title: Penile and Scrotal Swelling: An Underrecognized Presentation of Crohn's Disease.
abstract: BACKGROUND
  Penile and scrotal swelling can occur as an extraintestinal manifestation of Crohn's disease (CD) and is thought to be an uncommon form of metastatic CD (MCD). Because of the rarity of this manifestation, much is unknown concerning the presentation, treatment, and response to therapy in children with genital MCD.
  
  
  METHODS
  Boys ages 1 to 17 years presenting with genital edema and a confirmed diagnosis or strong suspicion of CD who were evaluated at the Mayo Clinic between 1996 and 2014 were included for review. We sought to characterize the clinical and pathologic features of genital MCD and response to treatment in our cohort of patients.
  
  
  RESULTS
  Eight patients with genital MCD were identified from our institution (mean age 11.4 yrs, range 7-16 yrs). Seven (88%) patients experienced cutaneous symptoms before a formal diagnosis of CD was made, and two of the seven had no adverse gastrointestinal symptoms at that time. Patients were prescribed an average of 3.4 medications (topical and systemic) for management of their gastrointestinal CD and MCD.
  
  
  CONCLUSIONS
  Penile and scrotal swelling can occur as an extraintestinal manifestation of CD and is thought to be an uncommon form of MCD. In boys, genital swelling typically precedes intestinal CD. Treatment of the underlying CD with systemic medications was most helpful in this series. An evaluation for CD is necessary in all patients presenting with unexplained genital swelling.
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Barrick
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, Minnesota.|Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Megha M
authors.initials: MM
authors.lastname: Tollefson
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Schoch
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, Minnesota.|Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Marian T
authors.initials: MT
authors.lastname: McEvoy
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, Minnesota.|Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota.|Department of Medical Genetics, Mayo Clinic, Rochester, Minnesota.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Hand
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, Minnesota.|Division of Anatomic Pathology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Carilyn N
authors.initials: CN
authors.lastname: Wieland
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, Minnesota.|Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Dawn M R
authors.initials: DM
authors.lastname: Davis
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003424:Crohn Disease / Q000473:pathology*; D004487:Edema / Q000473:pathology; D006801:Humans; D007223:Infant; D008297:Male; D010413:Penis / Q000473:pathology*; D012611:Scrotum / Q000473:pathology*