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炎症性肠病的皮肤表现

Dermatological Manifestations in Inflammatory Bowel Diseases.

作者信息

Antonelli Elisabetta, Bassotti Gabrio, Tramontana Marta, Hansel Katharina, Stingeni Luca, Ardizzone Sandro, Genovese Giovanni, Marzano Angelo Valerio, Maconi Giovanni

机构信息

Gastroenterology Section, Perugia General Hospital, 06156 Perugia, Italy.

Gastroenterology & Hepatology Section, Department of Medicine, University of Perugia, 06156 Perugia, Italy.

出版信息

J Clin Med. 2021 Jan 19;10(2):364. doi: 10.3390/jcm10020364.

Abstract

Inflammatory bowel diseases (IBDs) may be associated with extra-intestinal manifestations. Among these, mucocutaneous manifestations are relatively frequent, often difficult to diagnose and treat, and may complicate the course of the underlying disease. In the present review, a summary of the most relevant literature on the dermatologic manifestations occurring in patients with inflammatory bowel diseases has been reviewed. The following dermatological manifestations associated with IBDs have been identified: (i) specific manifestations with the same histological features of the underlying IBD (occurring only in Crohn's disease); (ii) cutaneous disorders associated with IBDs (such as aphthous stomatitis, erythema nodosum, psoriasis, epidermolysis bullosa acquisita); (iii) reactive mucocutaneous manifestations of IBDs (such as pyoderma gangrenosum, Sweet's syndrome, bowel-associated dermatosis-arthritis syndrome, aseptic abscess ulcers, pyodermatitis-pyostomatitis vegetans, etc.); (iv) mucocutaneous conditions secondary to treatment (including injection site reactions, infusion reactions, paradoxical reactions, eczematous and psoriasis-like reactions, cutaneous infections, and cutaneous malignancies); (v) manifestations due to nutritional malabsorption (such as stomatitis, glossitis, angular cheilitis, pellagra, scurvy, purpura, acrodermatitis enteropathica, phrynoderma, seborrheic-type dermatitis, hair and nail abnormalities). An accurate dermatological examination is essential in all IBD patients, especially in candidates to biologic therapies, in whom drug-induced cutaneous reactions may assume marked clinical relevance.

摘要

炎症性肠病(IBD)可能与肠外表现相关。其中,皮肤黏膜表现相对常见,往往难以诊断和治疗,并且可能使基础疾病的病程复杂化。在本综述中,我们回顾了关于炎症性肠病患者发生的皮肤表现的最相关文献。已确定以下与IBD相关的皮肤表现:(i)具有与基础IBD相同组织学特征的特异性表现(仅发生在克罗恩病中);(ii)与IBD相关的皮肤疾病(如阿弗他口炎、结节性红斑、银屑病、获得性大疱性表皮松解症);(iii)IBD的反应性皮肤黏膜表现(如坏疽性脓皮病、Sweet综合征、肠病性皮肤病-关节炎综合征、无菌性脓肿溃疡、增殖性脓皮病-脓性口炎等);(iv)治疗继发的皮肤黏膜状况(包括注射部位反应、输液反应、矛盾反应、湿疹样和银屑病样反应、皮肤感染和皮肤恶性肿瘤);(v)营养吸收不良引起的表现(如口炎、舌炎、口角炎、糙皮病、坏血病、紫癜、肠病性肢端皮炎、蟾皮病、脂溢性皮炎型、毛发和指甲异常)。准确的皮肤科检查对所有IBD患者至关重要,尤其是对生物治疗的候选者,在这些患者中药物引起的皮肤反应可能具有显著的临床相关性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1280/7835974/becb7bebc2d0/jcm-10-00364-g001.jpg

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