Crohn disease - Anogenital in
See also in: Overview,Oral Mucosal LesionAlerts and Notices
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.
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.
Crohn disease may involve the vulva and groin in 22%-44% of cases, either primarily or secondarily. Granulomatous infiltration of genital skin may compress lymphatics, leading to lymphedema of the vulva. Linear ulceration or aphthae may be present. True fistulas may occur. Hidradenitis suppurativa may be associated.
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.
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.
Crohn disease may involve the vulva and groin in 22%-44% of cases, either primarily or secondarily. Granulomatous infiltration of genital skin may compress lymphatics, leading to lymphedema of the vulva. Linear ulceration or aphthae may be present. True fistulas may occur. Hidradenitis suppurativa may be associated.
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.
Codes
ICD10CM:
K50.918 – Crohn's disease, unspecified, with other complication
SNOMEDCT:
34000006 – Crohn's disease
K50.918 – Crohn's disease, unspecified, with other complication
SNOMEDCT:
34000006 – Crohn's disease
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Amebiasis
- Behçet disease
- Actinomycosis
- Pyoderma gangrenosum
- Cutaneous sarcoidosis
- Lymphogranuloma venereum
- Hidradenitis suppurativa – May present with firm or fluctuant, tender abscesses and cysts, often with extensive scars and sinus tracking under the surface of the skin. These sinus tracts may drain pus, which is often malodorous.
- Granuloma inguinale
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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:01/02/2019
Last Updated:10/27/2021
Last Updated:10/27/2021
Crohn disease - Anogenital in
See also in: Overview,Oral Mucosal Lesion