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Effectiveness of Infliximab in the Treatment of Refractory Perineal Cutaneous Crohn Disease
Adam S. Geyer, AB;
Grant J. Anhalt, MD;
Hossein C. Nousari, MD
Arch Dermatol. 2000;136:459-460.
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REPORT OF A CASE
A 47-year-old woman presented with a 19-year history of Crohn disease, complicated by ileocolitis, fistulous tract formation, and multiple cutaneous manifestations, including nonfistulous erosions, ulcerations, and nodules involving her perineum and inner thighs. Her clinical course included several surgical reconstructive procedures, azathioprine therapy (100-300 mg/d orally for over 5 years), and long-term courses of intravenous methylprednisolone and oral prednisone (up to 100 mg/d), ciprofloxacin, and metronidazole. All of these therapeutic interventions failed to achieve complete and prolonged remission of her intestinal and cutaneous disease.
Her ileocolitis had been severe throughout her disease course. Fistulas, both enterocutaneous and enterovaginal, had been recurrent, slow to heal, and characterized by profuse yellow fibrinous drainage. Nonfistulous cutaneous manifestations began to emerge as a prominent feature after approximately 10 years of active Crohn disease. Initial complaints of persistent nonhealing erosions and ulcerations in . . . [Full Text of this Article]
DIAGNOSTIC CHALLENGE
COMMENT
From the Division of Dermatoimmunology, Department of Dermatology, Johns Hopkins Medical Institutions, Baltimore, Md.
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