Abstract
Inflammatory bowel disease (IBD) with its two main subtypes Crohn’s disease and ulcerative colitis is not restricted to the gastrointestinal tract. Indeed, so-called extraintestinal manifestations (EIMs) are frequent and considerably affect morbidity and mortality. The prevalence of EIMs ranges from 6 to 47%. In up to one quarter of the patients, EIMs can present even before an IBD diagnosis is established. The pathophysiology of EIMs remains elusive, although data from clinical trials demonstrating anti-tumor necrosis factor (TNF) efficacy suggest a common pathogenic link between intestinal and extraintestinal disease activity. However, not all EIMs parallel intestinal disease. Skin lesions are usually classified based on their pathophysiological association with the underlying intestinal disease into four categories: (1) specific, (2) reactive, (3) associated, and (4) treatment-induced manifestations. Cutaneous manifestations include erythema nodosum (EN), pyoderma gangrenosum (PG), Sweet’s syndrome, and oral lesions, with EN being the most commonly reported and PG showing the most debilitating disease course. Anti-TNF-induced skin reactions are a new, but increasingly recognized phenomenon, which can be eventually misinterpreted as psoriatic lesions. Medical treatment modalities are limited with topical and systemic steroids being the most frequently employed agents. If EIMs parallel intestinal disease activity, the therapeutic cornerstone usually is the management of underlying intestinal disease activity rather than direct treatment of the EIMs. However, increasing evidence for anti-TNF agents’ efficacy in EIM management has changed the approach to complicating and debilitating disease courses. In the case of anti-TNF-induced lesions, topical steroids are usually sufficient and discontinuation of anti-TNF is seldom warranted. In this review, we summarize current knowledge on cutaneous EIMs, their diagnostic criteria and clinical presentation, natural history, pathogenesis, and treatment options.
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Abbreviations
- ANCA:
-
Anti-neutrophil cytoplasmic antibody
- ASCA:
-
Anti-Saccharomyces cerevisiae antibody
- CD:
-
Crohn’s disease
- CRP:
-
C-reactive protein
- ECCO:
-
European Crohn’s and Colitis Organization
- EIM:
-
Extraintestinal manifestation
- EN:
-
Erythema nodosum
- HIV:
-
Human immunodeficiency virus
- HSV:
-
Herpes simplex virus
- IBD:
-
Inflammatory bowel disease
- IFN:
-
Interferon
- IL:
-
Interleukin
- PG:
-
Pyoderma gangrenosum
- PSC:
-
Primary sclerosing cholangitis
- TNF:
-
Tumor necrosis factor
- UC:
-
Ulcerative colitis
- UV:
-
Ultraviolet
References
Shivashankar R, Tremaine WJ, Harmsen WS, Loftus EV (2016) Incidence and prevalence of Crohn’s disease and ulcerative colitis in Olmsted County, Minnesota from 1970 through 2010. Clin Gastroenterol Hepatol 15(6):857–863
Loftus EV, Sandborn WJ (2002) Epidemiology of inflammatory bowel disease. Gastroenterol Clin N Am 31(1):1–20
Kaser A, Zeissig S, Blumberg RS (2010) Inflammatory bowel disease. Annu Rev Immunol 28:573–621
Bernstein CN, Blanchard JF, Rawsthorne P, Yu N (2001) The prevalence of extraintestinal diseases in inflammatory bowel disease: a population-based study. Am J Gastroenterol 96(4):1116–1122
Bernstein CN, Wajda A, Blanchard JF (2005) The clustering of other chronic inflammatory diseases in inflammatory bowel disease: a population-based study. Gastroenterology 129(3):827–836
Mendoza JL, Lana R, Taxonera C, Alba C, Izquierdo S, Díaz-Rubio M. Extraintestinal manifestations in inflammatory bowel disease: differences between Crohn’s disease and ulcerative colitis. Med Clin (Barc). 2005;125(8):297–300.
