Delayed Diagnosis of Vulvar Crohn’s Disease in a Patient with No Gastrointestinal Symptoms

Though Crohn’s disease primarily affects the gastrointestinal tract, cutaneous Crohn’s disease of the vulva can occur in the absence of gastrointestinal symptoms, complicating the diagnosis. Once clinicians suspect cutaneous Crohn’s disease, antibiotics and traditional immunosuppressants comprise in...

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Bibliographic Details
Main Authors: Leah Ellis Wells, David Cohen
Format: Article
Language:English
Published: Karger Publishers 2018-11-01
Series:Case Reports in Dermatology
Subjects:
Online Access:https://www.karger.com/Article/FullText/495000
Description
Summary:Though Crohn’s disease primarily affects the gastrointestinal tract, cutaneous Crohn’s disease of the vulva can occur in the absence of gastrointestinal symptoms, complicating the diagnosis. Once clinicians suspect cutaneous Crohn’s disease, antibiotics and traditional immunosuppressants comprise initial treatment. Unfortunately, sometimes these therapies are not effective, or they provide only short-lived symptomatic improvement. A few case reports have found tumor necrosis factor-α inhibitors to be helpful in such refractory cases. We describe a patient with long-standing, painful vulvar Crohn’s lesions with no gastrointestinal manifestations of the disease. Her diagnosis was delayed for years, and initial therapy with antibiotics and steroids was unsuccessful. Finally, the patient experienced effective and long-lasting symptom improvement with infliximab (RemicadeTM).
ISSN:1662-6567