Wells Leah Ellis, Cohen David
Mercer University School of Medicine, Macon, Georgia, USA.
Skin Care Physicians of Georgia, Macon, Georgia, USA.
Case Rep Dermatol. 2018 Nov 28;10(3):263-267. doi: 10.1159/000495000. eCollection 2018 Sep-Dec.
Though Crohn's disease primarily affects the gastrointestinal tract, cutaneous Crohn's disease of the vulva can occur in the absence of gastrointestinal symptoms, complicating the diagnosis. Once clinicians suspect cutaneous Crohn's disease, antibiotics and traditional immunosuppressants comprise initial treatment. Unfortunately, sometimes these therapies are not effective, or they provide only short-lived symptomatic improvement. A few case reports have found tumor necrosis factor-α inhibitors to be helpful in such refractory cases. We describe a patient with long-standing, painful vulvar Crohn's lesions with no gastrointestinal manifestations of the disease. Her diagnosis was delayed for years, and initial therapy with antibiotics and steroids was unsuccessful. Finally, the patient experienced effective and long-lasting symptom improvement with infliximab (Remicade).
尽管克罗恩病主要影响胃肠道，但外阴部的皮肤克罗恩病可在无胃肠道症状的情况下发生，这使得诊断变得复杂。一旦临床医生怀疑是皮肤克罗恩病，抗生素和传统免疫抑制剂构成初始治疗。不幸的是，有时这些疗法无效，或者仅能提供短暂的症状改善。一些病例报告发现肿瘤坏死因子-α抑制剂对此类难治性病例有帮助。我们描述了一位患有长期疼痛性外阴克罗恩病损且无该疾病胃肠道表现的患者。她的诊断被延误了数年，最初使用抗生素和类固醇的治疗未成功。最后，该患者使用英夫利昔单抗（类克）后症状得到了有效且持久的改善。
