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Published on: February 14, 2021
Clinical experience and diagnostic algorithm of vulval Crohn's disease
Lotte Boxhoorn1, Tom J Stoof, Tim de Meij
1Departments of aGastroenterology and Hepatology bGynaecology cPediatric Gastroenterology, VU University Medical Center dDepartment of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam eDepartment of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen fDepartment of Gastroenterology and Hepatology, University Medical Center, Utrecht gDepartment of Gastroenterology, Geriatrics, Internal and Intensive Care Medicine, Zuyderland Medical Center, Heerlen-Sittard-Geleen, The Netherlands.
Vulval Crohn's disease (VCD) is rare. Diagnosis requires multidisciplinary approach. Combination therapy with immunosuppressants and TNF-α inhibitors offers sustained remission for VCD.
Area of Science:
- Gastroenterology
- Dermatology
- Immunology
Background:
- Vulval Crohn's disease (VCD) is a rare extraintestinal manifestation of Crohn's disease.
- Current literature lacks consensus on VCD diagnosis and management.
Purpose of the Study:
- To describe the diagnostic workup and therapeutic management of VCD.
- To evaluate treatment outcomes for VCD.
Main Methods:
- Retrospective, multicentre descriptive case series.
- Chart review of female patients diagnosed and treated with VCD.
- Data collection on symptoms, clinical course, histology, and treatment.
Main Results:
- Fifteen female patients with VCD included, median age 28.
- Common symptoms: vulval swelling (93%), pain (80%), erythema (73%).
- Histology showed granulomatous inflammation (78%). Topical therapy provided temporary relief; combination therapy (immunosuppressants + TNF-α inhibitors) achieved sustained remission in 33%.
Conclusions:
- VCD diagnosis is challenging, requiring a multidisciplinary approach.
- Histopathology is crucial for VCD diagnosis.
- Topical and systemic therapies, including immunosuppressants and TNF-α inhibitors, are recommended for VCD treatment.
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