Cutaneous Manifestations of Inflammatory Bowel Disease in theHospital of Lithuanian University of Health Sciences

Abstract

Introduction It is well known that skin lesions may be frequent extraintestinal manifestations of inflammatory bowel diseases (IBD) [1,2]. However, during literature analysis we found out that there is a lack of epidemiological data regarding this issue. Aim The aim of our study was to establish the prevalence of cutaneous manifestations among the IBD patients in the hospital of Lithuanian University of Health Sciences (LUHS). Methods The study included in- and out-patients with IBD who were managed in the hospital of LUHS from January to October of 2022. Patients completed the questionnaire including the demographic and IBD data and history or present state of skin lesions. We considered cutaneous lesions related to IBD or its treatment if they were diagnosed following the diagnosis of IBD. Skin lesions which were reported before the diagnosis of IBD were considered as not related toIBD. Statistical data was analysed using IBM SPSS Statistics. χ2 test was used to determine the relation between cutaneous manifestations and different forms of IBD. The selected level of statistical significance was p<0.05. Results 152 patients were included, mean age (MA) – 42.0±13.9 years. There were 88 (57.9%) males and 64 (42.1%) females. Ulcerative colitis (UC) was diagnosed in 110 (72.4%) patients, Crohn’s disease (CD) – in 42 (27.6%) patients. MA of UC patients was 42.3±13.6, CD – 41.1±14.9, p>0.05.In total, cutaneous lesions were indicated by 65 (42.8%) subjects. According to our criteria, in 46 (30.3%; 95% CI: 23-38%) cases, skin lesions were considered as obviously related to IBD or its treatment. We further analysed latter cases. Among UC patients, 32 (29.1%; 95% CI: 20-38%) had skin lesions related to IBD, among CD patients – 14 (33.3%; 95 CI: 18-48%), p>0.05.Erythema nodosum was diagnosed in 6 (3.9%) patients, pyoderma gangrenosum – 5 (3.3%), acne– 1 (0.7%), psoriasis – 9 (5.9%), vitiligo – 2 (1.3%), epidermolysis bullosa acquisita – 1 (0.7%), haemorrhagic vasculitis – 1 (0.7%), eczema – 9 (5.9%), allergic rash – 4 (2.6%).The comparison of cutaneous lesions among UC and CD patients is presented in Table 1. Table 1. [...]. Among the patients with UC proctitis, skin lesions were reported in 2 out of 15 (13.3%); among left-sided colitis – in 8 out of 27 (29.6%); among pancolitis – in 22 out of 67 (32.8%); p<0.05 between the groups of proctitis and pancolitis. Comparing the different forms of CD, skin lesions were reported in 3 out of 15 (20.0%) patients with ileitis, 4 out of 10 (40.0%) patients with colitis and 7 out of 17 (41.2%) patients with ileocolitis; p>0.05 between different groups. Conclusions In our study the prevalence of cutaneous manifestations related to IBD or its treatment is 30.3%.There were no differences in the prevalence of skin lesions between the UC and CD patients. The most common skin lesions in UC were psoriasis and skin eczema, in CD – erythema nodosum and skin eczema. Cutaneous lesions were significantly more prevalent in extensive UC compared to distal disease.