Cutaneous Manifestations Associated with Non-Neoplastic Bowel Diseases
Main Article Content
Abstract
There are several non-neoplastic bowel diseases, which include inflammatory bowel disease and celiac disease, both of which have been shown to have associated extraintestinal manifestations many of which are cutaneous. The implications of dermatologic manifestations are vast, as earlier identification can spur expedited testing and diagnosis of associated gastrointestinal disease as well as being a marker for gastrointestinal flare ups. It has been estimated that approximately 25.8% of cases of extra-intestinal manifestations precede the diagnosis of inflammatory bowel disease. This is especially useful as skin diseases may be the first easily recognizable feature of an underlying gastrointestinal condition. In the case of inflammatory bowel disease, lack of timely intervention either medically or surgically can lead to progression and worsening of symptoms, which if left untreated could lead to chronic and severe disease as well as malignancy. Similarly, in celiac disease, earlier diagnosis and treatment/ lifestyle modifications can not only improve the quality of life, but also decrease risks of long-term complications of other systemic extra-intestinal manifestations including neuropathies, infertility, osteoporosis, and malignancy.
In this report, inflammatory bowel disease and celiac disease will be investigated through the review of literature, and identification of illustrative cases from pathology files, to elucidate the extraintestinal manifestations focusing on cutaneous manifestations.
Keywords:
Cutaneous Extraintestinal Manifestations, Celiac Disease, Crohn’s Disease, Ulcerative Colitis, Dermatitis Herpetiformis
Article Details
How to Cite
VIGNAU, Alexia; MILIKOWSKI, Clara.
Cutaneous Manifestations Associated with Non-Neoplastic Bowel Diseases.
Medical Research Archives, [S.l.], v. 12, n. 10, oct. 2024.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/5869>. Date accessed: 15 nov. 2024.
doi: https://doi.org/10.18103/mra.v12i10.5869.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
1. Greuter T, Vavricka SR. Extraintestinal manifestations in inflammatory bowel disease - epidemiology, genetics, and pathogenesis. Expert Rev Gastroenterol Hepatol. Apr 2019;13(4):307-317. doi:10.1080/17474124.2019.1574569
2. Greuter T, Navarini A, Vavricka SR. Skin Manifestations of Inflammatory Bowel Disease. Clin Rev Allergy Immunol. Dec 2017;53(3):413-427. doi:10.1007/s12016-017-8617-4
3. Guillo L, D'Amico F, Serrero M, et al. Assessment of extraintestinal manifestations in inflammatory bowel diseases: A systematic review and a proposed guide for clinical trials. United European Gastroenterol J. Nov 2020;8(9):1013-1030. doi:10.1177/2050640620950093
4. Roth N, Biedermann L, Fournier N, et al. Occurrence of skin manifestations in patients of the Swiss Inflammatory Bowel Disease Cohort Study. PLoS One. 2019;14(1):e0210436. doi:10.1371/journal.pone.0210436
5. Alvarez-Payares JC, Ramírez-Urrea S, Correa-Parra L, Salazar-Uribe D, Velásquez-López M. Mucocutaneous Manifestations of Inflammatory Bowel Disease. Cureus. Aug 2021;13(8):e17191. doi:10.7759/cureus.17191
6. Rodrigo L, Beteta-Gorriti V, Alvarez N, et al. Cutaneous and Mucosal Manifestations Associated with Celiac Disease. Nutrients. Jun 21 2018;10(7)doi:10.3390/nu10070800
