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Cutaneous Crohn's disease in children
T Ploysangam1, J E Heubi, D Eisen
1Department of Dermatology, University of Cincinnati Medical Center, OH, USA.
Insights
Cutaneous Crohn's disease is rare in children, often presenting before gastrointestinal symptoms. Genital involvement is common in pediatric cases, frequently preceding diagnosis.
Area of Science:
- Pediatric Gastroenterology
- Dermatology
- Inflammatory Bowel Disease
Background:
- Cutaneous Crohn's disease (CCD) is infrequently observed in pediatric populations.
- This study addresses the rarity of CCD in children, contrasting it with adult prevalence.
Observation:
- Five pediatric cases of CCD were identified, with onset between 6-12 years.
- Manifestations included genital swelling and buttock abscesses.
- Most cases were diagnosed with skin lesions before gastrointestinal Crohn's disease was identified.
Findings:
- The study reviewed 80 CCD cases, with only 14 in children.
- Pediatric CCD cases showed a higher rate of genital involvement (two-thirds) compared to adults (half).
- A significant proportion of CCD cases (16/80) occurred without prior gastrointestinal diagnosis, predominantly with genital lesions (70%).
Implications:
- Pediatric CCD, though rare, can be an early indicator of Crohn's disease.
- Recognition of cutaneous signs is crucial for timely diagnosis in children.
- Genital manifestations are a key feature in pediatric CCD, often preceding GI diagnosis.
Background:
Although cutaneous Crohn's disease is well recognized in adults, in children it is extremely rare.
Objective:
Our purpose was to describe five children with cutaneous Crohn's disease and to review the literature.
Methods:
The medical records of five children with cutaneous Crohn's disease were retrospectively reviewed for clinical features and laboratory data. An extensive review of the literature was conducted.
Results:
Five children, one boy and four girls, 6 to 12 years of age at onset, had cutaneous manifestations of Crohn's disease. Three had genital swelling, and the other 2 had buttock abscesses. Most were seen before the diagnosis of gastrointestinal Crohn's disease was made. There have been 80 cases of cutaneous Crohn's disease described, including our series. Only 14 were in children. Two thirds of children with cutaneous Crohn's disease had genital involvement compared with about half of the adult cases. Sixteen of the 80 patients had cutaneous lesions without preceding gastrointestinal Crohn's disease. Of these, approximately 70% had genital lesions.
Conclusion:
Although Crohn's disease is common in children, cutaneous manifestations are rarely a presenting sign. However, when cutaneous Crohn's disease is present in children, it commonly precedes the gastrointestinal disease.