Antonelli Elisabetta, Bassotti Gabrio, Tramontana Marta, Hansel Katharina, Stingeni Luca, Ardizzone Sandro, Genovese Giovanni, Marzano Angelo Valerio, Maconi Giovanni
Gastroenterology Section, Perugia General Hospital, 06156 Perugia, Italy.
Gastroenterology & Hepatology Section, Department of Medicine, University of Perugia, 06156 Perugia, Italy.
J Clin Med. 2021 Jan 19;10(2):364. doi: 10.3390/jcm10020364.
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.
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。