Ricart E, Panaccione R, Loftus EV, Tremaine WJ, Harmsen WS, Zinsmeister AR et al (2004) Autoimmune disorders and extraintestinal manifestations in first-degree familial and sporadic inflammatory bowel disease: a case-control study. Inflamm Bowel Dis 10(3):207–214
Rankin GB, Watts HD, Melnyk CS, Kelley ML (1979) National Cooperative Crohn’s Disease Study: extraintestinal manifestations and perianal complications. Gastroenterology 77(4 Pt 2):914–920
Su CG, Judge TA, Lichtenstein GR (2002) Extraintestinal manifestations of inflammatory bowel disease. Gastroenterol Clin N Am 31(1):307–327
Veloso FT, Carvalho J, Magro F (1996) Immune-related systemic manifestations of inflammatory bowel disease. A prospective study of 792 patients. J Clin Gastroenterol 23(1):29–34
Vavricka SR, Brun L, Ballabeni P, Pittet V, Prinz Vavricka BM, Zeitz J et al (2011) Frequency and risk factors for extraintestinal manifestations in the Swiss inflammatory bowel disease cohort. Am J Gastroenterol 106(1):110–119
Vavricka SR, Scharl M, Gubler M, Rogler G (2014) Biologics for extraintestinal manifestations of IBD. Curr Drug Targets 15(11):1064–1073
Tontini GE, Vecchi M, Pastorelli L, Neurath MF, Neumann H (2015) Differential diagnosis in inflammatory bowel disease colitis: state of the art and future perspectives. World J Gastroenterol 21(1):21–46
Vermeire S, Van Assche G, Rutgeerts P (2006) Laboratory markers in IBD: useful, magic, or unnecessary toys? Gut 55(3):426–431
Bossuyt X (2006) Serologic markers in inflammatory bowel disease. Clin Chem 52(2):171–181
Baumgart DC, Sandborn WJ (2012) Crohn’s disease. Lancet 380(9853):1590–1605
Danese S, Fiocchi C (2011) Ulcerative colitis. N Engl J Med 365(18):1713–1725
Magro F, Gionchetti P, Eliakim R, Ardizzone S, Armuzzi A, Barreiro-de Acosta M, et al. (2017) Third European evidence-based consensus on diagnosis and management of ulcerative colitis. Part 1: definitions, diagnosis, extra-intestinal manifestations, pregnancy, cancer surveillance, surgery, and ileo-anal pouch disorders. J Crohns Colitis 11(6):649–670
Gomollón F, Dignass A, Annese V, Tilg H, Van Assche G, Lindsay JO et al (2017) Third European evidence-based consensus on the diagnosis and management of Crohn’s disease 2016: part 1: diagnosis and medical management. J Crohns Colitis. 11(1):3–25
Kalla R, Ventham NT, Satsangi J, Arnott ID (2014) Crohn’s disease. BMJ 349:g6670
Sands BE (2004) From symptom to diagnosis: clinical distinctions among various forms of intestinal inflammation. Gastroenterology 126(6):1518–1532
Charpentier C, Salleron J, Savoye G, Fumery M, Merle V, Laberenne JE et al (2014) Natural history of elderly-onset inflammatory bowel disease: a population-based cohort study. Gut 63(3):423–432
Lennard-Jones JE, Shivananda S (1997) Clinical uniformity of inflammatory bowel disease a presentation and during the first year of disease in the north and south of Europe. EC-IBD Study Group. Eur J Gastroenterol Hepatol 9(4):353–359
Hampe J, Cuthbert A, Croucher PJ, Mirza MM, Mascheretti S, Fisher S et al (2001) Association between insertion mutation in NOD2 gene and Crohn’s disease in German and British populations. Lancet 357(9272):1925–1928
