title: Disease-related and drug-induced skin manifestations in inflammatory bowel disease.
abstract: Skin manifestations are common in patients with inflammatory bowel diseases (IBD) and can be part of a concomitant illness with a shared genetic background, an extra-intestinal manifestation of the disease, or a drug side-effect. Areas covered: We provide a practical overview of the epidemiology, pathogenesis, diagnosis, therapeutic approach and prognosis of the most frequent disease-related and drug-induced cutaneous manifestations in IBD, illustrated by cases encountered in our clinical practice. Among the most frequently encountered IBD-related lesions are erythema nodosum, pyoderma gangrenosum and Sweet's syndrome. Common skin manifestations with a strong association to TNF antagonists are local injection site reactions, psoriasiform lesions, cutaneous infections, vasculitides and lupus-like syndromes. In addition, we discuss the relation of thiopurines and TNF antagonists with the risk of skin cancer. Expert commentary: We hope this review will help caretakers involved in the management of IBD patients to recognize the lesions and to manage them in close collaboration with a dedicated dermatologist.
authors.affiliation: a Department of Gastroenterology , University of Ghent , Ghent , Belgium.
authors.forename: Pieter
authors.initials: P
authors.lastname: Hindryckx
authors.affiliation: b Department of Gastroenterology , University Medical Centre Ljubljana , Ljubljana , Slovenia.
authors.forename: Gregor
authors.initials: G
authors.lastname: Novak
authors.affiliation: c Skin Pathology Lab and Dermatology Unit , Humanitas Clinical and Research Center , Milan , Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Costanzo
authors.affiliation: d Department of Biomedical Sciences , Humanitas University , Milan , Italy.|e Department of Gastroenterology , IBD Center, Humanitas Clinical and Research Center , Milan , Italy.
authors.forename: Silvio
authors.initials: S
authors.lastname: Danese
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000009:adverse effects*; D003875:Drug Eruptions / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D004893:Erythema Nodosum / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D005765:Gastrointestinal Agents / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017511:Pyoderma Gangrenosum / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D012307:Risk Factors; D012867:Skin / Q000187:drug effects* / Q000473:pathology; D012878:Skin Neoplasms / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D016463:Sweet Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D005765:Gastrointestinal Agents
keywords: Skin lesions; cutaneous; drug-induced; extra-intestinal; inflammatory bowel disease