7. Guan Q. A Comprehensive Review and Update on the Pathogenesis of Inflammatory Bowel Disease. J Immunol Res. 2019;2019:7247238. doi:10.1155/2019/7247238
8. Torres J, Mehandru S, Colombel JF, Peyrin-Biroulet L. Crohn's disease. Lancet. Apr 29 2017;389(10080):1741-1755. doi:10.1016/s0140-6736(16)31711-1
9. Feuerstein JD, Cheifetz AS. Crohn Disease: Epidemiology, Diagnosis, and Management. Mayo Clin Proc. Jul 2017;92(7):1088-1103. doi:10.1016/j.mayocp.2017.04.010
10. Du L, Ha C. Epidemiology and Pathogenesis of Ulcerative Colitis. Gastroenterol Clin North Am. Dec 2020;49(4):643-654. doi:10.1016/j.gtc.2020.07.005
11. Ordás I, Eckmann L, Talamini M, Baumgart DC, Sandborn WJ. Ulcerative colitis. Lancet. Nov 3 2012;380(9853):1606-19. doi:10.1016/s0140-6736(12)60150-0
12. Mak WY, Zhao M, Ng SC, Burisch J. The epidemiology of inflammatory bowel disease: East meets west. J Gastroenterol Hepatol. Mar 2020;35(3):380-389. doi:10.1111/jgh.14872
13. Peppercorn MA, Kane SV. Clinical manifestations, diagnosis, and prognosis of crohn disease in adults. Accessed Jan, 2024. https://www.uptodate.com/contents/clinical-manifestations-diagnosis-and-prognosis-of-crohn-disease-in-adults
14. Peppercorn MA, Kane SV. Clinical manifestations, diagnosis, and prognosis of ulcerative colitis in adults. UpToDate. https://www.uptodate.com/contents/clinical-manifestations-diagnosis-and-prognosis-of-ulcerative-colitis-in-adults?search=peppercorn%202022%20ulcerative%20colitis&source=search_result&selectedTitle=5%7E150&usage_type=default&display_rank=5
15. Peppercorn MA, Cheifetz AS. Dermatologic and ocular manifestations of inflammatory bowel disease. Accessed Jan, 2023. https://www.uptodate.com/contents/dermatologic-and-ocular-manifestations-of-inflammatory-bowel-disease#!
16. Leung AKC, Leong KF, Lam JM. Erythema nodosum. World J Pediatr. Dec 2018;14(6):548-554. doi:10.1007/s12519-018-0191-1
17. Pérez-Garza DM, Chavez-Alvarez S, Ocampo-Candiani J, Gomez-Flores M. Erythema Nodosum: A Practical Approach and Diagnostic Algorithm. Am J Clin Dermatol. May 2021;22(3):367-378. doi:10.1007/s40257-021-00592-w
18. George C, Deroide F, Rustin M. Pyoderma gangrenosum - a guide to diagnosis and management Clin Med (Lond). May 2019;19(3):224-228. doi:10.7861/clinmedicine.19-3-224
19. Maverakis E, Marzano AV, Le ST, et al. Pyoderma gangrenosum. Nat Rev Dis Primers. Oct 8 2020;6(1):81. doi:10.1038/s41572-020-0213-x
20. Cohen PR. Sweet's syndrome--a comprehensive review of an acute febrile neutrophilic dermatosis. Orphanet J Rare Dis. Jul 26 2007;2:34. doi:10.1186/1750-1172-2-34
21. Lima CDS, Pinto RDB, Góes HFO, Salles SAN, Vilar EAG, Lima CDS. Sweet's syndrome associated with Crohn's disease. An Bras Dermatol. Mar-Apr 2017;92(2):263-265. doi:10.1590/abd1806-4841.20175298
22. Slebioda Z, Szponar E, Kowalska A. Etiopathogenesis of recurrent aphthous stomatitis and the role of immunologic aspects: literature review. Arch Immunol Ther Exp (Warsz). Jun 2014;62(3):205-15. doi:10.1007/s00005-013-0261-y
23. Akintoye SO, Greenberg MS. Recurrent aphthous stomatitis. Dent Clin North Am. Apr 2014;58(2):281-97. doi:10.1016/j.cden.2013.12.002
24. Cui RZ, Bruce AJ, Rogers RS, 3rd. Recurrent aphthous stomatitis. Clin Dermatol. Jul-Aug 2016;34(4):475-81. doi:10.1016/j.clindermatol.2016.02.020
25. Cottone M, Sapienza C, Macaluso FS, Cannizzaro M. Psoriasis and Inflammatory Bowel Disease. Dig Dis. 2019;37(6):451-457. doi:10.1159/000500116
