Cutaneous and ocular manifestations of IBD

Cutaneous and ocular manifestations of IBD (EN)

Karamanolis, G.P.

Cutaneous and ocular manifestations reflect the systemic nature of the inflammation seen in inflammatory bowel disease (IBD). These manifestations occur more commonly in association with active IBD. Thus, they may respond to therapy for bowel disease, but may require this at an intensity out of proportion to that needed for the bowel. Corticosteroids are considered to be the first line treatment, whereas in cases refractory to steroids or with, the presence of sideeffects, immunosuppressive drugs offer an alternative option. Recently, anti-TNF has been proposed as an effective treatment for extraintestinal manifestations of IBD refractory to conventional therapies, especially for pyoderma gangrenosum. However, the optimal form of treatment of extraintestinal manifestations has yet to be established. Cutaneous and ocular manifestations are well recognized complications of inflammatory bowel disease (IBD) and reflect the systemic nature of the inflammation seen in these conditions (1). Although the reported prevalence of these complications in IBD varies, it is well known that extra-intestinal manifestations occur preferiantally in patients with disease of the colon and they may rarely complicate disease confined to the small bowel. Cutaneous complications are reported in 6-15% of Crohn’s disease patients,1-3 and in 1-9% of ulcerative colitis (UC) patients,4 while acute ocular inflammation in up to 10% of Crohn’s and 5% of UC patients. 1-2 Both cutaneous and ocular complications are said to occur more commonly in association with active IBD, and often coexist with other extra-intestinal manifestations.5 Erythema nodosum (EN) is the most common form of cutaneous manifestations followed by pyoderma gangrenosum and Sweet’s syndrome. Ocular inflammation of IBD is predominantly anterior in contrast to other systemic inflammatory disorders; uveitis, iritis, episcleritis are the commonest forms of ocular complications in patients with IBD. (EN)

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Hellenic Society of Gastroenterology

Annals of Gastroenterology

Lecture

English

2007-04-05

http://www.annalsgastro.gr/index.php/annalsgastro/article/view/423

Hellenic Society of Gastroenterology (EN)

1792-7463

1108-7471

Annals of Gastroenterology; Volume 19, No 2 (2006) (EN)