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Erythema nodosum. Multiple red, warm, and tender nodules, classically located on pretibial surface of lower extremity
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![Table 1 Cutaneous manifestations in Inflammatory Bowel Disease [3]...](profile/Marta-Bosca/publication/261515939/figure/tbl7/AS:669618280607761@1536660847326/Cutaneous-manifestations-in-Inflammatory-Bowel-Disease-3-Specific-manifestations_Q320.jpg)
Almost one-third of patients with inflammatory bowel disease (IBD) develop skin lesions. Cutaneous disorders associated with IBD may be divided into 5 groups based on the nature of the association: specific manifestations (orofacial and metastatic IBD), reactive disorders (erythema nodosum, pyoderma gangrenosum, pyodermatitis-pyostomatitis vegetans...
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Targeted immune-modulating treatment with biological agents has revolutionized the management of immune-mediated inflammatory diseases, including rheumatologic conditions. The efficacy and tolerability of biological agents, from the initial tumour necrosis factor (TNF)-α inhibitors to the new anti-cytokine monoclonal antibodies, have dramatically c...
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... The therapy of VCD consists of topical therapy, like corticosteroids, and immunosuppressants. TNF alpha inhibitors can lead to complete healing in 70% of cases (1,6,7,8). According to the Ormerod, et al study, prednisolone, and cyclosporine, had led to 50% healing at 6 months, without any difference between this treatment, although infections were more in the steroid group and renal toxicity in the cyclosporine group (9). ...
... Biologics can however induce a wide variety of skin eruptions, especially those targeting the TNF-α and Th17 pathway. 26 While some of the drug infusion reactions can be prevented with premedications to be applied before the treatment, some others may require discontinuation of the treatment. These dermatological manifestations require cooperation with a dermatologist in their diagnosis and treatment. ...
... Typical symptoms of UC include diarrhea, mucus pus, bloody stools and abdominal pain, and its time of onset is more than 4 to 6 weeks, simultaneously, extraintestinal manifestations involve skin mucosa, joints, eyes, lungs and nervous system [7][8][9][10][11][12][13][14][15]. Additionally, diarrhea, which does not exceed 6 weeks of disease process, needs to be distinguished from infectious enteritis [16]. ...
Abstract Nuclear factor-kappa B (NF-κB) is a kind of multi-functional nuclear transcription factor involved in regulating gene transcription to influence pathological evolution of inflammatory and immune diseases. Numerous literature evidence that NF-κB pathway plays an essential role in pathogenic development of ulcerative colitis (UC). UC is a chronic non-specific inflammatory bowel disease, and until now, therapeutic agents for UC including aminosalicylates, corticosteroids and immune inhibitors still cannot exert satisfied effects on patients. In recent years, Chinese medicines suggest the advantages of alleviating symptoms and signs, decreasing side-effects and recurrence, whose one of mechanisms is related to regulation of NF-κB pathway. In this review, we categorize Chinese medicines according to their traditional therapeutic functions, and summarize the characteristics of Chinese medicines targeting NF-κB pathway in UC treatment. It indicates that 85 kinds of Chinese medicines’ compounds and formulae can directly act on NF-κBp65; while 58 Chinese medicines’ ingredients and formulae indirectly suppress NF-κBp65 by regulation of its upstream or other related pathways. Moreover, by the analysis of Chinese medicines’ category based on their traditional functions, we conclude the category of dampness-drying and detoxificating medicine targeting NF-κB pathway accounts for primary status for amelioration of UC. Simultaneously, this review also contributes to the choices of Chinese medicine category and provides curative potential of Chinese medicines for clinical UC treatment.
... Multiple previous studies have considered PDV as a clinical marker for IBD activity and recommended that a total/subtotal colectomy is a therapeutic option for complete remission of symptoms. 3,6,13 However, in 2015, Uzunçakmak et al 9 reported on a case of PDV developed shortly after a total colectomy and discontinuation of systemic corticosteroid. 9 Here we report a first presentation of PDV 3 years after total colectomy in a patient with Crohn's disease. ...
... Other reported therapeutic agents include dapsone, sulfasalazine, tacrolimus, azathioprine, cyclosporine, isotretinoin, infliximab, and methotrexate. 13 For patients with positive bacterial cultures, appropriate antibiotics were added as a conjunctive therapy. In spite of the morphologic similarities of PDV to HS, the combined antibiotic therapy of rifampicin and clindamycin is not a treatment that is suggested for PDV. ...
... Regarding IBD therapy, all of the currently used drug classes have been linked to alterations in the oral cavity due to their direct toxic effect on tissues and their indirect immunosuppressive effects [21]. ...
Dysbiosis has been associated with the onset of several chronic autoimmune or inflammatory pathologies (e.g., inflammatory bowel diseases—IBD), because of its primary role in the establishment of a chronic inflammatory process leading to tissue damage. Inflammatory bowel diseases can even involve areas far away from the gut, such as the extraintestinal manifestations involving the oral cavity with the onset of aphthous-like ulcers (ALU). Studies carried out on animal models have shown that intestinal dysbiosis may be related to the development of autoimmune diseases, even if the mechanisms involved are not yet well known. The aim of this paper is to verify the hypothesis that in inflammatory bowel diseases patients, aphthous-like ulcers are the result of the concomitance of intestinal dysbiosis and other events, e.g., the microtraumas, occurring in the oral mucosa, and that ex adiuvantibus therapy with probiotics can be employed to modify the natural course of the aphthous-like ulcers.