26. Murphy M, Kerr P, Grant-Kels JM. The histopathologic spectrum of psoriasis. Clin Dermatol. Nov-Dec 2007;25(6):524-8. doi:10.1016/j.clindermatol.2007.08.005
27. Kimmel JN, Taft TH, Keefer L. Inflammatory Bowel Disease and Skin Cancer: An Assessment of Patient Risk Factors, Knowledge, and Skin Practices. J Skin Cancer. 2016;2016:4632037. doi:10.1155/2016/4632037
28. Cushing KC, Du X, Chen Y, et al. Inflammatory Bowel Disease Risk Variants Are Associated with an Increased Risk of Skin Cancer. Inflamm Bowel Dis. Nov 2 2022;28(11):1667-1676. doi:10.1093/ibd/izab336
29. Dev K, Rahul F, Makheja K, et al. Frequency of Cutaneous Disorders in Patients With Celiac Disease. Cureus. Sep 2021;13(9):e18148. doi:10.7759/cureus.18148
30. Rodrigo L, Beteta-Gorriti V, Alvarez N, et al. Cutaneous and Mucosal Manifestations Associated with Celiac Disease. Nutrients. Jun 21 2018;10(7)doi:10.3390/nu10070800
31. Abenavoli L, Dastoli S, Bennardo L, et al. The Skin in Celiac Disease Patients: The Other Side of the Coin. Medicina (Kaunas). Sep 9 2019;55(9)doi:10.3390/medicina55090578
32. Thrash B, Patel M, Shah KR, Boland CR, Menter A. Cutaneous manifestations of gastrointestinal disease: part II. J Am Acad Dermatol. Feb 2013;68(2):211 e1-33; quiz 244-6. doi:10.1016/j.jaad.2012.10.036
33. Hull C, Zone J, Ofori A. Dermatitis Herpetiformis. UpToDate. 2024. https://www.uptodate.com/contents/dermatitis-herpetiformis?search=hull%20dermatitis%20herpetiformis&source=search_result&selectedTitle=1~42&usage_type=default&display_rank=1
34. Rose C, Brocker EB, Zillikens D. Clinical, histological and immunpathological findings in 32 patients with dermatitis herpetiformis Duhring. J Dtsch Dermatol Ges. Apr 2010;8(4):265-70, 265-71. doi:10.1111/j.1610-0387.2009.07292.x
35. Garcia C, Araya M. [Dermatitis herpetiformis and celiac disease]. Rev Med Chil. Sep 2021;149(9):1330-1338. Dermatitis herpetiforme y enfermedad celiaca. Del intestino a la piel. doi:10.4067/S0034-98872021000901330
36. Thrash B, Patel M, Shah KR, Boland CR, Menter A. Cutaneous manifestations of gastrointestinal disease: part II. J Am Acad Dermatol. Feb 2013;68(2):211.e1-33; quiz 244-6. doi:10.1016/j.jaad.2012.10.036
37. Mihai IR, Burlui AM, Rezus, II, et al. Inflammatory Bowel Disease as a Paradoxical Reaction to Anti-TNF-α Treatment-A Review. Life (Basel). Aug 20 2023;13(8)doi:10.3390/life13081779
38. Passarini B, Infusino SD, Barbieri E, et al. Cutaneous manifestations in inflammatory bowel diseases: eight cases of psoriasis induced by anti-tumor-necrosis-factor antibody therapy. Dermatology. 2007;215(4):295-300. doi:10.1159/000107622
39. Peer FC, Miller A, Pavli P, Subramaniam K. Paradoxical psoriasiform reactions of anti-tumour necrosis factor therapy in inflammatory bowel disease patients. Intern Med J. Dec 2017;47(12):1445-1448. doi:10.1111/imj.13637
2. Greuter T, Navarini A, Vavricka SR. Skin Manifestations of Inflammatory Bowel Disease. Clin Rev Allergy Immunol. Dec 2017;53(3):413-427. doi:10.1007/s12016-017-8617-4
3. Guillo L, D'Amico F, Serrero M, et al. Assessment of extraintestinal manifestations in inflammatory bowel diseases: A systematic review and a proposed guide for clinical trials. United European Gastroenterol J. Nov 2020;8(9):1013-1030. doi:10.1177/2050640620950093
