Crohn's Disease is a chronic, incurable disease where the immune system attacks the body's digestive tract, causing stomach pain, diarrhoea, bleeding, weight loss, fatigue and other problems. Crohn's Disease is known as a systemic disease, meaning that the disease processes can affect areas of the body outside of the digestive tract, and there are several ways in which Crohn's Disease affects the skin.
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Erythema nodosum is a Latin/medical term meaning, literally, "red bumps" or "red nodules." These painful little red bumps are commonly known to appear on the arms and legs (usually the shin and ankle regions) of people with Crohn's Disease. They generally only emerge during flare-ups in disease activity and are more common among women than men.
Pyoderma gangrenosum are painful, pus-filled sores or ulcerations that form on the legs (again mostly the shin and ankle areas) and arms of Crohn's Disease patients. They can start as small blisters, but they can eventually cluster together causing larger ulcerous sores. Like erythema nodosum, their appearance usually coincides with disease activity. Pyoderma gangrenosum are treated with antibiotics, topical medications and some medications must be injected directly into the ulcer.
Enterocutaneous fistulas are small channels or tunnels that form due to the ongoing inflammation in the digestive tract and then create a connection between loops of bowel and the skin, usually in the rectal area. Because they usually come from the bowel, enterocutaneous fistulas can cause stool and bacteria to leak into the body, or outside as well, when the fistulas open out from the skin. Treatments include antibiotics, some surgical procedures and the new biologic drugs show much promise here as well.
Skin tags are a less severe manifestation of Crohn's Disease on the skin. Most commonly, these small, extra-thickened flaps of skin (callous-like) form around inflamed areas of the anus, especially haemorrhoids. Good hygiene and skincare usually avoid complications to the skin tags and surgery is usually seen as too risky for a rather benign problem.
Anal fissures are essentially tears in the skin around the anus from frequent diarrhoea and wiping. They can be extremely painful, but many rectal creams include both antibiotics to prevent infection and a pain-relieving agent as well, in addition to soothing skin conditioners.
Aphthous stomatitis are more commonly known as canker sores. But in people with Crohn's Disease these are caused by the immune system attacking the skin, whereas they are otherwise caused by viral or bacterial infections. There is no way to prevent their formation around the mouth, lips and gums and even down into the throat. Treatment may include antibiotic rinses and pain-relieving mouthwashes.
Because Crohn's Disease can leave its sufferers severely malnourished, many other skin conditions, usually stemming from vitamin and mineral deficiencies, can develop. The above conditions are the most frequently seen skin problems in Crohn's Disease.
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