... Regarding IBD therapy, all of the currently used drug classes have been linked to alterations in the oral cavity due to their direct toxic effect on tissues and their indirect immunosuppressive effects [21]. ...
Dysbiosis has been associated with the onset of several chronic autoimmune or inflammatory pathologies (e.g., inflammatory bowel diseases-IBD), because of its primary role in the establishment of a chronic inflammatory process leading to tissue damage. Inflammatory bowel diseases can even involve areas far away from the gut, such as the extraintestinal manifestations involving the oral cavity with the onset of aphthous-like ulcers (ALU). Studies carried out on animal models have shown that intestinal dysbiosis may be related to the development of autoimmune diseases, even if the mechanisms involved are not yet well known. The aim of this paper is to verify the hypothesis that in inflammatory bowel diseases patients, aphthous-like ulcers are the result of the concomitance of intestinal dysbiosis and other events, e.g., the microtraumas, occurring in the oral mucosa, and that ex adiuvantibus therapy with probiotics can be employed to modify the natural course of the aphthous-like ulcers.
... Prevalence of work disability varies from 19% to 27% in cohort studies, 16,17 but the impact of iron supplementation on this outcome is not established. Other symptoms such as restless legs syndrome, 5 hair loss 6 or glossitis 7 have also shown to be improved with iron therapy in non-IBD patients. [46][47][48] During their disease course, IBD patients are often hospitalised, with hospitalisation rate of 0.66/person-year in CD 49 and 0.05/person-year in ulcerative colitis. ...
... They are often associated with extra-intestinal manifestations involving multiple organ systems including joints, liver and biliary tracts, eyes, and skin. Less frequently, the lungs, heart, pancreas, and the vascular system are also affected [122][123][124][125][126]. IBD-associated arthritis, which affects almost 40% of patients with IBD, is characterized by a subtype of seronegative spondyloarthritis, with axial, peripheral, or a combination of both joint manifestations. ...
Extra-articular manifestations of rheumatoid arthritis, juvenile idiopathic arthritis, and various spondyloarthritides including psoriatic arthritis, ankylosing spondylitis, reactive arthritis, and inflammatory bowel disease-associated spondyloarthritis often involve the skin and may occur before or after diagnosis of these rheumatic diseases. Cutaneous manifestations encompass a wide range of reactions that may have a notable negative impact not only on the physical but especially on the emotional and psychosocial well-being of these patients. Several cutaneous manifestations have been related to rheumatoid arthritis such as subcutaneous nodules including classical rheumatoid nodules, accelerated rheumatoid nodulosis, and rheumatoid nodulosis; vascular disorders like rheumatoid vasculitis, livedo racemosa, and Raynaud’s phenomenon; and neutrophilic and/or granulomatous diseases like pyoderma gangrenosum, Sweet’s syndrome, rheumatoid neutrophilic dermatitis, interstitial granulomatous dermatitis with arthritis, as well as palisaded neutrophilic and granulomatous dermatitis. In juvenile idiopathic arthritis, the main cutaneous manifestations include an evanescent rash, rheumatoid nodules, as well as plaque and guttate psoriasis. Plaque psoriasis is also the main skin disease involved in spondyloarthritides. Furthermore, other forms of psoriasis including guttate, inverse, erythrodermic, pustular, and particularly nail psoriasis may also occur. In addition, a variety of drug-induced skin reactions may also appear in these diseases. Early recognition and understanding of these different dermatologic manifestations together with an interdisciplinary approach are often needed to optimize management of these diseases.
... However, its mechanism of action in antibody-mediated diseases remains unclear [6,7]. It may cause, with frequent dose-related effect, hemolysis in subjects with G-6PDH deficiency or methemoglobin reductase deficiency or hemoglobin M. Other known adverse effects are represented by peripheral neuropathy, vomiting, nausea, vertigo, pancreatitis, abdominal pain, headache, fever, psychosis, tachycardia and nephrotic syndrome [8]. ...
Introduction: Linear immunoglobulin A bullous dermatosis (LABD) is a rare, heterogeneous, autoimmune blistering skin disorder that can be associated with other autoimmune conditions.
Case presentation: We describe the case of a 14-year-old Italian boy with previously diagnosed ulcerative colitis who presented a severe LABD well controlled after appropriate medical therapy and in total remission after a follow-up of one year.
Conclusion: Our case shows that LABD can occur in adolescent with ulcerative colitis and can be successful treated with appropriate medical therapy avoiding bowel surgery. A longer follow-up and a larger sample of patients would be of critical importance to detect long-term efficacy of dapsone and to identify responders and non-responders LABD patients.
... Among the cutaneous manifestations, the metastatic Crohn's disease is considered an uncommon manifestation of the disease, as it is characterized by granulomatous skin lesions with the same histological characteristics of the underlying bowel disease (3) . Its pathogenesis is not well understood. ...
Patients with Crohn's disease may show extraintestinal manifestations, including cutaneous, whose frequency ranges from 2% to 34%. Metastatic cutaneous Crohn's disease is considered a specific and rare manifestation, since the histopathology reveals granulomatous pattern with the same characteristics of the underlying bowel condition. The objective of this study is to report two cases of metastatic cutaneous Crohn's disease confirmed by histopathologic analysis, after excluding other granulomatous skin diseases. Case 1: Adult woman with pruritic erythematous scaly plaques disseminated on the upper limbs. Case 2: Adult man with grayish hyperchromic plaque infiltrated on the left buttock. © 2016, Sociedade Brasileira de Pneumologia e Tisiologia. All rights reserved.
