[Cutaneous metastasis of Crohn's disease].

BACKGROUND

Involvement of the skin in Crohn's disease is rare. We report the case of a young woman presenting cutaneous nodules revealing a Crohn's disease.

METHODS

R. K. a 19 year old woman was admitted the impatient clinic for a 2 week history of nodular lesions of the extremities. Simultaneously, she had watery diarrhoea and abdominal pain associated with a bad general condition and fever. Skin examination showed ulcerated lesions with a non infiltrated inflammatory bader of the left food and the right calf associated with an abscess of the left forearm. Skin biopsy showed an inflammatory infiltrate of the deep dermis with tuberculoid noncaseating granulomas. Colonoscopy demonstrated multiple ulcers, a "globlestone appearance" of the glow and segmental glitis. Colonoscopy was followed by a peritonitis which made steroid therapy questionable. Meanwhile, the patient underwent a colonostomy and was fed intravenously, the skin lesions resolved. A follow up colonoscopy demonstrated colon polyps, and the biopsy of the colon showed features of colitis and "follicular" duodenitis which was in concordance with the diagnosis of Crohn's disease.

CONCLUSIONS

Usually, cutaneous lesions in Crohn's disease are consistent with nodules and granulomatous fissures of the grain. Involvement of the mucosa is rare. We report the case of "metastatic" localisation of nodular abscesses in Corhn disease. Improvement of cutaneous lesions might be explained by the nonuse of the digestive track allowed by the parenteral supplementation.