Hugot JP, Chamaillard M, Zouali H, Lesage S, Cézard JP, Belaiche J et al (2001) Association of NOD2 leucine-rich repeat variants with susceptibility to Crohn’s disease. Nature 411(6837):599–603
Ogura Y, Bonen DK, Inohara N, Nicolae DL, Chen FF, Ramos R et al (2001) A frameshift mutation in NOD2 associated with susceptibility to Crohn’s disease. Nature 411(6837):603–606
Stappenbeck TS, Rioux JD, Mizoguchi A, Saitoh T, Huett A, Darfeuille-Michaud A et al (2011) Crohn disease: a current perspective on genetics, autophagy and immunity. Autophagy 7(4):355–374
Kostic AD, Xavier RJ, Gevers D (2014) The microbiome in inflammatory bowel disease: current status and the future ahead. Gastroenterology 146(6):1489–1499
Norman JM, Handley SA, Baldridge MT, Droit L, Liu CY, Keller BC et al (2015) Disease-specific alterations in the enteric virome in inflammatory bowel disease. Cell 160(3):447–460
Sandborn WJ, Feagan BG, Rutgeerts P, Hanauer S, Colombel JF, Sands BE et al (2013) Vedolizumab as induction and maintenance therapy for Crohn’s disease. N Engl J Med 369(8):711–721
Langner C, Magro F, Driessen A, Ensari A, Mantzaris GJ, Villanacci V et al (2014) The histopathological approach to inflammatory bowel disease: a practice guide. Virchows Arch 464(5):511–527
Magro F, Langner C, Driessen A, Ensari A, Geboes K, Mantzaris GJ et al (2013) European consensus on the histopathology of inflammatory bowel disease. J Crohns Colitis 7(10):827–851
Feakins RM, Gastroenterology BS (2013) Inflammatory bowel disease biopsies: updated British Society of Gastroenterology reporting guidelines. J Clin Pathol 66(12):1005–1026
Kleer CG, Appelman HD (1998) Ulcerative colitis: patterns of involvement in colorectal biopsies and changes with time. Am J Surg Pathol 22(8):983–989
Cross SS, Harrison RF (2002) Discriminant histological features in the diagnosis of chronic idiopathic inflammatory bowel disease: analysis of a large dataset by a novel data visualisation technique. J Clin Pathol 55(1):51–57
Vavricka SR, Schoepfer A, Scharl M, Lakatos PL, Navarini A, Rogler G (2015) Extraintestinal manifestations of inflammatory bowel disease. Inflamm Bowel Dis 21(8):1982–1992
Monsén U, Sorstad J, Hellers G, Johansson C (1990) Extracolonic diagnoses in ulcerative colitis: an epidemiological study. Am J Gastroenterol 85(6):711–716
Das KM (1999) Relationship of extraintestinal involvements in inflammatory bowel disease: new insights into autoimmune pathogenesis. Dig Dis Sci 44(1):1–13
Ardizzone S, Puttini PS, Cassinotti A, Porro GB (2008) Extraintestinal manifestations of inflammatory bowel disease. Dig Liver Dis 40(Suppl 2):S253–S259
Veloso FT, Ferreira JT, Barros L, Almeida S (2001) Clinical outcome of Crohn’s disease: analysis according to the Vienna classification and clinical activity. Inflamm Bowel Dis 7(4):306–313
Greuter T, Bertoldo F, Rechner R, Straumann A, Biedermann L, Zeitz J et al (2016) Extraintestinal manifestations of pediatric inflammatory bowel disease: prevalence, presentation and anti-TNF treatment. J Pediatr Gastroenterol Nutr. doi:10.1097/MPG.0000000000001455
Dotson JL, Hyams JS, Markowitz J, LeLeiko NS, Mack DR, Evans JS et al (2010) Extraintestinal manifestations of pediatric inflammatory bowel disease and their relation to disease type and severity. J Pediatr Gastroenterol Nutr 51(2):140–145
