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CLINICAL IMAGES
Year : 2015  |  Volume : 142  |  Issue : 4  |  Page : 497

Metastatic Crohn's disease


1 Clinical Management Unit of Heart Department, Virgen de la Victoria University Hospital, Institute of Biomedical Research of Málaga (IBIMA), Cardiovascular Research Network (RIC), University of Málaga, Málaga, Spain
2 Department of Dermatology, Regional University Hospital of Málaga, Málaga, Spain

Date of Web Publication10-Nov-2015

Correspondence Address:
Pérez-Belmonte Luis Miguel
Clinical Management Unit of Heart Department, Virgen de la Victoria University Hospital, Institute of Biomedical Research of Málaga (IBIMA), Cardiovascular Research Network (RIC), University of Málaga, Málaga
Spain
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-5916.169229

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How to cite this article:
Miguel PBL, Elisabeth GM. Metastatic Crohn's disease. Indian J Med Res 2015;142:497

How to cite this URL:
Miguel PBL, Elisabeth GM. Metastatic Crohn's disease. Indian J Med Res [serial online] 2015 [cited 2019 Aug 22];142:497. Available from: http://www.ijmr.org.in/text.asp?2015/142/4/497/169229

A 51 year old man presented to the department of Dermatology, Regional University Hospital of Mαlaga, Mαlaga, Spain, in May 2013, with remarkable lesions on the perineal, perianal and gluteal regions reaching the top of the lower limbs, which he had first noted two years earlier. The physical examination revealed large erythematous-brownish plaques with a granulomatous appearance, polypoid lesions and areas of ulceration [Figure 1]. For the past five years, he had been treated for perianal fistulizing Crohn's disease with infliximab, though the patient admitted poor adherence. Skin biopsy demonstrated the presence of non-caseating granulomas in the dermis [Figure 2] and did not show picture suggestive of cutaneous tuberculosis (pseudoepitheliomatous hyperplasia or neutrophilic microabcesses in the epidermis). In addition, Mycobacterium tuberculosis culture and serum QuantiFERON® TB Gold were negative. The patient was diagnosed to have metastatic Crohn's disease which is an uncommon complication of Crohn's disease. He was treated unsuccessfully, with different therapies (metronidazole, topical and oral tacrolimus and infliximab plus methotrexate) due to the poor treatment adherence of the patient.
Figure 1. Large and erythematous-brownish plaques with a granulomatous appearance on the perineal, perianal and gluteal regions reaching the top of the lower limbs (arrows)

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Figure. 2. Histological study (hematoxilin and eosin stain) showed the presence of non-caseating granulomas in the dermis (arrow)

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    Figures

  [Figure 1], [Figure 2]



 

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