Eames Tatjana, Landthaler Michael, Karrer Sigrid
Department of Dermatology, University of Regensburg, Franz-Josef-Strauss Alle 11, D-93042 Regensburg, Germany.
Eur J Dermatol. 2009 Jul-Aug;19(4):360-4. doi: 10.1684/ejd.2009.0674. Epub 2009 May 14.
Metastatic Crohn's disease is a very rare skin manifestation of Crohn's disease. Its time of occurrence and severity do not necessarily correlate with the intestinal disease. The main characteristic is that the granulomatous skin changes occur at sites distant from the bowel. We report the case of a 65-year-old woman with metastatic Crohn's disease on her right lower leg without clinical intestinal signs at the time of diagnosis. The inflammatory pustulating skin lesions resolved after systemic and topical treatment with corticosteroids. After reducing immunosuppressive therapy, fistulating lesions reappeared on the lower legs and at the mons pubis. Coloscopy now, more than five years after the onset of the first skin lesions, showed an intestinal Crohn's disease. Metastatic Crohn's disease and its differential diagnoses with granulomatous reaction pattern are discussed in this manuscript.
转移性克罗恩病是克罗恩病一种非常罕见的皮肤表现。其发生时间和严重程度不一定与肠道疾病相关。主要特征是肉芽肿性皮肤改变发生在远离肠道的部位。我们报告一例65岁女性，右小腿患有转移性克罗恩病，诊断时无临床肠道症状。经全身及局部使用皮质类固醇治疗后，炎性脓疱性皮肤病变消退。在减少免疫抑制治疗后，小腿和耻骨联合处再次出现瘘管性病变。在首次出现皮肤病变五年多后进行的结肠镜检查显示患有肠道克罗恩病。本文讨论了转移性克罗恩病及其与肉芽肿反应模式的鉴别诊断。
