Division of Dermatology, Department of Internal Medicine, Baylor University Medical Center, Dallas, Texas 75246, USA.
J Am Acad Dermatol. 2013 Feb;68(2):211.e1-33; quiz 244-6. doi: 10.1016/j.jaad.2012.10.036.
The gastrointestinal (GI) and cutaneous organ systems are closely linked. In part I of this continuing medical education article, the intricacies of this relationship were explored as they pertained to hereditary polyposis disorders, hamartomatous disorders, and paraneoplastic disease. Part II focuses on the cutaneous system's links to inflammatory bowel disease and vascular disorders. An in-depth analysis of inflammatory bowel disease skin findings is provided to aid dermatologists in recognizing and facilitating early consultation and intervention by gastroenterologists. Cutaneous signs of inflammatory bowel disease include fissures and fistulae, erythema nodosum, pyoderma gangrenosum, pyostomatitis vegetans, oral aphthous ulcers, cutaneous polyarteritis nodosa, necrotizing vasculitis, and epidermolysis bullosa acquisita. Additional immune-mediated conditions, such as diverticulitis, bowel-associated dermatosis-arthritis syndrome, Henoch-Schönlein purpura, dermatitis herpetiformis, and Degos disease, in which the skin and GI system are mutually involved, will also be discussed. Genodermatoses common to both the GI tract and the skin include Hermansky-Pudlak syndrome, pseudoxanthoma elasticum, Ehlers-Danlos syndrome, hereditary hemorrhagic telangiectasia, and blue rubber bleb nevus syndrome. Kaposi sarcoma is a neoplastic disease with lesions involving both the skin and the gastrointestinal tract. Acrodermatitis enteropathica, a condition of zinc deficiency, likewise affects both the GI and dermatologic systems. These conditions are reviewed with updates on the genetic basis, diagnostic and screening modalities, and therapeutic options. Finally, GI complications associated with vascular disorders will also be discussed.
胃肠道（GI）和皮肤器官系统密切相关。在本继续教育文章的第一部分中，探讨了这种关系的复杂性，涉及遗传性息肉病、错构瘤性疾病和副肿瘤疾病。第二部分重点介绍皮肤系统与炎症性肠病和血管疾病的联系。对炎症性肠病皮肤表现进行了深入分析，以帮助皮肤科医生识别并促进胃肠病学家的早期咨询和干预。炎症性肠病的皮肤表现包括肛裂和瘘管、结节性红斑、坏疽性脓皮病、匐行性回状红斑、口腔阿弗他溃疡、皮肤多发性动脉炎、坏死性血管炎和获得性大疱性表皮松解症。还将讨论其他免疫介导的疾病，如憩室炎、肠相关皮肤病关节炎综合征、过敏性紫癜、疱疹样皮炎和 Degos 病，其中皮肤和胃肠道系统相互涉及。胃肠道和皮肤均常见的遗传皮肤病包括 Hermansky-Pudlak 综合征、假性黄色瘤弹性组织营养不良、Ehlers-Danlos 综合征、遗传性出血性毛细血管扩张症和蓝色橡皮疱痣样痣综合征。卡波西肉瘤是一种涉及皮肤和胃肠道的肿瘤性疾病。锌缺乏症的肠病性肢端皮炎同样影响胃肠道和皮肤系统。本文综述了这些疾病的更新内容，包括遗传基础、诊断和筛查方法以及治疗选择。最后，还将讨论与血管疾病相关的胃肠道并发症。
