Renuka Sandesh
BACKGROUND
Ulcerative colitis and Crohn’s disease are Inflammatory Bowel Diseases (IBD) that have many common cutaneous manifestations. At the time of diagnosis of IBD, the mean incidence of cutaneous manifestations is around 10%. However, during the course of the disease, a variety of skin lesions may develop.
The aim of this study is to study the prevalence of cutaneous manifestations in inflammatory bowel disease patients attending Medical College Hospital, Calicut, from November 2004 to November 2005.
MATERIALS AND METHODS
72 Consecutive patients presenting to the Outpatient and Inpatient Departments of Gastroenterology with inflammatory bowel disease are the subjects of the study. Patients presenting with bleeding per rectum or diarrhoea are evaluated by sigmoidoscopy or colonoscopy as part of investigative workup. Histopathological examination is done when indicated. Patients who are already diagnosed cases of inflammatory bowel disease either ulcerative colitis or Crohn’s disease and followed up in Gastroenterology Outpatient Department were examined for skin manifestations. Detailed history was taken and clinical examination done. Biopsy of the skin lesion was done in indicated cases. Routine blood tests were done including blood counts, blood sugar, renal and liver function tests.
RESULTS
A total of 72 patients with inflammatory bowel disease who attended the Outpatient and Inpatient Departments of Gastroenterology were studied. There were 67 (94%) cases of ulcerative colitis and 5 (6.9%) cases of Crohn’s disease. Skin manifestations were seen in 19 (26.3%) patients, 17 (89.4%) were ulcerative colitis and 2 (10.5%) were Crohn’s disease patients.
CONCLUSION
26.3% of patients with inflammatory bowel disease had cutaneous manifestations. Patients with ulcerative colitis had more prevalence of cutaneous manifestations than Crohn’s disease. Pyoderma gangrenosum was the most common cutaneous manifestation seen in inflammatory bowel disease and was seen in 6.9% of patients. Erythema nodosum was the second commonest cutaneous manifestation and was seen in 4.16% of patients. Rare cutaneous manifestations like metastatic Crohn’s disease and pyoderma vegetans is reported in our patients. Cutaneous manifestations are more common in the initial 5 years of diagnosis of the inflammatory bowel disease.
