Crohn’s disease is a type of inflammatory bowel disease (IBD). It is a long-term 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 typical Crohn’s disease rash 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 lumps to appear on the reddened skin, and usually develops on the legs, usually below the knees. This rash has many possible causes, including bacterial and viral infections. Therefore, it is important to see a doctor to get 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 can 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 the blood vessels that can cause red spots 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 break open and turn into ulcers. They often grow larger over time.
– Medication-related injuries
Some people develop skin blisters 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 flaking, 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 biologics.
In some cases, a person may need additional treatment, such as dental work, skin tag removal, 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 fistulae
– blisters, sores or painful lesions in the vagina
– skin tags
Doctors treat this condition with medications to control the inflammation caused by Crohn’s disease. A doctor may also surgically remove large or painful 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 lump 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 causes the anus to narrow a lot. A person may notice that their anus feels small, tight, or unusual, and that it is painful or impossible to pass stool.
anal skin tags
Some people with Crohn’s disease develop papillomas on the anal skin.
Skin tags look like loose, fleshy bumps. They can be as small as a freckle or larger than the tip of a pencil eraser. They can be the color of the skin, but also darker or lighter than a person’s skin. Skin tags are nothing to worry about. However, they can stick to clothing or other objects and bleed or become infected as a result. As with cutaneous Crohn’s disease, treatment focuses on reducing the inflammation due to the disease and treating any infection. A doctor can also remove skin tags.
Orofacial Crohn’s disease
Orofacial Crohn’s disease affects the face, the 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 may crack and bleed
– swollen gums
– Crohn’s rash on the face, such as groups of blisters or spots.
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 problems.
Crohn’s disease and bowel movements
Crohn’s disease causes inflammation of the intestines and digestive tract. This can make it difficult for the body to absorb nutrients from food. Changes in the stool that a person may notice, especially during a Crohn’s disease flare, include:
– Watery stools: a greater difficulty in absorbing water and nutrients can cause diarrhea. A person may have more frequent or very loose bowel movements.
– Constipation: inflammation, particularly of the anus and rectum, can make it difficult to pass stool. This can cause constipation. A person may notice that their stools are very hard or come out in small lumps.
– 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 in the upper part of the gastrointestinal tract, which is a medical emergency.
– Oily stools: When the body cannot absorb nutrients such as fats, a person’s stools may appear greasy or more viscous than normal.
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:
– have 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
– cannot eat or drink without 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’s disease.
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Hafsi, W., et al. (2020). erythema nodosum.
Heymann, W.R. (2017). Understanding the association of orofacial granulomatosis and Crohn’s disease would be great.
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