title: Treatment of metastatic cutaneous Crohn disease with certolizumab.
abstract: Metastatic Crohn disease is a rare cutaneous manifestation of Crohn disease characterized by granulomatous lesions discontinuous with the diseased areas of the gastrointestinal tract. We report a case of a 32-year-old woman with history of Crohn disease who was admitted for treatment of cellulitis after presenting with a tender erythematous plaque of the left calf. Microbiological tests including tissue cultures were negative. A skin biopsy revealed granulomatous dermatitis consistent with metastatic cutaneous Crohn disease. Owing to concomitant perianal fistulas and abscesses and prior infusion reaction to infliximab, the patient was treated with certolizumab, a pegylated tumor necrosis factor (TNF) inhibitor combined with methotrexate resulting in complete resolution of the skin lesion. This case emphasizes the importance of recognizing this rare skin manifestation of Crohn disease and adds certolizumab as one of TNF inhibitors useful in the treatment of metastatic cutaneous Crohn disease.
authors.affiliation: University of California Davis, Sacramento. mkiuru@ucdavis.edu.
authors.forename: Maija
authors.initials: M
authors.lastname: Kiuru
authors.forename: Brendan
authors.initials: B
authors.lastname: Camp
authors.forename: Katayun
authors.initials: K
authors.lastname: Adhami
authors.forename: Vinita
authors.initials: V
authors.lastname: Jacob
authors.forename: Cynthia
authors.initials: C
authors.lastname: Magro
authors.forename: Horatio
authors.initials: H
authors.lastname: Wildman
mesh_terms: D000328:Adult; D000068582:Certolizumab Pegol / Q000627:therapeutic use*; D003424:Crohn Disease / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008727:Methotrexate / Q000627:therapeutic use; D012871:Skin Diseases / Q000188:drug therapy*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha; D000068582:Certolizumab Pegol; D008727:Methotrexate