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Chronic Paronychia
Published in Nilton Di Chiacchio, Antonella Tosti, Therapies for Nail Disorders, 2020
Walter Refkalefsky Loureiro, Hind M. Almohanna
Differential diagnosis includes squamous cell carcinoma (SSC) and SSC in situ (Bowen disease).10 The clinical features are nonhealing ulceration or persistent eczematous lesion involving the nail folds that does not respond to standard treatments.10–12 Other mimickers to chronic paronychia are cutaneous leishmaniasis;13,14 pemphigus vulgaris;15 pemphigus vegetans;16 pyodermatitis-pyostomatitis vegetans associated with inflammatory bowel disease, particularly ulcerative colitis;10 and cutaneous metastases of internal malignancies.17,18
Upper GI Crohn’s Disease
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
Diane Mege, Janindra Warusavitarne, Yves Panis
Other lesions have been reported, such as persistent submental lymphadenopathy, perioral oedema or erythema with scaling, recurrent buccal abscesses, angular cheilitis, pyostomatitis vegetans, glossitis, gingivitis, mucosal discolouration, disgeusia, lichen planus and periodontitis with or without dental caries.8–10 These non-specific lesions are often related to nutritional deficiencies or adverse effects of medication.
Edema
Published in Giuseppe Micali, Pompeo Donofrio, Maria Rita Nasca, Stefano Veraldi, Vulval Dermatologic Diagnosis, 2015
Stefano Veraldi, Maria Rita Nasca, Giuseppe Micali
Clinical aspect: Genital Crohn’s disease (CD) can present in several different forms, extending to the inguinal, perineal, and perianal regions and involving the vulva in women. Anogenital patterns of CD include the following: contiguous (in which skin lesions follow direct extensions from areas near the affected bowel), metastatic (in which skin sites distant from the gastrointestinal tract are involved), and nonspecific mucocutaneous lesions. Genital lesions often appear as nonhealing ulcers, but they can present as a papule, a plaque, or swelling. In vulvar CD, partial or massive labial edema, eventually leading to labial hypertrophy, which may or may not be inflammatory, is frequently observed (Figure 3.2.2). Although superimposed coalescing pustules may occasionally occur, single or multiple erosions or ulcers of variable extension and depth usually represent the most common associated findings (Figures 3.2.3 and 3.2.4). Distinctive ulcerations associated with this condition are the so-called “knife cut” linear fissures, which are located along the labiocrural fold. Deep single necrotic ulcers, eventually progressing to perianal or rectovaginal fistulae, may also develop. In some patients, raised growths mimicking anogenital warts (pyostomatitis vegetans) may be observed (Figure 3.2.5). Skin ulcers may be very painful, causing considerable discomfort and impairing the quality of life. Interestingly, the severity of the cutaneous findings may not correlate with the severity of the bowel symptoms (abdominal pain, chronic diarrhea, vomiting, and wasting or weight loss).
A case of granulomatosis with polyangiitis accompanied with strawberry gingivitis, and a review of the literatures
Published in Modern Rheumatology Case Reports, 2018
Yukiko Tokuda, Nobuyuki Ono, Mariko Sakai, Yuri Sadanaga, Akihito Maruyama, Rie Suematsu, Syuichi Koarada, Hiromi Kimura, Daiji Shimohira, Yoshifumi Tada
This patient had a past history of UC. There are some reports of GPA-like pulmonary symptoms in UC patients [5–8], with some authors concluding that the extra-intestinal pulmonary complications of UC could mimic GPA [5]. PR3-ANCA is a well-known serological marker of GPA. Less commonly, c-ANCA/PR3-ANCA exhibits positive reactions in other disorders, including inflammatory bowel disease. As with inflammatory bowel disease, PR3-ANCA is positive in 29.2% of UC patients [9]. We investigated whether the patient’s oral manifestation was caused by UC or not. First, UC had been well controlled at the onset of gingivitis in our case. Second, oral lesions are not common in UC [10]. A chronic mucocutaneous ulcerative disorder called pyostomatitis vegetans is the exception, characterised by multiple miliary white or yellow pustules and vegetation, with hyperkeratosis, acanthosis, and acantholysis as histopathological findings [10,11]. From our literature search, we could not find any cases of UC that also described oral manifestation similar to SG, which is one of the characteristic signs of GPA. We also considered that SS caused her swollen gum. Due to decreased salivation, periodontal disease is one of the common complications in SS patients. In our case, not the dental hygiene but the immunosuppressive treatment was effective. There was no case report of SS with such an aggressive gingivitis like SG. Therefore, we excluded that her oral involvement was caused by UC or SS.