Dermatology Department, North Hospital, Assistance-Publique Hopitaux de Marseille, Aix-Marseille University, Marseille, France.
Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
Ann Dermatol Venereol. 2024 Sep;151(3):103301. doi: 10.1016/j.annder.2024.103301. Epub 2024 Aug 1.
Mucocutaneous manifestations can be indicative of a variety of gastrointestinal diseases, and the dermatologist needs to know how to recognize them to refer the right patients to the gastroenterologist. Conversely, the gastroenterologist is often confronted with mucocutaneous lesions that raise the question of a possible association with a known digestive disease. Among the extra-intestinal manifestations of inflammatory bowel disease (IBD), mucocutaneous manifestations are the most common. This review will provide a breakdown by classifying them into 4 groups: 1) reactive manifestations, which include neutrophilic dermatoses, aphthous stomatitis, erythema nodosum, and vasculitis; 2) Crohn's disease-specific granulomatous skin lesions, which are histologically characterized by tuberculoid granulomas similar to those found in the gastrointestinal tract; 3) nutritional deficiency manifestations secondary to anorexia, malabsorption, loss, and drug interactions; and 3) a variety of autonomous autoimmune or inflammatory skin diseases. Dermatologists may also be involved in the management of the adverse effects of IBD treatments, especially the so-called "paradoxical" psoriatic eruptions.
黏膜皮肤表现可能提示多种胃肠道疾病，皮肤科医生需要了解如何识别这些表现，以便将合适的患者转介给胃肠病学家。相反，胃肠病学家经常会遇到黏膜皮肤病变，这就需要考虑与已知的消化道疾病是否存在关联。在炎症性肠病（IBD）的肠外表现中，黏膜皮肤表现最为常见。本文将通过分类对其进行介绍，分为 4 组：1）反应性表现，包括中性粒细胞皮肤病、口腔溃疡、结节性红斑和血管炎；2）克罗恩病特异性肉芽肿性皮肤病变，其组织学特征为类似于胃肠道中发现的结核样肉芽肿；3）由于厌食、吸收不良、丢失和药物相互作用引起的营养缺乏表现；4）各种自身免疫性或炎症性皮肤病。皮肤科医生也可能参与 IBD 治疗的不良反应的管理，尤其是所谓的“矛盾性”银屑病样发作。
