Skin manifestations in inflammatory bowel disease.

Koldijk, M.J. (2014) Skin manifestations in inflammatory bowel disease. thesis, Medicine.

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Abstract

Background: The skin is one of the most commonly affected extraintestinal organ systems in patients with inflammatory bowel disease (IBD). Similar pathophysiological mechanisms regarding immunology are suggested to be responsible in both IBD and the skin disorders. Well-known cutaneous manifestations are erythema nodosum (EN), pyoderma gangrenosum (PG), psoriasis and metastatic Crohn’s disease. Possible association with IBD is also recently found in hidradenitis suppurativa (HS), a disabling chronic skin disease characterized by painful abscesses and sinus tracts. Perianal fibromas, better known as anal skin tags, seem to be associated with IBD as well. However, not enough research had been done yet to confirm these associations. Objective: To investigate the prevalences of different cutaneous manifestations in IBD patients in a large cohort, with perianal fibromas and HS as main focus. Furthermore, to define the association between HS and IBD and to identify the potential risk factors for HS. Methods: A questionnaire was sent to all 1,969 IBD patients from the University Medical Center Groningen (UMCG) in February 2014. Consequently, accurate validation regarding HS was performed. All acquired data were studied for patient characteristics and prevalences of the skin diseases. The association between IBD and HS was precisely described and risk factors for HS in IBD patients were investigated. Results: From all 1,260 patients who returned the questionnaire, 50.3% was suffering from Crohn’s disease (CD) and 49.7% was diagnosed with ulcerative colitis (UC). 10.6% of all subjects was affected with HS. Female gender demonstrated to be the best independent predictor for having HS (OR = 4.282), followed by CD as IBD type (OR = 2.761). Cigarette smoking, high BMI and younger age demonstrated to be independent predictors for HS as well (OR = 2.054, OR = 1.050, OR = 0.974 respectively). 21.5% of the IBD patients suffered from perianal fibromas, 14.1% from EN, 9.2% from PG, 6.8% from psoriasis and 3.1% was affected with metastatic CD. Conclusion: This large cohort study shows the association between IBD and HS and the important risk factors for this group of patients. Moreover, perianal fibromas and other skin manifestations are confirmed to appear frequently in IBD. More research is necessary to find genetic links and pathophysiological mechanisms regarding these cutaneous manifestations in IBD.

Item Type:	Thesis (Thesis)
Supervisor name:	Horváth, Dr. B. and Janse, Drs. I.C. and Dijkstra, Prof. Dr. G.
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:54
Last Modified:	25 Jun 2020 10:54
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1461

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