Jose FA, Garnett EA, Vittinghoff E, Ferry GD, Winter HS, Baldassano RN et al (2009) Development of extraintestinal manifestations in pediatric patients with inflammatory bowel disease. Inflamm Bowel Dis 15(1):63–68
Guariso G, Gasparetto M, Visonà Dalla Pozza L, D'Incà R, Zancan L, Sturniolo G et al (2010) Inflammatory bowel disease developing in paediatric and adult age. J Pediatr Gastroenterol Nutr 51(6):698–707
Vind I, Riis L, Jess T, Knudsen E, Pedersen N, Elkjaer M et al (2006) Increasing incidences of inflammatory bowel disease and decreasing surgery rates in Copenhagen City and County, 2003–2005: a population-based study from the Danish Crohn colitis database. Am J Gastroenterol 101(6):1274–1282
Vavricka SR, Spigaglia SM, Rogler G, Pittet V, Michetti P, Felley C et al (2012) Systematic evaluation of risk factors for diagnostic delay in inflammatory bowel disease. Inflamm Bowel Dis 18(3):496–505
Schoepfer AM, Dehlavi MA, Fournier N, Safroneeva E, Straumann A, Pittet V et al (2013) Diagnostic delay in Crohn’s disease is associated with a complicated disease course and increased operation rate. Am J Gastroenterol 108(11):1744–1753
Greenstein AJ, Janowitz HD, Sachar DB (1976) The extra-intestinal complications of Crohn’s disease and ulcerative colitis: a study of 700 patients. Medicine (Baltimore) 55(5):401–412
Burgdorf W (1981) Cutaneous manifestations of Crohn’s disease. J Am Acad Dermatol 5(6):689–695
Palamaras I, El-Jabbour J, Pietropaolo N, Thomson P, Mann S, Robles W et al (2008) Metastatic Crohn’s disease: a review. J Eur Acad Dermatol Venereol 22(9):1033–1043
Marzano AV, Borghi A, Stadnicki A, Crosti C, Cugno M (2014) Cutaneous manifestations in patients with inflammatory bowel diseases: pathophysiology, clinical features, and therapy. Inflamm Bowel Dis 20(1):213–227
Timani S, Mutasim DF (2008) Skin manifestations of inflammatory bowel disease. Clin Dermatol 26(3):265–273
Harbord M, Annese V, Vavricka SR, Allez M, Barreiro-de Acosta M, Boberg KM et al (2016) The first European evidence-based consensus on extra-intestinal manifestations in inflammatory bowel disease. J Crohns Colitis. 10(3):239–254
Vavricka SR, Rogler G, Gantenbein C, Spoerri M, Prinz Vavricka M, Navarini AA et al (2015) Chronological order of appearance of extraintestinal manifestations relative to the time of IBD diagnosis in the Swiss inflammatory bowel disease cohort. Inflamm Bowel Dis 21(8):1794–1800
Yüksel I, Başar O, Ataseven H, Ertuğrul I, Arhan M, Ibiş M et al (2009) Mucocutaneous manifestations in inflammatory bowel disease. Inflamm Bowel Dis 15(4):546–550
Huang W, McNeely MC (1997) Neutrophilic tissue reactions. Adv Dermatol 13:33–64
Lakatos PL, Lakatos L, Kiss LS, Peyrin-Biroulet L, Schoepfer A, Vavricka S (2012) Treatment of extraintestinal manifestations in inflammatory bowel disease. Digestion 86(Suppl 1):28–35
Galbraith SS, Drolet BA, Kugathasan S, Paller AS, Esterly NB (2005) Asymptomatic inflammatory bowel disease presenting with mucocutaneous findings. Pediatrics 116(3):e439–e444
Levitt MD, Ritchie JK, Lennard-Jones JE, Phillips RK (1991) Pyoderma gangrenosum in inflammatory bowel disease. Br J Surg 78(6):676–678
