

Section: Discussionmentioning

confidence: 99%

Vitiligo during Treatment of Crohn’s Disease with Adalimumab: Adverse Effect or Co-Occurrence

Posada¹,

Flórez²,

Batalla³

et al. 2011

Case Rep Dermatol

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Adalimumab is a fully human monoclonal anti-tumor necrosis factor-α agent that is approved for the treatment of Crohn’s disease. It has a good safety profile, injection site reactions being the most common adverse effect. We report a case of a 54-year-old woman with a 30-year history of Crohn’s disease who developed achromic patches on the trunk and upper extremities after initiating treatment with adalimumab. Cutaneous biopsy confirmed diagnosis of vitiligo and laboratory testing ruled out thyroid disease. Concomitant occurrence of vitiligo and inflammatory bowel disease, although rare, has been described. A common autoimmune basis could explain this fact. Moreover, multiple cutaneous adverse effects have been described in the literature secondary to biologic treatments, including vitiligo. In this report, we discuss the possibility of vitiligo as secondary to adalimumab treatment or as an association between both diseases.

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Section: Discussionmentioning

confidence: 99%

Vitiligo during Treatment of Crohn’s Disease with Adalimumab: Adverse Effect or Co-Occurrence

Posada¹,

Flórez²,

Batalla³

et al. 2011

Case Rep Dermatol

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“…Compared to an incidence of 0.3% of vitiligo in the normal population, the incidence of vitiligo is higher in CD (0.5%) and UC (1.1%; Pashankar et al, 1999). The pathogenesis of vitiligo in IBD has been proposed to be autoimmune or genetic HLA linkage in nature (Pashankar et al, 1999; Quan et al, 2010). Secondary amyloidosis is rare in IBD and occurs as a systemic response to chronic inflammation.…”

Section: Cutaneous Disorders or Dermatosis Associated With Ibdmentioning

confidence: 98%

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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“…43,44 Oral tacrolimus therapy seems to be associated with short-and long-term benefits 45 and may represent a therapeutic option in CD when conventional therapies fail. Tables 1 and 2) Reactive (immune-related) lesions secondary to CD Pyoderma gangrenosum 155,156 Erythema nodosum 156 Erythema multiforme 157,158 Finger clubbing 159 Palmar erythema 6 Rosacea-like eruption 160 Pyoderma faciale 161 Epidermolysis bullosa acquisita 162 Secondary systemic amyloidosis 163 Vitiligo 95,164 Palmo-plantar pustulosis 165 Sweet's syndrome 166 Lesions from nutritional deficiencies Acrodermatitis enteropathica-like syndrome (acquired zinc deficiency) 167 Marasmic striae 6 Infliximab has been used with success for treatment of extra-intestinal manifestations of CD. [46][47][48] There are four successfully treated cases of MCD; [49][50][51][52] one of them uses a combination of infliximab with methotrexate.…”

Section: Treatmentmentioning

confidence: 99%

Metastatic Crohn's disease: a review

Παλαμάρας

El-Jabbour

Pietropaolo

et al. 2008

Acad Dermatol Venereol

108

123

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Metastatic Crohn's disease (MCD) indicates the presence of non-caseating granuloma of the skin at sites separated from the gastrointestinal tract by normal tissue and is the least common dermatologic manifestation of CD. In adults, MCD usually appears after the initial diagnosis of CD in 70% of cases, whereas in children, it appears at the same time as CD in almost half of the cases. The most frequent skin lesions in adults are nodules, plaques with or without ulceration on the extremities and ulcers on the genitals. In children, genital swelling with or without erythema is the most frequent presentation of MCD. Simultaneous presence of perianal CD affects more females (60%) and particularly children. Associated gastrointestinal symptoms are present in one third of the cases in adults and in half of the cases in children. Treatment is often unsatisfactory. Randomised controlled trials are lacking. Various chemotherapeutic agents have been used such as oral metronidazole, topical and/or oral steroids, azathioprine, cyclosporine, sulfasalazine, tetracyclines, topical or systemic tacrolimus, infliximab alone or with methotrexate, and surgical treatment with oral zinc sulphate. MCD represents another 'great imitator'. This reviews the most relevant characteristics of this disease, in order to increase awareness and to avoid delay in diagnosis and improve management of the whole CD complex.

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Vitiligo and Crohn's Disease in Children

Cited by 8 publications

References 9 publications

Vitiligo during Treatment of Crohn’s Disease with Adalimumab: Adverse Effect or Co-Occurrence

Vitiligo during Treatment of Crohn’s Disease with Adalimumab: Adverse Effect or Co-Occurrence

Skin Manifestations of Inflammatory Bowel Disease

Metastatic Crohn's disease: a review

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