A continuous spectrum of neutrophilic dermatoses in Crohn's disease
Mendoza, J.L.; García-Paredes, J.; Peña, A.S.; Cruz-Santamaría, D.M.; Iglesias, C.; Díaz Rubio, M.
Revista Espanola de Enfermedades Digestivas Organo Oficial de la Sociedad Espanola de Patologia Digestiva 95(3): 233-6 229-32
2003
ISSN/ISBN: 1130-0108 PMID: 12760712 Document Number: 555505
The inflammatory bowel disease is accompanied by cutaneous manifestations in approximately 10% of the cases. Neutrophilic dermatoses are located on the dermis and/or epidermis and are characterised on histological examination by the presence of an infiltrate that consists largely of neutrophils. The prototype of neutrophilic dematoses is Sweet's syndrome; which is rarely associated with Crohn's disease. Case report: A 63 year old woman was admitted to hospital with pyrexia, abdominal pain, episcleritis and skin lesions. She presented erythematous lesions on trunk, legs and arms, with tendency towards formation of plaques, nodules and vesicular pustular lesions. Both the colonoscopy and colonic biopsies confirmed the diagnosis of colonic Crohn's disease. Cutaneous biopsies revealed an infiltrate consisting mainly of neutrophils. These biopsies, together with clinical details led to the diagnosis of Sweet's syndrome. A methylprednisolone treatment rapidly improved the skin lesions and clinical symptoms. The different clinical forms of neutrophilic dermatosis are an extra intestinal manifestation of Crohn's disease, and are sometimes found concurrently in the same patient, which would indicate a common pathogenesis with different clinical presentations (spectrum of neutrophilic dermatoses).