[皮肤转移性克罗恩病]
[Cutaneous metastatic Crohn's disease].
作者信息
Ciubotaru V, Tattevin P, Cartron-Savin L, Le Gall F, Arvieux C, Gosselin M, Michelet C
机构信息
Clinique des maladies infectieuses et réanimation médicale, centre hospitalier universitaire Pontchaillou, 35033 cedex, Rennes, France.
出版信息
Rev Med Interne. 2003 Mar;24(3):198-201. doi: 10.1016/s0248-8663(02)00814-7.
INTRODUCTION
Cutaneous metastatic Crohn's disease is a granulomatous inflammation of the skin that is noncontiguous to the gastrointestinal tract.
CASE REPORT
A 42-year-old man with Crohn's disease is admitted for antibiotic resistant erysipela-like dermo-hypodermitis. The presence of granulomatous lesions on skin biopsy, the absence of any infectious agent identified despite extensive investigations and the dramatic improvement observed with corticosteroid eventually lead to the diagnosis of cutaneous metastatic Crohn's disease.
CONCLUSION
During Crohn's disease, biopsy should be considered for every undiagnosed skin lesion as the characteristics of cutaneous metastatic Crohn's disease are not specific. The presence of a non caseous granulomatous dermal infiltration suggests the diagnosis and should make consider the initiation of corticosteroid and the discontinuation of others inappropriate therapeutics (i.e. surgical treatment, antibiotics).
引言
皮肤转移性克罗恩病是一种皮肤的肉芽肿性炎症，与胃肠道不连续。
病例报告
一名42岁克罗恩病男性因对抗生素耐药的丹毒样真皮皮下炎入院。皮肤活检发现肉芽肿性病变，尽管进行了广泛检查但未发现任何感染病原体，且使用皮质类固醇后病情显著改善，最终确诊为皮肤转移性克罗恩病。
结论
在克罗恩病期间，对于每一个未确诊的皮肤病变都应考虑进行活检，因为皮肤转移性克罗恩病的特征并不特异。非干酪样肉芽肿性真皮浸润提示诊断成立，应考虑开始使用皮质类固醇并停用其他不适当的治疗方法（如手术治疗、抗生素）。
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