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Metastatic vulval Crohn's disease and infliximab: a case report
Sara M Tritton1, Liesel Whyte, Gayle Fischer
1Department of Dermatology, Level 11, Royal North Shore Hospital, St. Leonards, Sydney, New South Wales 2065, Australia. stritton@med.usyd.edu.au
Background:
Metastatic vulval Crohn's disease is uncommon, and diagnosis is frequently delayed. Topical therapy is often ineffective, and systemic immunosuppressive agents are required.
Case:
A 32-year-old Caucasian female with known gastrointestinal Crohn's disease presented with a 7-year history of vulvitis. Perianal biopsy demonstrated typical granulomas. Her disease was resistant to treatment with prednisone and azathioprine; however, infliximab effected good control, and she remains well on 8 weekly infusions 1 year later.
Conclusion:
Biopsy should be performed in patients with vulvitis who have Crohn's disease to rule out metastatic involvement. Infliximab was successfully used in this case to control Crohn's vulvitis.
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