Prevalence of inflammatory skin disorders in patients with inflammatory bowel disease (IBD)

Abstract

Inflammatory bowel disease (IBD) is a chronic inflammatory disorder, which primarily affects the gut, but is not restricted to the intestinal tract. IBD is result of a complex interplay between a dysfunctional host immune response and environmental triggers. Extraintestinal manifestations (EIMs) are frequently observed in patients with IBD. The aim of this study was to evaluate the prevalence and features of the major cutaneous manifestations and associating factors in patients with IBD. This cross-sectional study was conducted on patients with IBD who were referred to gastroenterology and dermatology outpatient clinics in Imam Khomeini Hospital Complex, in Tehran, Iran, between March 2020 and March 2021. All patients underwent a body examination by a gastroenterologist and dermatologist. We used SPSS (version 25) to run appropriate statistical tests to analyze any relationship between skin diseases, and socio-demographic and disease-related characteristics of the patients, as well as medications used. A total of 226 patients were included in this study of which 59 (26.1%) were diagnosed with CD and 167 (73.9%) with UC. Eighty-six participants (38.1%) of all IBD patients (52.5% of CD patients and 32.9% of UC patients) had skin disease at the time of examination. Patients with CD were significantly more likely to have skin disease at the time of examination or while IBD was active (p = 0.008 and p = 0.019, respectively). Aphthous stomatitis and atopic dermatitis were the most frequent skin disease observed in all IBD patients (11.1% for both) as well as UC patients, whereas perianal fissure was the most frequent cutaneous manifestation in CD patients. Psoriasis and aphthous stomatitis were more common in female patients (p = 0.046 and p = 0.004, respectively). Skin diseases were generally more frequent in female (p = 0.001) and married patients (p = 0.015). Our research revealed that aphthous stomatitis and atopic dermatitis were the most common skin-related extraintestinal manifestations (EIMs) observed in all patients with inflammatory bowel disease (IBD). Furthermore, individuals with Crohn's disease (CD) were more prone to developing skin manifestations. Women and married individuals are considered high-risk groups for skin lesions, and it is advisable for these patients to undergo regular skin examinations.

Keywords: Cutaneous extraintestinal manifestations; Epidemiology; Extraintestinal manifestations; Inflammatory bowel disease.