Cutaneous Crohn's disease and progressive vitiligo

A patient with Crohn's colitis rapidly developed violaceous papules and plaques on the thigh, breast, and back during an exacerbation of colitis. Biopsy specimens of lesional bowel and skin showed noncaseating granulomatous inflammation consistent with Crohn's disease. The rare occurrence of granulomatous skin lesions widely separated from the perirectal area, previously reported as metastatic Crohn's disease, is reviewed, and the additional finding of concomitant vitiligo with a possible linked pathogenesis is briefly discussed.