Enfermedad de Crohn metástasica de la vulva

A 32-year-old woman with Crohn's disease for six years, but asymptomatic at that moment, consulted due to a persistent and progressive vulvar erythema and oedema with erosions and hypertrophy of the lips. Infectious agents were discarded and only after three cutaneous biopsies the presenece of granulomatous infiltrate from Crohn's disease could be demonstrated. There was no connection with bowel lesions, and clear improvement was achieved with topical steroid therapy. Cutaneous involvement by regional ileitis occurs generally due to direct extension to perianal region, but it is exceptional the presentation of lesions at a remote site far from the gastrointestinal tract. Clinics is not characteristic and hystopathological study is very important for the diagnosis. A cutaneous biopsy must practiced at any cutaneous alteration in Crohn's disease patients, and repeated if it is not conclusive.