Coexistent pyoderma gangrenosum and tibialis anterior myositis as presenting manifestations of Crohn’s disease: case report and review of the literature

Crohn’s disease (CD) is a well defined inflammatory bowel disease. Patients primarily present with abdominal pain and diarrhea, however, extra-intestinal manifestations due to musculoskeletal and cutaneous involvement are seen in a varying range of patients. In this communication we describe a young woman who presented with a severe inflammatory illness that consequently developed into pyoderma gangrenosum, anterior tibialis myositis and arthritis that were all antecedent to the intestinal involvement. The patient favorably responded to infliximab with concomitant azathioprine therapy.