P211 : PPP with Crohn`s disease

Crohn’s disease is a type of inflammatory bowel disease that may affect any part of the GI tract. Extraintestinal features are common in Crohn’s disease and include arthritis, skin problems and inflammation in the eyes or mouth. Cutaneous involvement in the Crohn’s disease occurs in about 40% of the patients, including hidradenitis suppurativa, phlebitis, erythema multiforme, urticaria, lichen planus, secondary amyloidosis, and various autoimmune skin disorders. Palmoplantar pustulosis (PPP) presents as crops of sterile pustules occurring on one or both hands and/or feet. They are associated with thickened, scaly, red skin that easily develops painful cracks Histologic findings of PPP shows the intraepidermal pustules in the acanthotic epidermis and superficial perivascular lymphocytic infiltrates in the dermis. We report a case of PPP in a patient with Crohn’s disease. A 43-year old male presented with 6 months history of pruritic yellowish pustules and erythematous based patches on the palms and soles. This patient had been diagnosed with the Crohn’s disease 10 years ago and since then he had been treated with daily oral azathioprine, mesalazine and infilximab injection in every 8 weeks. The clinical and histopathological findings were compatible with PPP. The patient’s skin lesion was subsided after the 6 weeks treatment with systemic steroid and antihistamine. We report this rare case of PPP associated with Crohn’s disease