Disease-related and drug-induced skin manifestations in inflammatory bowel disease

Expert Rev Gastroenterol Hepatol. 2017 Mar;11(3):203-214. doi: 10.1080/17474124.2017.1283985. Epub 2017 Feb 1.

Abstract

Skin manifestations are common in patients with inflammatory bowel diseases (IBD) and can be part of a concomitant illness with a shared genetic background, an extra-intestinal manifestation of the disease, or a drug side-effect. Areas covered: We provide a practical overview of the epidemiology, pathogenesis, diagnosis, therapeutic approach and prognosis of the most frequent disease-related and drug-induced cutaneous manifestations in IBD, illustrated by cases encountered in our clinical practice. Among the most frequently encountered IBD-related lesions are erythema nodosum, pyoderma gangrenosum and Sweet's syndrome. Common skin manifestations with a strong association to TNF antagonists are local injection site reactions, psoriasiform lesions, cutaneous infections, vasculitides and lupus-like syndromes. In addition, we discuss the relation of thiopurines and TNF antagonists with the risk of skin cancer. Expert commentary: We hope this review will help caretakers involved in the management of IBD patients to recognize the lesions and to manage them in close collaboration with a dedicated dermatologist.

Keywords: Skin lesions; cutaneous; drug-induced; extra-intestinal; inflammatory bowel disease.

Publication types

  • Review

MeSH terms

  • Adult
  • Anti-Inflammatory Agents / adverse effects*
  • Drug Eruptions / diagnosis
  • Drug Eruptions / epidemiology*
  • Drug Eruptions / therapy
  • Erythema Nodosum / diagnosis
  • Erythema Nodosum / epidemiology*
  • Erythema Nodosum / therapy
  • Female
  • Gastrointestinal Agents / adverse effects*
  • Humans
  • Incidence
  • Inflammatory Bowel Diseases / diagnosis
  • Inflammatory Bowel Diseases / drug therapy*
  • Inflammatory Bowel Diseases / epidemiology
  • Male
  • Middle Aged
  • Pyoderma Gangrenosum / diagnosis
  • Pyoderma Gangrenosum / epidemiology*
  • Pyoderma Gangrenosum / therapy
  • Risk Factors
  • Skin / drug effects*
  • Skin / pathology
  • Skin Neoplasms / chemically induced
  • Skin Neoplasms / diagnosis
  • Skin Neoplasms / epidemiology*
  • Skin Neoplasms / therapy
  • Sweet Syndrome / diagnosis
  • Sweet Syndrome / epidemiology*
  • Sweet Syndrome / therapy
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents
  • Gastrointestinal Agents