A Rare Clinical Presentation of Metastatic Crohn's Disease

Authors

Kaitlyn L Streight
Tara L Braun
Nicholas Lowe
Soo Jung Kim

Publication Date

5-26-2020

Journal

Cureus

DOI

10.7759/cureus.8285

PMID

32467818

PMCID

PMC7250390

PubMedCentral® Posted Date

5-26-2020

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

metastatic crohn’s disease, cutaneous crohn’s disease, cutaneous manifestations of systemic disease, crohn’s disease

Abstract

A 31-year-old female with a history of systemic lupus erythematous, IgA nephropathy, and psoriasis presented with a one-month history of a painful, pruritic rash under the bilateral breasts and in the genital region. Cutaneous examination revealed a large, tender ulcer under the left breast with a shiny erythematous base and peripheral hypertrophic changes. Small ulcers were present on the bilateral inguinal folds, and the labia majora were edematous with multiple erythematous papules. Histological examination of the left breast revealed ulceration with granulomatous dermatitis, consistent with a diagnosis of metastatic Crohn's disease. Metastatic Crohn's disease is a rare cutaneous manifestation of Crohn's disease characterized by non-caseating granulomas in regions non-contiguous with the gastrointestinal tract. At the time of diagnosis, our patient reported no gastrointestinal symptoms aside from occasional blood-streaked stools from hemorrhoids. This case demonstrates the importance of considering the disease when a patient presents with intertriginous or genital lesions, even in the absence of systemic manifestations.