Vulval Crohn's disease: A tertiary center experience of 23 patients

✍ Scribed by J. Landy; S.T.C. Peake; A. Akbar; A.L. Hart

• Publisher: John Wiley and Sons
• Year: 2011
• Tongue: English
• Weight: 36 KB
• Volume: 17
• Category: Article
• ISSN: 1078-0998
• DOI: 10.1002/ibd.21755

✦ Synopsis

s disease (CD) affecting the vulva is often unrecognized and can be difficult to treat. The majority of cases reported describe metastatic CD, where the vulval inflammation is not contiguous with the gastrointestinal tract. Overall, only 56 cases of vulval CD are reported in the literature since the first description by Parks et al in 1965. 1 We present our experience of 23 patients with vulval CD in a single tertiary center between 1999 and 2010. To our knowledge, this is the largest reported series of patients with vulval CD.

The inflammatory bowel disease (IBD) database was searched for all patients with a diagnosis of CD (based on standard clinical, endoscopic, and histological criteria), also affecting the vulva. Twenty-three patients were identified and their case notes were reviewed.

Five patients had metastatic vulval CD, while 18/23 had contiguous disease. Vulval involvement was the first presentation of CD for two patients. All of the patients were premenopausal and the median age at the time of vulval CD was 29 years (range, 19-50 years). The median interval from diagnosis of CD to vulval involvement was 10 years (range, 0-32 years).

The median age of CD diagnosis was 18 years (range, 13-40 years). Thirteen of the patients had previously undergone at least one surgical resection prior to their presentation of vulval disease. Seven had undergone proctocolectomy and four patients subtotal or hemicolectomy prior to presentation with vulval disease. Seventeen