External ear dermatitis
in a Crohn’s disease patient

Konstantinos H. Katsanos^a, Georgios Gaitanis^b, Ioannis Bassoukas^b,
Epameinondas V. Tsianos^a

Medical School of Ioannina, Greece

^a1st Department of Internal Medicine & Hepato-Gastroenterology Unit, Medical School of Ioannina, Ioannina, Greece
(Konstantinos H. Katsanos, Epameinondas V. Tsianos); ^bDepartment of Dermatology, Medical School of Ioannina, Ioannina, Greece (Georgios Gaitanis, Ioannis Bassoukas)

Conflict of Interest: None

Correspondence to: Prof. Epameinondas V. Tsianos, MD, Ph.D, FEBG, AGAF, Professor of Internal Medicine, Department of Internal Medicine, Medical School, University of Ioannina,
Leoforos Panepistimiou, 45 110 Ioannina, tel: +30-26510-07501,
fax: +30-26510-07016, e-mail: etsianos@uoi.gr

Received 17 January 2011; accepted 9 February 2011

Inflammatory bowel disease often begins during adolescence, but may also affect younger children. Associated lesions of the skin or oral and/or perianal mucosa are not uncommon [1]. Especially Crohn’s disease may be associated with many different typical and atypical cutaneous manifestations [2]. Occasionally, cutaneous alterations may precede the onset of signs or symptoms in the gastrointestinal tract. Erythema nodosum and pyoderma gangrenosum are the most commonly associated skin lesions, but numerous others may be found. Although treating Crohn’s disease often leads to a remission of these skin lesions, additional therapy, varying from corticosteroid to anti-tumor necrosis factor agents, may be required [3]. A 19-year-old patient diagnosed two years ago with fistulizing Crohn’s disease presented with an erythematous plaque behind his right ear (Fig. 1). The plaque was accompanied by edema of the surrounding skin with signs of vasculitis. The patient recovered with topical corticosteroids the lesion healed and was left with a flat hypertrophic scar.

References

1. Paller AS. Cutaneous changes associated with inflammatory bowel disease. Pediatr Dermatol 1986;3:439-345.

2. Kontzi M, Reifenberger J, Homey B. Metastatic Crohn disease. Atypical manifestation. Hautarzt 2010;61:281-284.

3. Feliciani C, De Simone C, Amerio P. Dermatological signs during inflammatory bowel diseases. Eur Rev Med Pharmacol Sci 2009;13:15-21.