Abdat Rana, Markova Alina, Farraye Francis A, Lichtman Michael K
Department of Dermatology, Boston University School of Medicine, Boston, MA.
Dermatol Online J. 2016 Oct 15;22(10):13030/qt6v402170.
Cutaneous Crohn disease (CD) affecting the vulva, perineum, and perianal skin, is a rare entity, which may accompany or precede gastrointestinal CD. Vulvar involvement, if untreated, may ultimately require extensive surgery including vulvectomy to gain control of the disease. Both gastrointestinal and cutaneous CD respond to biologics, which block TNF. In addition, ustekinumab, which targets both IL-12 and IL-23 cytokines, is effective in patients with gastrointestinal CD who fail TNF blockade. However, it is unclear if ustekinumab is effective for cutaneous CD. Herein we present a patient with cutaneous CD affecting the vulva and perianal skin, which, at seven months, had a marked response to ustekinumab administered at higher doses than typically used for psoriasis.
累及外阴、会阴和肛周皮肤的皮肤克罗恩病（CD）是一种罕见的疾病，可伴有胃肠道CD或先于胃肠道CD出现。如果不进行治疗，外阴受累最终可能需要包括外阴切除术在内的广泛手术来控制病情。胃肠道和皮肤CD对阻断肿瘤坏死因子（TNF）的生物制剂均有反应。此外，靶向白细胞介素-12（IL-12）和白细胞介素-23（IL-23）细胞因子的乌司奴单抗对TNF阻断治疗无效的胃肠道CD患者有效。然而，尚不清楚乌司奴单抗对皮肤CD是否有效。在此，我们报告一名患有累及外阴和肛周皮肤的皮肤CD患者，该患者在七个月时对以高于治疗银屑病通常使用剂量给药的乌司奴单抗有显著反应。
