DermAtlas: Dermatology Image Inflammatory_bowel_disease_4_090421 (Crohn disease

Dermatology - BUCCAL MUCOSA: Crohn disease - perleche

Image Name:

Inflammatory_bowel_disease_4_090421

File Type:

jpg

Diagnosis:

CROHN DISEASE / PERLECHE
GRANULOMATOUS REACTION / CHEILITIS

Category:

granulomatous disorder /
cutaneous sign of systemic disease /
dental/oral disorder /
gastrointestinal disorder

Morphology:

papule / fissure
ulcerated (erosion / ulcer)

Organization:

Pattern:

symmetric

Color:

red

Body Site:

buccal mucosa / mouth

Age:

13 years

Gender:

female

Image Year:

2009

Contributor:

James Scuibba

First Published:

May 03, 2009

Description:

cobblestoning of the mucosa with linear ulcers and hyperplastic folds

Comments:

This 13-year-old girl was referred for evaluation of oral ulcerations, facial swelling and oral pain. A concomitant history of swelling involving the lower lip, cheeks and cervical lymphadenopathy was also noted. Last year she missed 27 school days due to abdominal pain. She had a tonsillectomy at 2 years of age and complained of severe depression and anxiety, nasal stuffiness, asthma, and abdominal pain. She had multiple treatments including oral antibiotics, parenteral antibiotics, chlorhexidine rinses, and topical steroids. A biopsy of the buccal mucosa revealed focal and diffuse chronic inflammation with scattered non-caseating epitheloid granulomas. Special stains were negative for acid fast bacteria, fungus, and polarizing microscopy was negative for foreign material. Further evaluation by pediatric gastroenterology including upper and lower gastrointestinal tract studies showed characteristic changes of Crohn disease. Oral and gastrointestinal lesions and symptoms resolved with treatment of her inflammatory bowel disease.

Related Links:

SkinCell International Forum
SkinCell International Forum
Crohn's Disease Fact Book & Latest Medical News

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