4. Roth N, Biedermann L, Fournier N, et al. Occurrence of skin manifestations in patients of the Swiss Inflammatory Bowel Disease Cohort Study. PLoS One. 2019;14(1):e0210436. doi:10.1371/journal.pone.0210436
5. Alvarez-Payares JC, Ramírez-Urrea S, Correa-Parra L, Salazar-Uribe D, Velásquez-López M. Mucocutaneous Manifestations of Inflammatory Bowel Disease. Cureus. Aug 2021;13(8):e17191. doi:10.7759/cureus.17191
6. Rodrigo L, Beteta-Gorriti V, Alvarez N, et al. Cutaneous and Mucosal Manifestations Associated with Celiac Disease. Nutrients. Jun 21 2018;10(7)doi:10.3390/nu10070800
7. Guan Q. A Comprehensive Review and Update on the Pathogenesis of Inflammatory Bowel Disease. J Immunol Res. 2019;2019:7247238. doi:10.1155/2019/7247238
8. Torres J, Mehandru S, Colombel JF, Peyrin-Biroulet L. Crohn's disease. Lancet. Apr 29 2017;389(10080):1741-1755. doi:10.1016/s0140-6736(16)31711-1
9. Feuerstein JD, Cheifetz AS. Crohn Disease: Epidemiology, Diagnosis, and Management. Mayo Clin Proc. Jul 2017;92(7):1088-1103. doi:10.1016/j.mayocp.2017.04.010
10. Du L, Ha C. Epidemiology and Pathogenesis of Ulcerative Colitis. Gastroenterol Clin North Am. Dec 2020;49(4):643-654. doi:10.1016/j.gtc.2020.07.005
11. Ordás I, Eckmann L, Talamini M, Baumgart DC, Sandborn WJ. Ulcerative colitis. Lancet. Nov 3 2012;380(9853):1606-19. doi:10.1016/s0140-6736(12)60150-0
12. Mak WY, Zhao M, Ng SC, Burisch J. The epidemiology of inflammatory bowel disease: East meets west. J Gastroenterol Hepatol. Mar 2020;35(3):380-389. doi:10.1111/jgh.14872
13. Peppercorn MA, Kane SV. Clinical manifestations, diagnosis, and prognosis of crohn disease in adults. Accessed Jan, 2024. https://www.uptodate.com/contents/clinical-manifestations-diagnosis-and-prognosis-of-crohn-disease-in-adults
14. Peppercorn MA, Kane SV. Clinical manifestations, diagnosis, and prognosis of ulcerative colitis in adults. UpToDate. https://www.uptodate.com/contents/clinical-manifestations-diagnosis-and-prognosis-of-ulcerative-colitis-in-adults?search=peppercorn%202022%20ulcerative%20colitis&source=search_result&selectedTitle=5%7E150&usage_type=default&display_rank=5
15. Peppercorn MA, Cheifetz AS. Dermatologic and ocular manifestations of inflammatory bowel disease. Accessed Jan, 2023. https://www.uptodate.com/contents/dermatologic-and-ocular-manifestations-of-inflammatory-bowel-disease#!
16. Leung AKC, Leong KF, Lam JM. Erythema nodosum. World J Pediatr. Dec 2018;14(6):548-554. doi:10.1007/s12519-018-0191-1
17. Pérez-Garza DM, Chavez-Alvarez S, Ocampo-Candiani J, Gomez-Flores M. Erythema Nodosum: A Practical Approach and Diagnostic Algorithm. Am J Clin Dermatol. May 2021;22(3):367-378. doi:10.1007/s40257-021-00592-w
18. George C, Deroide F, Rustin M. Pyoderma gangrenosum - a guide to diagnosis and management Clin Med (Lond). May 2019;19(3):224-228. doi:10.7861/clinmedicine.19-3-224
19. Maverakis E, Marzano AV, Le ST, et al. Pyoderma gangrenosum. Nat Rev Dis Primers. Oct 8 2020;6(1):81. doi:10.1038/s41572-020-0213-x
20. Cohen PR. Sweet's syndrome--a comprehensive review of an acute febrile neutrophilic dermatosis. Orphanet J Rare Dis. Jul 26 2007;2:34. doi:10.1186/1750-1172-2-34
21. Lima CDS, Pinto RDB, Góes HFO, Salles SAN, Vilar EAG, Lima CDS. Sweet's syndrome associated with Crohn's disease. An Bras Dermatol. Mar-Apr 2017;92(2):263-265. doi:10.1590/abd1806-4841.20175298
