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Refractory oral manifestations of Crohn's disease
1Aix-Marseille University, APHM, CHU Timone Hospital, Oral Surgery Department, Marseille, France.
Introduction:
Persistent oral manifestations of Crohn's disease (CD), despite intestinal remission, remain a therapeutic challenge. This study aimed to describe two such cases and review available literature on management strategies.
Case Reports:
Despite infliximab and methotrexate, the first patient developed progressive oral lesions with only partial improvement under upadacitinib. The second achieved digestive remission under golimumab and successfully controlled oral lesions with intralesional corticosteroids.
Discussion:
A literature review (Pubmed, ScienceDirect; up to January 2025) identified 17 articles involving 75 patients. Oral lesions appeared independently (54 %), concomitantly with digestive disease (20 %), or preceded it (26 %). Therapeutic responses were variable, with limited efficacy of anti-TNF antibodies, immunosuppressants, and corticosteroids. Anti-IL12/23 antibodies showed promising results in isolated cases, while data on anti-IL-23 antibodies and JAK inhibitors remain lacking.
Conclusion:
Due to the absence of standardized therapeutic protocols, a personalized, multidisciplinary approach is essential. Further studies are needed to better define effective treatments.
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