Trikudanathan G, Venkatesh PG, Navaneethan U (2012) Diagnosis and therapeutic management of extra-intestinal manifestations of inflammatory bowel disease. Drugs 72(18):2333–2349
Polcz M, Gu J, Florin T (2011) Pyoderma gangrenosum in inflammatory bowel disease: the experience at Mater Health Services’ Adult Hospital 1998–2009. J Crohns Colitis 5(2):148–151
Menachem Y, Gotsman I (2004) Clinical manifestations of pyoderma gangrenosum associated with inflammatory bowel disease. Isr Med Assoc J 6(2):88–90
Nguyen GC, Torres EA, Regueiro M, Bromfield G, Bitton A, Stempak J et al (2006) Inflammatory bowel disease characteristics among African Americans, Hispanics, and non-Hispanic Whites: characterization of a large North American cohort. Am J Gastroenterol 101(5):1012–1023
Freeman HJ (2005) Erythema nodosum and pyoderma gangrenosum in 50 patients with Crohn’s disease. Can J Gastroenterol 19(10):603–606
Xavier RJ, Podolsky DK (2007) Unravelling the pathogenesis of inflammatory bowel disease. Nature 448(7152):427–434
Lapidus A, Bernell O, Hellers G, Löfberg R (1998) Clinical course of colorectal Crohn’s disease: a 35-year follow-up study of 507 patients. Gastroenterology 114(6):1151–1160
Sands BE, Anderson FH, Bernstein CN, Chey WY, Feagan BG, Fedorak RN et al (2004) Infliximab maintenance therapy for fistulizing Crohn’s disease. N Engl J Med 350(9):876–885
Lebwohl M, Fleischmajer R, Janowitz H, Present D, Prioleau PG (1984) Metastatic Crohn’s disease. J Am Acad Dermatol 10(1):33–38
Hawryluk EB, Izikson L, English JC (2010) Non-infectious granulomatous diseases of the skin and their associated systemic diseases: an evidence-based update to important clinical questions. Am J Clin Dermatol 11(3):171–181
Guest GD, Fink RL (2000) Metastatic Crohn’s disease: case report of an unusual variant and review of the literature. Dis Colon rectum 43(12):1764–1766
Kafity AA, Pellegrini AE, Fromkes JJ (1993) Metastatic Crohn’s disease. A rare cutaneous manifestation. J Clin Gastroenterol 17(4):300–303
Hoffmann RM, Kruis W (2004) Rare extraintestinal manifestations of inflammatory bowel disease. Inflamm Bowel Dis 10(2):140–147
Konrad A, Seibold F (2003) Response of cutaneous Crohn’s disease to infliximab and methotrexate. Dig Liver Dis 35(5):351–356
Jorizzo JL, Solomon AR, Zanolli MD, Leshin B (1988) Neutrophilic vascular reactions. J Am Acad Dermatol 19(6):983–1005
Bennett ML, Jackson JM, Jorizzo JL, Fleischer AB, White WL, Callen JP (2000) Pyoderma gangrenosum. A comparison of typical and atypical forms with an emphasis on time to remission. Case review of 86 patients from 2 institutions. Medicine (Baltimore) 79(1):37–46
Farhi D, Cosnes J, Zizi N, Chosidow O, Seksik P, Beaugerie L et al (2008) Significance of erythema nodosum and pyoderma gangrenosum in inflammatory bowel diseases: a cohort study of 2402 patients. Medicine (Baltimore) 87(5):281–293
Rothfuss KS, Stange EF, Herrlinger KR (2006) Extraintestinal manifestations and complications in inflammatory bowel diseases. World J Gastroenterol 12(30):4819–4831
Callen JP (1998) Pyoderma gangrenosum. Lancet 351(9102):581–585
