title: Association of collagenous colitis with prurigo nodularis.
abstract: The etiology and pathogenesis of collagenous colitis (CC) is poorly understood and probably multifactorial; many potential pathophysiological mechanisms have been described, although none have been conclusively proved. Circumstantial evidence suggests that CC appears as an autoimmune response to a luminal or epithelial antigen of unknown origin. Infections and certain drugs (e.g. NSAID, lansoprazole) may act as triggers for an immune-mediated process. CC is characterized clinically by chronic watery, nonbloody diarrhea with normal endoscopic appearance and without radiological abnormalities, but specific microscopic changes in the colon. Histopathology is featured by the presence of a thickened subepithelial collagen band adjacent to the basal membrane. Up to 40% of patients with CC have associated diseases of autoimmune or inflammatory origin, such as thyroid disease, coeliac disease, rheumatoid arthritis, diabetes mellitus, Sjögren's syndrome, CREST syndrome, scleroderma, pernicious anemia, and sarcoidosis. Prurigo nodularis is a chronic condition characterized by intensely pruritic, lichenified, or excoriated papules and nodules of unknown etiology. It is assumed to represent a cutaneous reaction pattern to repeated scrubbing or scratching caused by pruritus. We report a case of CC and prurigo nodularis. To our knowledge, this association has not been reported earlier.
authors.affiliation: 2nd Department of Internal Medicine, Semmelweis University, Budapest, Hungary.
authors.forename: Hajnal
authors.initials: H
authors.lastname: Székely
authors.forename: Györgyi
authors.initials: G
authors.lastname: Pónyai
authors.forename: Erzsébet
authors.initials: E
authors.lastname: Temesvári
authors.forename: Lajos
authors.initials: L
authors.lastname: Berczi
authors.forename: Judit
authors.initials: J
authors.lastname: Hársing
authors.forename: Sarolta
authors.initials: S
authors.lastname: Kárpáti
authors.forename: László
authors.initials: L
authors.lastname: Herszényi
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Tulassay
authors.forename: Márk
authors.initials: M
authors.lastname: Juhász
mesh_terms: D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D019819:Budesonide / Q000627:therapeutic use; D046729:Colitis, Collagenous / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D003967:Diarrhea / Q000209:etiology; D005260:Female; D006801:Humans; D011536:Prurigo / Q000150:complications* / Q000188:drug therapy; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D019819:Budesonide