title: Perianal Crohn disease.
abstract: Crohn disease is a chronic inflammatory disease characterized by sharply demarcated segments of gastrointestinal involvement from mouth to anus. Its perineal manifestations are among the most devastating and mutilating complications. They occur at any time and may precede the intestinal manifestations. Their most common presentations are perineal ulceration, fistula, and abscess. Proliferative and polypoid morphology of the cutaneous lesions mimicking warts and condyloma are rarely described. We report a 25-year-old woman with a 4-month history of confluent plaques of the perineal region with vegetant surfaces, suspected to be genital warts. The lesions progressed to fistulas, inducing deep ulcerations surrounded by pseudocondylomatous tumors. About 2 months prior to presentation she began to suffer from gastrointestinal symptoms and noted weight loss. Physical examination, endoscopic examination, and pathological interpretation led to the diagnosis of Crohn disease with perineal involvement being the initial presenting sign. Significant improvement was induced with prednisone (45 mg daily) and azathioprine. Our observation is notable for the pseudocondylomatous appearance and the dramatic response to medical treatment despite severe involvement.
authors: Department of dermatology, Military Hospital of Tunis, Tunisia. asma_sidh@yahoo.fr
authors: Sioud Dhrif
authors: SD
authors: Asma
authors: Youssef
authors: Y
authors: Soumaya
authors: Jaber
authors: J
authors: Kahena
authors: Dhaoui Mohamed
authors: DM
authors: Raouf
authors: Doss
authors: D
authors: Nejib
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001379:Azathioprine / Q000627:therapeutic use; D002439:Cefotaxime / Q000627:therapeutic use; D003424:Crohn Disease / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008795:Metronidazole / Q000627:therapeutic use; D010502:Perineum; D011241:Prednisone / Q000627:therapeutic use; D012006:Rectovaginal Fistula / Q000188:drug therapy* / Q000209:etiology
chemical_list: D000900:Anti-Bacterial Agents; D007166:Immunosuppressive Agents; D008795:Metronidazole; D001379:Azathioprine; D002439:Cefotaxime; D011241:Prednisone