Weizman A, Huang B, Berel D, Targan SR, Dubinsky M, Fleshner P et al (2014) Clinical, serologic, and genetic factors associated with pyoderma gangrenosum and erythema nodosum in inflammatory bowel disease patients. Inflamm Bowel Dis 20(3):525–533
Weenig RH, Davis MD, Dahl PR, Su WP (2002) Skin ulcers misdiagnosed as pyoderma gangrenosum. N Engl J Med 347(18):1412–1418
Powell RJ, Holbrook MR, Stevens A (1997) Pyoderma gangrenosum and its treatment. Lancet 350(9093):1720–1721
Trost LB, McDonnell JK (2005) Important cutaneous manifestations of inflammatory bowel disease. Postgrad Med J 81(959):580–585
Jolles S, Niclasse S, Benson E (1999) Combination oral and topical tacrolimus in therapy-resistant pyoderma gangrenosum. Br J Dermatol 140(3):564–565
Marzano AV, Trevisan V, Lazzari R, Crosti C (2011) Pyoderma gangrenosum: study of 21 patients and proposal of a ‘clinicotherapeutic’ classification. J Dermatolog Treat 22(5):254–260
Friedman S, Marion JF, Scherl E, Rubin PH, Present DH (2001) Intravenous cyclosporine in refractory pyoderma gangrenosum complicating inflammatory bowel disease. Inflamm Bowel Dis 7(1):1–7
Marzano AV, Ishak RS, Saibeni S, Crosti C, Meroni PL, Cugno M (2013) Autoinflammatory skin disorders in inflammatory bowel diseases, pyoderma gangrenosum and Sweet’s syndrome: a comprehensive review and disease classification criteria. Clin Rev Allergy Immunol 45(2):202–210
Brooklyn TN, Dunnill MG, Shetty A, Bowden JJ, Williams JD, Griffiths CE et al (2006) Infliximab for the treatment of pyoderma gangrenosum: a randomised, double blind, placebo controlled trial. Gut 55(4):505–509
Argüelles-Arias F, Castro-Laria L, Lobatón T, Aguas-Peris M, Rojas-Feria M, Barreiro-de Acosta M et al (2013) Characteristics and treatment of pyoderma gangrenosum in inflammatory bowel disease. Dig Dis Sci 58(10):2949–2954
Vavricka SR, Gubler M, Gantenbein C, Spoerri M, Fröhlich F, Seibold F et al (2017) Anti-TNF treatment for extraintestinal manifestations of inflammatory bowel disease in the Swiss IBD Cohort Study. Inflamm Bowel Dis 23(7):1174–1181
Schoch JJ, Tolkachjov SN, Cappel JA, Gibson LE, Davis DM (2017) Pediatric pyoderma gangrenosum: a retrospective review of clinical features, etiologic associations, and treatment. Pediatr Dermatol 34(1):39–45
Becuwe C, Delaporte E, Colombel JF, Piette F, Cortot A, Bergoend H (1989) Sweet’s syndrome associated with Crohn’s disease. Acta Derm Venereol 69(5):444–445
Cohen PR, Kurzrock R (2003) Sweet’s syndrome revisited: a review of disease concepts. Int J Dermatol 42(10):761–778
Ali M, Duerksen DR (2008) Ulcerative colitis and Sweet’s syndrome: a case report and review of the literature. Can J Gastroenterol 22(3):296–298
Fitzgerald RL, McBurney EI, Nesbitt LT (1996) Sweet’s syndrome. Int J Dermatol 35(1):9–15
Travis S, Innes N, Davies MG, Daneshmend T, Hughes S (1997) Sweet’s syndrome: an unusual cutaneous feature of Crohn’s disease or ulcerative colitis. The South West Gastroenterology Group. Eur J Gastroenterol Hepatol 9(7):715–720
Catalán-Serra I, Martín-Moraleda L, Navarro-López L, Gil-Borrás R, Pont-Sanjuán V, Ferrando-Marco J et al (2010) Crohn’s disease and Sweet’s syndrome: an uncommon association. Rev Esp Enferm Dig 102(5):331–337
von den Driesch P (1994) Sweet’s syndrome (acute febrile neutrophilic dermatosis). J Am Acad Dermatol 31(4):535–556
