Response of cutaneous Crohn's disease to infliximab and methotrexate.
Cutaneous or metastatic Crohn's disease is a rare complication of Crohn's disease and is frequently refractory to medical treatment. A case of metastatic Crohn's disease affecting first the abdominal wall and subsequently both submammary folds is reported. These extraintestinal manifestations occurred many years after proctocolectomy. The activity of cutaneous disease was associated with a chronic active fistulizing disease. Skin manifestations were resistant to treatment with steroids, antibiotics and azathioprine. Repetitive treatment with infliximab led to significant improvement of both cutaneous and fistulous disease. However, disease relapsed and even progressed after a period of 6 weeks following each infliximab treatment. Only the introduction of methotrexate, together with repetitive administration of infliximab, allowed maintenance of the patient in remission.
Konrad
A
A
Division of Gastroenterology, Inselspital, University Hospital of Berne, Freiburgstrasse, CH 3010 Bern, Switzerland.
Seibold
F
F
D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D003424:Crohn Disease / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D017577:Cutaneous Fistula / Q000209:etiology; D003879:Dermatologic Agents / Q000627:therapeutic use*; D018450:Disease Progression; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D000069285:Infliximab; D008727:Methotrexate / Q000627:therapeutic use*; D012008:Recurrence; D012871:Skin Diseases / Q000473:pathology*
D000911:Antibodies, Monoclonal; D003879:Dermatologic Agents; D000069285:Infliximab; D008727:Methotrexate