title: Crohn's disease of the vulva.
abstract: Crohn's disease (CD) of the vulva is a rare, yet under recognized condition. Fistulae arising from the digestive tract account for the greater part of genital lesions in CD. However, cutaneous so-called metastatic lesions of the vulva have been reported in the literature. They are clinically challenging for gastroenterologists as well as for gynecologists, with numerous differential diagnoses, especially among venereal diseases, and require a multidisciplinary approach. The most frequently observed features of the disease are labial swelling, vulvar ulcers, and hypertrophic lesions. Biopsy samples for histological study are mandatory, in order to establish the diagnosis of vulvar CD. Treatment options include oral prolonged courses of metronidazole and systemic immunosuppressive therapy such as corticosteroids and azathioprine, with promising data published on the efficacy of infliximab. Surgery remains restricted to medical treatment failures or resection of unsightly lesions. Prospective studies or case series with long follow-up data are still missing to guide the treatment of this condition.
authors.affiliation: Department of Gastroenterology and Endoscopy, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de médecine, Paris, France. Electronic address: maxbarret5744@yahoo.fr.
authors.forename: Maximilien
authors.initials: M
authors.lastname: Barret
authors.affiliation: Department of Medical and Surgical Proctology, Groupe Hospitalier Saint-Joseph, Institut Léopold Bellan, Paris, France. Electronic address: v.deparades@gmail.com.
authors.forename: Vincent
authors.initials: V
authors.lastname: de Parades
authors.affiliation: Department of Pathology, Hôpital Saint Louis, Paris, France. Electronic address: maxime.battistella@sls.aphp.fr.
authors.forename: Maxime
authors.initials: M
authors.lastname: Battistella
authors.affiliation: Department of Gastroenterology, Hôpital Saint Antoine, Paris, France. Electronic address: harry.sokol@sat.aphp.fr.
authors.forename: Harry
authors.initials: H
authors.lastname: Sokol
authors.affiliation: Department of Medical and Surgical Proctology, Groupe Hospitalier Saint-Joseph, Institut Léopold Bellan, Paris, France. Electronic address: nlemarchand@noos.fr.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Lemarchand
authors.affiliation: Department of Gastroenterology and Digestive Surgery, Hôpital Lariboisière, Paris, France. Electronic address: philippe.marteau@lrb.aphp.fr.
authors.forename: Philippe
authors.initials: P
authors.lastname: Marteau
mesh_terms: D000038:Abscess / Q000209:etiology*; D003424:Crohn Disease / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000473:pathology; D014456:Ulcer / Q000209:etiology*; D014844:Vulva / Q000473:pathology*; D014845:Vulvar Diseases / Q000209:etiology* / Q000473:pathology* / Q000628:therapy
keywords: Metastatic Crohn's disease; Vulvar Crohn's disease; Vulvar hypertrophy; Vulvar swelling; Vulvar ulceration