Mert A, Ozaras R, Tabak F, Pekmezci S, Demirkesen C, Ozturk R (2004) Erythema nodosum: an experience of 10 years. Scand J Infect Dis 36(6–7):424–427
Apgar JT (1991) Newer aspects of inflammatory bowel disease and its cutaneous manifestations: a selective review. Semin Dermatol 10(3):138–147
Mascaró JM, Baselga E (2008) Erythema induratum of bazin. Dermatol Clin 26(4):439–445 v
Löfberg R, Louis EV, Reinisch W, Robinson AM, Kron M, Camez A et al (2012) Adalimumab produces clinical remission and reduces extraintestinal manifestations in Crohn’s disease: results from CARE. Inflamm Bowel Dis 18(1):1–9
Clayton TH, Walker BP, Stables GI (2006) Treatment of chronic erythema nodosum with infliximab. Clin Exp Dermatol 31(6):823–824
Quin A, Kane S, Ulitsky O (2008) A case of fistulizing Crohn’s disease and erythema nodosum managed with adalimumab. Nat Clin Pract Gastroenterol Hepatol 5(5):278–281
Kugathasan S, Miranda A, Nocton J, Drolet BA, Raasch C, Binion DG (2003) Dermatologic manifestations of Crohn disease in children: response to infliximab. J Pediatr Gastroenterol Nutr 37(2):150–154
Ortego-Centeno N, Callejas-Rubio JL, Sanchez-Cano D, Caballero-Morales T (2007) Refractory chronic erythema nodosum successfully treated with adalimumab. J Eur Acad Dermatol Venereol 21(3):408–410
Vavricka SR, Manser CN, Hediger S, Vögelin M, Scharl M, Biedermann L et al (2013) Periodontitis and gingivitis in inflammatory bowel disease: a case-control study. Inflamm Bowel Dis 19(13):2768–2777
VanHale HM, Rogers RS, Doyle JA, Schroeter AL (1981) Immunofluorescence microscopic studies of recurrent aphthous stomatitis. Arch Dermatol 117(12):779–781
Berezow AB, Darveau RP (2011) Microbial shift and periodontitis. Periodontol 2000 55(1):36–47
Habashneh RA, Khader YS, Alhumouz MK, Jadallah K, Ajlouni Y (2012) The association between inflammatory bowel disease and periodontitis among Jordanians: a case-control study. J Periodontal Res 47(3):293–298
Kaufman I, Caspi D, Yeshurun D, Dotan I, Yaron M, Elkayam O (2005) The effect of infliximab on extraintestinal manifestations of Crohn’s disease. Rheumatol Int 25(6):406–410
Fiorino G, Allez M, Malesci A, Danese S (2009) Review article: anti TNF-alpha induced psoriasis in patients with inflammatory bowel disease. Aliment Pharmacol Ther 29(9):921–927
Fiorino G, Danese S, Pariente B, Allez M (2014) Paradoxical immune-mediated inflammation in inflammatory bowel disease patients receiving anti-TNF-α agents. Autoimmun Rev 13(1):15–19
Cullen G, Kroshinsky D, Cheifetz AS, Korzenik JR (2011) Psoriasis associated with anti-tumour necrosis factor therapy in inflammatory bowel disease: a new series and a review of 120 cases from the literature. Aliment Pharmacol Ther 34(11–12):1318–1327
Rahier JF, Buche S, Peyrin-Biroulet L, Bouhnik Y, Duclos B, Louis E et al (2010) Severe skin lesions cause patients with inflammatory bowel disease to discontinue anti-tumor necrosis factor therapy. Clin Gastroenterol Hepatol 8(12):1048–1055
Ramos-Casals M, Brito-Zerón P, Muñoz S, Soria N, Galiana D, Bertolaccini L et al (2007) Autoimmune diseases induced by TNF-targeted therapies: analysis of 233 cases. Medicine (Baltimore) 86(4):242–251
