Ghani Usman, Ahmed Mahwish, Nayeem Athar, Qayyum Zunaira
Mohtarma Benazir Bhutto Shaheed Medical College Mirpur-AJK.
HBS Medical and Dental College Islamabad.
J Ayub Med Coll Abbottabad. 2024 Jul-Sep;36(3):616-620. doi: 10.55519/JAMC-03-13956.
Inflammatory bowel disease (IBD) is a group of chronic inflammatory conditions of the gastrointestinal tract. Skin manifestations are frequently found with IBD yet they are not completely comprehended regarding how common they are and whether they reflect the seriousness of disease. Objective was to determine the prevalence, type and treatment of skin recall manifestations among a cohort of patients with CD and ulcerative colitis (UC).
A total of 250 IBD patients (140 CD and 110 UC) were enrolled in the study. Demographics of patients, disease duration, skin morphology were enrolled. We evaluated the frequency of skin manifestations, their association with disease activity, and course in response to therapy.
Skin manifestations appeared in 31.2% of patients, and were more prevalent in CD (35%) compared to UC (26%) (p=0.04). The most common skin manifestations were erythema nodosum (11.2%), pyoderma gangrenosum (5.6%), and perianal skin tags (8%). Active disease demonstrated a significant association with skin manifestations (45% active disease vs 18% remission, p<0.001). Patients receiving anti-TNF therapy had fewer new skin manifestations (20%) when compared to patients receiving conventional therapy (36%) (p=0.03), however 5% of patients receiving biologic therapy reported developing paradoxical skin reactions. Management of skin manifestations consisted mainly of systemic corticosteroids therapy, which was effective in 80% of cases, while 10% of patients with more severe perianal disease underwent surgical intervention to treat their skin manifestations.
Skin manifestations appear to be common in patients with IBD, and a significant difference was observed between patients with CD and UC. The disease activity showed a strong association with the occurrence of skin manifestations. Anti-TNF therapy is likely to be associated with less frequent new skin manifestation, however it remains substantive that patients with biologic therapy can have paradoxical skin reactions.
炎症性肠病（IBD）是一组胃肠道慢性炎症性疾病。IBD患者常出现皮肤表现，但对于其常见程度以及是否反映疾病严重程度，仍未完全了解。目的是确定一组克罗恩病（CD）和溃疡性结肠炎（UC）患者中皮肤回忆反应的患病率、类型及治疗情况。
共纳入250例IBD患者（140例CD和110例UC）。记录患者的人口统计学资料、疾病病程、皮肤形态。评估皮肤表现的频率、其与疾病活动的关联以及治疗反应过程。
31.2%的患者出现皮肤表现，CD患者（35%）比UC患者（26%）更常见（p=0.04）。最常见的皮肤表现为结节性红斑（11.2%）、坏疽性脓皮病（5.6%）和肛周皮赘（8%）。活动期疾病与皮肤表现显著相关（活动期疾病患者为45%，缓解期患者为18%，p<0.001）。与接受传统治疗的患者（36%）相比，接受抗TNF治疗的患者出现新皮肤表现的较少（20%）（p=0.03）；然而，5%接受生物治疗的患者报告出现矛盾性皮肤反应。皮肤表现的治疗主要包括全身用皮质类固醇治疗，80%的病例有效，而10%肛周疾病较严重的患者接受了手术干预以治疗其皮肤表现。
皮肤表现在IBD患者中似乎很常见，CD患者和UC患者之间存在显著差异。疾病活动与皮肤表现的发生密切相关。抗TNF治疗可能与较少出现新的皮肤表现相关，然而接受生物治疗的患者会出现矛盾性皮肤反应这一情况仍很突出。
