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Crohn disease - Anogenital in
See also in: Overview,Oral Mucosal Lesion
Other Resources UpToDate PubMed

Crohn disease - Anogenital in

See also in: Overview,Oral Mucosal Lesion
Contributors: Michael W. Winter MD, Craig N. Burkhart MD, Dean Morrell MD, Lowell A. Goldsmith MD, MPH
Other Resources UpToDate PubMed

Synopsis

Crohn disease is a disease of chronic inflammation in the gastrointestinal tract that can involve anywhere from the mouth to the anus. It is characterized by transmural inflammation and often noncaseating granulomas. The etiology is unclear, but it is likely triggered by a combination of genetic and environmental factors, with mucosal injury caused in part by immune activation against healthy intestinal microbiota.

Crohn disease may involve the skin of the groin in 2% of cases, either primarily or secondarily.

Symptoms from Crohn disease can vary considerably, both due to location but also to the severity of disease involvement. Patients may present with abdominal pain, bloody or nonbloody diarrhea, weight loss or malnutrition, fistulas, abscesses (often perianal), dysphagia, or oral ulcerations. Additionally, Crohn disease has many extraintestinal manifestations that can at times be the presenting symptoms. These manifestations can involve joints, skin, eyes, vasculature, the lungs, or the kidneys.

Chronic inflammation from Crohn disease can lead to fistula and stricture formation, which predispose to small and large bowel obstructions, infections secondary to fistula tracts, and malnutrition as a result of long-standing intestinal inflammation. These complications result in much of the morbidity from Crohn disease, highlighting the importance of achieving and sustaining deep remission as a primary goal of treatment.  

Crohn disease presents most typically in the second to fourth decades of life, with a slight female predominance. While no clear genetic mutation is linked to the development of Crohn disease, there are many genetic mutations that are associated with Crohn disease. For unclear reasons, Crohn disease is more prevalent at higher latitudes and in certain patient populations, namely individuals of Ashkenazi Jewish descent and individuals of Northern European descent in the United States.

Crohn disease is a chronic disease with many pharmacologic options that can be used depending on the severity of symptoms and on radiographic and endoscopic findings. Many patients are able to achieve remission, although the disease is progressive in nature and characterized by disease flares.

Codes

ICD10CM:
K50.918 – Crohn's disease, unspecified, with other complication

SNOMEDCT:
34000006 – Crohn's disease

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Aphthous stomatitis
  • Cutaneous amebiasis
  • Behçet syndrome
  • Ulcerative colitis
  • Actinomycosis
  • Pyoderma gangrenosum
  • Tuberculous enteritis
  • Granuloma inguinale
  • Melkersson-Rosenthal syndrome
  • Child sexual abuse
  • Hidradenitis suppurativa

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed:12/18/2016
Last Updated:09/26/2017
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Crohn disease - Anogenital in
See also in: Overview,Oral Mucosal Lesion
A medical illustration showing key findings of Crohn disease : Abdominal pain, Diarrhea, Fatigue, Oral ulcers, Abdominal cramp, Abdominal distension, Abdominal mass
Clinical image of Crohn disease - imageId=248831. Click to open in gallery.  caption: 'Scarring and tunnels on the inner, upper thigh and labium majus (hidradenitis suppurativa in a patient with Crohn disease).'
Scarring and tunnels on the inner, upper thigh and labium majus (hidradenitis suppurativa in a patient with Crohn disease).
Copyright © 2024 VisualDx®. All rights reserved.