Palucka AK, Blanck JP, Bennett L, Pascual V, Banchereau J (2005) Cross-regulation of TNF and IFN-alpha in autoimmune diseases. Proc Natl Acad Sci U S A 102(9):3372–3377
de Gannes GC, Ghoreishi M, Pope J, Russell A, Bell D, Adams S et al (2007) Psoriasis and pustular dermatitis triggered by TNF-{alpha} inhibitors in patients with rheumatologic conditions. Arch Dermatol 143(2):223–231
Nestle FO, Gilliet M (2005) Defining upstream elements of psoriasis pathogenesis: an emerging role for interferon alpha. J Invest Dermatol 125(5):xiv–xxv
Notley CA, Inglis JJ, Alzabin S, McCann FE, McNamee KE, Williams RO (2008) Blockade of tumor necrosis factor in collagen-induced arthritis reveals a novel immunoregulatory pathway for Th1 and Th17 cells. J Exp Med 205(11):2491–2497
Tillack C, Ehmann LM, Friedrich M, Laubender RP, Papay P, Vogelsang H et al (2014) Anti-TNF antibody-induced psoriasiform skin lesions in patients with inflammatory bowel disease are characterised by interferon-γ-expressing Th1 cells and IL-17A/IL-22-expressing Th17 cells and respond to anti-IL-12/IL-23 antibody treatment. Gut 63(4):567–577
Andrisani G, Marzo M, Celleno L, Guidi L, Papa A, Gasbarrini A et al (2013) Development of psoriasis scalp with alopecia during treatment of Crohn’s disease with infliximab and rapid response to both diseases to ustekinumab. Eur Rev Med Pharmacol Sci 17(20):2831–2836
Gregoriou S, Kazakos C, Christofidou E, Kontochristopoulos G, Vakis G, Rigopoulos D (2011) Pustular psoriasis development after initial ustekinumab administration in chronic plaque psoriasis. Eur J Dermatol 21(1):104–105
Peyrin-Biroulet L, Van Assche G, Gómez-Ulloa D, García-Álvarez L, Lara N, Black CM, et al. Systematic review of tumor necrosis factor antagonists in extraintestinal manifestations in inflammatory bowel disease. Clin Gastroenterol Hepatol. 2016.
Barreiro-de-Acosta M, Lorenzo A, Domínguez-Muñoz JE (2012) Efficacy of adalimumab for the treatment of extraintestinal manifestations of Crohn’s disease. Rev Esp Enferm Dig 104(9):468–472
Rispo A, Scarpa R, Di Girolamo E, Cozzolino A, Lembo G, Atteno M et al (2005) Infliximab in the treatment of extra-intestinal manifestations of Crohn’s disease. Scand J Rheumatol 34(5):387–391
Caspersen S, Elkjaer M, Riis L, Pedersen N, Mortensen C, Jess T et al (2008) Infliximab for inflammatory bowel disease in Denmark 1999–2005: clinical outcome and follow-up evaluation of malignancy and mortality. Clin Gastroenterol Hepatol 6(11):1212–1217
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This work was supported by a research grant from the Swiss National Science Foundation (The Swiss IBD Cohort Study [Grant No. 3347CO-108792]).
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This work was supported by a research grant from the Swiss National Science Foundation (The Swiss IBD Cohort Study [Grant No. 3347CO-108792]).
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Greuter, T., Navarini, A. & Vavricka, S.R. Skin Manifestations of Inflammatory Bowel Disease. Clinic Rev Allerg Immunol 53, 413–427 (2017). https://doi.org/10.1007/s12016-017-8617-4
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DOI: https://doi.org/10.1007/s12016-017-8617-4