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Article Details
Clinical Image
Volume 3, Issue 1 (January Issue)

Atypical Cutaneous Ulcer Revealing Crohns Disease

Salahiddine Saghir1, Sara Benchidmi2, Abdelhakim El Yajouri1, Rachid Abilkassem1, Abdelhakim Ourrai1, Amal Hassani1 and Aomar Agadr1

1Department of Pediatrics, Military Hospital Mohamed V of Rabat, Morocco
2Department of Pediatrics, Children’s Hospital of Rabat, Morocco

*Corresponding author: Salahiddine Saghir, Department of Pediatrics, Military Hospital Mohamed V of Rabat, Morocco, Tel: +212600626456; E-mail: s.salahiddine@gmail.com

Received: October 29, 2020; Accepted: November 18, 2020; Published: December 08, 2020

Citation: Salahiddine Saghir*, Sara Benchidmi, Abdelhakim El Yajouri, et al. Atypical Cutaneous Ulcer Revealing Crohn's Disease. Clin Image Case Rep J. 2021; 3(2): 133.

Abstract

Crohn's disease is a chronic inflammatory bowel disease, the most common symptoms involve the digestive tract, but sometimes other body parts can be affected essentially the skin [1].
We report a clinical observation of a 9 years old infant admitted for management of skin ulceration with multiple micro-abscesses of the lower extremity of the right limb (Figure 1 and 2), the onset of the symptoms dated back to 30 days before admission, during this period the patient consulted several times and was put under oral and intravenous antibiotics without improvement.
The interrogation found recurrent episodes of mucus-bloody diarrhea associated to fever and progressive weight loss and anorexia. Clinical examination reveals a failure to thrive, anemic syndrome, delay in weight with signs of moderate undernutrition and eventually the skin disorder.

Laboratory assessment confirmed anemia and inflammatory syndrome, the bacteriological culture of the lesion was sterile and the skin biopsy was nonspecific with neutrophilic polynuclear infiltrates.
Colonoscopy revealed ulcerative colitis, without ileal or rectal involvement, with digging ulcers. Staged colonic biopsies showed inflammatory and diffuse colonic reshuffles, erosive and scarring lesions, evoking Crohn's disease.
The evolution of the skin lesion was favorable after starting local corticosteroid therapy and healing was achieved after 2 weeks, the interest of this observation is that the symptomatology was dominated by cutaneous involvement while the digestive symptoms were rough.