Crohn’s disease is a type of inflammatory bowel disease (IBD). It is a long-lasting, or chronic, condition that results in inflammation of the digestive tract. It can also cause skin problems, such as rashes. About 40% of people with Crohn’s disease have non-digestive symptoms, most commonly affecting the skin. In about 25% of cases, these symptoms appear before the person is diagnosed or even before they experience digestive symptoms. In this article, we describe and explain the skin symptoms of Crohn’s disease by type.
Crohn’s disease on the skin
A rash typical of Crohn’s disease causes reddened skin lesions with chronic inflammation. The rash may look like swollen blisters, which may appear in groups or as a single lesion.
One of the most common causes of Crohn’s disease is erythema nodosum. It can cause painful, swollen bumps to appear on reddened skin, and usually develops on the legs, usually below the knees. This rash has many possible causes, including bacterial and viral infections. It is therefore important to consult a doctor to obtain the correct diagnosis.
Other skin disorders
Here are some other types of skin rashes and symptoms that people with Crohn’s disease may develop:
– Skin “tags”
These are small growths of extra skin that may be flesh-colored, pink, or darker than the skin. Some people think they look like moles. They are more common in places where there is a lot of friction, such as the genital area.
This group of diseases refers to a type of inflammation of blood vessels that can cause patches of redness on the skin.
– Pyoderma gangrenosum
This skin condition is common in people with Crohn’s disease who have skin disorders. It causes painful, swollen blisters that can open and become ulcers. They often grow larger over time.
– Injuries related to taking medication
Some people develop blisters on their skin as a side effect of Crohn’s disease treatment. This is because the treatment weakens the immune system, which can increase the risk of skin infections.
– Oral lesions
Some people with Crohn’s disease develop blisters or sores in the mouth. Others develop gum disease. About 10% of people with the disease develop skin problems in the mouth.
IBD can sometimes cause vitiligo, which is a loss of pigment in the skin.
This condition causes peeling, itching, redness or inflammation of the skin. For most Crohn’s disease skin lesions, treatment focuses on reducing Crohn’s disease-related inflammation using disease-modifying agents, such as biologic drugs.
In some cases, a person may need additional treatment, such as dental work, removal of skin tags, or antibiotic treatment for an infected blister.
Vulvar Crohn’s disease
It is rare for Crohn’s disease to affect the vulva or vagina, but it is possible.
If this happens, a person may notice the following:
– swelling of the lips
– skin growths called fistulas
– blisters, sores or painful lesions on the vagina
– skin tags
Doctors treat this condition with medication to control the inflammation caused by Crohn’s disease. A doctor may also surgically remove painful or large skin growths.
Anal Crohn’s disease
Perianal Crohn’s disease means that a person has inflammation in or around the anus.
Here are some examples of symptoms a person may experience:
– Abscesses: Some people develop small pockets of infection. An abscess can look like a very swollen pimple or feel like a painful bump under the skin.
– Fissures: A fissure is a tear in the skin of the anus. It can cause symptoms similar to those of a hemorrhoid, such as pain and bleeding. A person may notice a patch of reddened skin, but it may also be too deep in the anus to be visible.
– Stenosis: Sometimes the inflammation due to Crohn’s disease makes the anus very narrow. A person may notice that their anus feels small, tight, or unusual, and that it is painful or impossible to have a bowel movement.
Anal skin tags
Some people with Crohn’s disease develop anal skin tags.
Skin tags look like fleshy, loose bumps. They can be as small as a freckle or larger than the tip of a pencil eraser. They can be skin-colored, but also darker or lighter than a person’s skin. Skin tags are nothing to worry about. However, they can cling to clothing or other objects and bleed or become infected as a result. As with cutaneous Crohn’s disease, treatment focuses on reducing inflammation due to the disease and treating any infections. A doctor can also remove skin tags.
Orofacial Crohn’s disease
Orofacial Crohn’s disease affects the face, mouth, or both. It may be more common in children than in adults.
Some symptoms are:
– deep and painful sores in the mouth
– swollen lips that can crack and bleed
– swollen gums
– Crohn’s rash on the face, such as clusters of blisters or dots.
Anti-inflammatory treatments for Crohn’s disease can be effective. Doctors may also recommend prescription mouthwashes, special diets, or additional dental care to prevent serious gum health issues.
Crohn’s disease and bowel movements
Crohn’s disease causes inflammation of the intestines and digestive tract. This can make it harder for the body to absorb nutrients from food. Changes in stool that a person may notice, especially during a Crohn’s disease flare, include:
– Watery stools: Greater difficulty in absorbing water and nutrients can lead to diarrhea. A person may have more frequent or very loose bowel movements.
– Constipation: Inflammation, especially of the anus and rectum, can make it more difficult to pass stools. This can lead to constipation. A person may notice that their stools are very hard or come out in small clumps.
– Presence of blood in the stool: Anal fissures or constipation can cause traces of red blood in the stool. Dark, tarry stools indicate that a person may have bleeding higher up in the gastrointestinal tract, which is a medical emergency.
– Oily stools: When the body cannot absorb nutrients such as fats, a person’s stools may look greasy or more viscous than usual.
When to contact a doctor
Crohn’s disease can be treated. However, without treatment, it can lead to serious complications.
A person should contact a doctor if:
– she has symptoms of Crohn’s disease, such as frequent diarrhea or stomach pain
– new symptoms of Crohn’s disease appear
– you think you have a skin infection
– they cannot eat or drink without having severe diarrhoea.
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Bernett, CN, et al. (2021). Cutaneous Crohn’s disease.
de Zoeten, EF, et al. (2013). Diagnosis and treatment of perianal Crohn disease.
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Hafsi, W., et al. (2020). Erythema nodosum.
Heymann, WR (2017). Understanding the association of orofacial granulomatosis and Crohn disease would be swell.
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