Медицинский совет (May 2020)
Skin diseases and inflammatory bowel diseases. Literature review
Abstract
The article presents data of some skin diseases, that often appear in inflammatory bowel diseases (IBD).Some of the skin diseases are directly connected with the activity of the main inflammatory process (erythema nodosum, Crohn’s disease of the skin and mucous, hidradenitis suppurativa) and the main method of the treatment is the decrease of main disease’s activity. Also the patient’s presence of skin lesions shows the presence of body’s system reaction and makes the main disease more difficult to cure. Medications for specific treatment of inflammatory process in the bowel (mesalasine, vedolizumab) for these patients are inefficient, as usual. Besides, patients with hidradenitis suppurativa and pyoderma gangrenous who have difficult cases of skin lesions will need the local therapy in addition to the main treatment. Generally, gastroenterologist needs dermatologist’s help in that case. Some of these diseases are not linked with the activity of inflammatory bowel diseases (“paradoxical” psoriasis, melanoma). The “paradoxical” psoriasis appears in inflammatory bowel diseases patients in the context of medication anti-TNF therapy and can be usually cured with local mecations. In case of inefficient local therapy we can appeal to change the supportive inflammatory bowel diseases therapy with anti-TNF medications to the medications belong to the group of antibodies to IL 12, 23 (ustekinumab). Also, the skin diseases, provoked by the therapy of these diseases (paradoxical psoriasis, melanoma, non-melanomic skin cancer) often appear at patients with inflammatory bowel diseases. The basic in treatment of skin diseases is reduction of activity. However, skin diseases, which are not connected with the inflammatory bowel diseases activity or are complications of therapy require to multidisciplinary approach with necessary participation of dermatologists.
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