TOPLINE:

Patients with Crohn’s disease (CD) with perianal disease involvement or a history of an ostomy had increased odds of developing metastatic cutaneous CD.

METHODOLOGY:

• Metastatic cutaneous CD is a rare, painful, and potentially disabling extraintestinal manifestation of CD, but data on risk factors are limited to case reports and small case series.
• Researchers conducted a retrospective case-control study using data from a large US registry (January 2016-August 2025) to identify risk factors associated with metastatic cutaneous CD.
• They included patients with CD who met the Delphi panel criteria — combinations of major features, such as genital swelling, knife-like ulcers, and lymphedema, and minor features, such as perianal tags, genital fissures, nonhealing ulcers, compatible biopsy findings, and a diagnosis of inflammatory bowel disease.
• Each patient was age- and sex-matched with two control patients with CD without metastatic lesions who had been seen by dermatologists for benign nevi.
• Researchers analyzed data on demographics, phenotype of CD, medication and surgical history, and other extraintestinal findings to identify the factors associated with metastatic cutaneous CD.

TAKEAWAY:

• The study included 61 patients with metastatic cutaneous CD matched with 122 control patients (mean ages, 41.7 and 42.6 years, respectively; 77% female in both groups).
• Patients with perianal disease involvement had increased odds of metastatic cutaneous CD (adjusted odds ratio [aOR], 6.79; P = .014).
• A history of an ostomy showed the strongest association with metastatic cutaneous CD (aOR, 72.65; P = .006), but the 95% CI was wide (3.50-1505.92) because only a few control patients underwent ostomy.

IN PRACTICE:

“Continued integration of gastroenterology-dermatology approaches and increased awareness of extraintestinal manifestations in CD patients with these identified risk factors is crucial for this patient population,” the authors of the study wrote.

SOURCE:

The study was jointly led by Natalie M. Baker, MS, Harvard Medical School, and Karla Santiago-Soltero, MD, Brigham and Women’s Hospital, Boston. It was published online in the American Journal of Gastroenterology.

LIMITATIONS:

The case-control design limited generalizability and could not establish the order of risk factors and disease onset. The rarity of the disease limited the statistical power and prevented subgroup analyses. The selection criteria for control patients limited the assessment of medication effects.

DISCLOSURES:

The study did not receive any funding. One author reported receiving consulting fees from Honeydew Care and Sanofi Pasteur.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.