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炎症性肠病的皮肤黏膜表现

Mucocutaneous Manifestations of Inflammatory Bowel Disease.

作者信息

Alvarez-Payares Jose C, Ramírez-Urrea Sara, Correa-Parra Laura, Salazar-Uribe Daniela, Velásquez-López Mateo

机构信息

Internal Medicine, University of Antioquia, Medellin, COL.

General Medicine, Fundación Universitaria San Martín, Medellin, COL.

出版信息

Cureus. 2021 Aug 15;13(8):e17191. doi: 10.7759/cureus.17191. eCollection 2021 Aug.

Abstract

Inflammatory bowel disease (IBD) is a chronic and incurable disease, of unknown etiology, associated with an unregulated immune response to environmental triggers in a genetically predisposed host. IBD affects mainly the gastrointestinal (GI) tract and includes Crohn's disease (CD) and ulcerative colitis (UC). However, a large percentage of patients may present with extraintestinal manifestations, including mucocutaneous ones (which are the most common) and dermatologic findings, such as erythema nodosum, pyoderma gangrenosum, and aphthous stomatitis (which are the most frequently occurring). According to pathophysiologic mechanisms, mucocutaneous manifestations of IBD are classified into five categories, namely, specific manifestations, associated manifestations, reactive manifestations, adverse effects of IBD therapy, and malabsorption manifestations. Recognizing such manifestations should not be performed only by a dermatologist but also other specialties such as internal medicine, gastroenterology, among others. This is because these manifestations can present before the IBD diagnosis, even in the absence of GI symptoms. Therefore, these skin lesions could be a fundamental tool for the earlier diagnosis of IBD. This review provides a comprehensive overview of the most common cutaneous manifestations of IBD with a focus on their epidemiology, diagnostic criteria, clinical presentation, and available medical treatment.

摘要

炎症性肠病(IBD)是一种慢性且无法治愈的疾病,病因不明,与遗传易感性宿主对环境触发因素的免疫反应失调有关。IBD主要影响胃肠道(GI),包括克罗恩病(CD)和溃疡性结肠炎(UC)。然而,很大一部分患者可能会出现肠外表现,包括皮肤黏膜表现(最常见)和皮肤病学表现,如结节性红斑、坏疽性脓皮病和阿弗他口炎(最常出现)。根据病理生理机制,IBD的皮肤黏膜表现分为五类,即特异性表现、相关表现、反应性表现、IBD治疗的不良反应以及吸收不良表现。认识这些表现不应仅由皮肤科医生进行,内科、胃肠病学等其他专科也应参与。这是因为这些表现在IBD诊断之前就可能出现,即使没有胃肠道症状。因此,这些皮肤病变可能是IBD早期诊断的重要工具。本综述全面概述了IBD最常见的皮肤表现,重点关注其流行病学、诊断标准、临床表现和可用的药物治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a332/8439267/3c79d54f9205/cureus-0013-00000017191-i01.jpg

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