22. Slebioda Z, Szponar E, Kowalska A. Etiopathogenesis of recurrent aphthous stomatitis and the role of immunologic aspects: literature review. Arch Immunol Ther Exp (Warsz). Jun 2014;62(3):205-15. doi:10.1007/s00005-013-0261-y
23. Akintoye SO, Greenberg MS. Recurrent aphthous stomatitis. Dent Clin North Am. Apr 2014;58(2):281-97. doi:10.1016/j.cden.2013.12.002
24. Cui RZ, Bruce AJ, Rogers RS, 3rd. Recurrent aphthous stomatitis. Clin Dermatol. Jul-Aug 2016;34(4):475-81. doi:10.1016/j.clindermatol.2016.02.020
25. Cottone M, Sapienza C, Macaluso FS, Cannizzaro M. Psoriasis and Inflammatory Bowel Disease. Dig Dis. 2019;37(6):451-457. doi:10.1159/000500116
26. Murphy M, Kerr P, Grant-Kels JM. The histopathologic spectrum of psoriasis. Clin Dermatol. Nov-Dec 2007;25(6):524-8. doi:10.1016/j.clindermatol.2007.08.005
27. Kimmel JN, Taft TH, Keefer L. Inflammatory Bowel Disease and Skin Cancer: An Assessment of Patient Risk Factors, Knowledge, and Skin Practices. J Skin Cancer. 2016;2016:4632037. doi:10.1155/2016/4632037
28. Cushing KC, Du X, Chen Y, et al. Inflammatory Bowel Disease Risk Variants Are Associated with an Increased Risk of Skin Cancer. Inflamm Bowel Dis. Nov 2 2022;28(11):1667-1676. doi:10.1093/ibd/izab336
29. Dev K, Rahul F, Makheja K, et al. Frequency of Cutaneous Disorders in Patients With Celiac Disease. Cureus. Sep 2021;13(9):e18148. doi:10.7759/cureus.18148
30. Rodrigo L, Beteta-Gorriti V, Alvarez N, et al. Cutaneous and Mucosal Manifestations Associated with Celiac Disease. Nutrients. Jun 21 2018;10(7)doi:10.3390/nu10070800
31. Abenavoli L, Dastoli S, Bennardo L, et al. The Skin in Celiac Disease Patients: The Other Side of the Coin. Medicina (Kaunas). Sep 9 2019;55(9)doi:10.3390/medicina55090578
32. Thrash B, Patel M, Shah KR, Boland CR, Menter A. Cutaneous manifestations of gastrointestinal disease: part II. J Am Acad Dermatol. Feb 2013;68(2):211 e1-33; quiz 244-6. doi:10.1016/j.jaad.2012.10.036
33. Hull C, Zone J, Ofori A. Dermatitis Herpetiformis. UpToDate. 2024. https://www.uptodate.com/contents/dermatitis-herpetiformis?search=hull%20dermatitis%20herpetiformis&source=search_result&selectedTitle=1~42&usage_type=default&display_rank=1
34. Rose C, Brocker EB, Zillikens D. Clinical, histological and immunpathological findings in 32 patients with dermatitis herpetiformis Duhring. J Dtsch Dermatol Ges. Apr 2010;8(4):265-70, 265-71. doi:10.1111/j.1610-0387.2009.07292.x
35. Garcia C, Araya M. [Dermatitis herpetiformis and celiac disease]. Rev Med Chil. Sep 2021;149(9):1330-1338. Dermatitis herpetiforme y enfermedad celiaca. Del intestino a la piel. doi:10.4067/S0034-98872021000901330
36. Thrash B, Patel M, Shah KR, Boland CR, Menter A. Cutaneous manifestations of gastrointestinal disease: part II. J Am Acad Dermatol. Feb 2013;68(2):211.e1-33; quiz 244-6. doi:10.1016/j.jaad.2012.10.036
37. Mihai IR, Burlui AM, Rezus, II, et al. Inflammatory Bowel Disease as a Paradoxical Reaction to Anti-TNF-α Treatment-A Review. Life (Basel). Aug 20 2023;13(8)doi:10.3390/life13081779
38. Passarini B, Infusino SD, Barbieri E, et al. Cutaneous manifestations in inflammatory bowel diseases: eight cases of psoriasis induced by anti-tumor-necrosis-factor antibody therapy. Dermatology. 2007;215(4):295-300. doi:10.1159/000107622
39. Peer FC, Miller A, Pavli P, Subramaniam K. Paradoxical psoriasiform reactions of anti-tumour necrosis factor therapy in inflammatory bowel disease patients. Intern Med J. Dec 2017;47(12):1445-1448. doi:10.1111/imj.13637