Intestinal diseases, skin changes

Monitored symptoms and diseases of the skin and skin appendages may indicate intestinal diseases. In most cases, they are not specific. In any case, however, they should prompt a thorough internal examination by a dermatologist.

• Chronic inflammatory bowel disease (IBD), (e.g. enteritis regionalis(Crohn's disease - see also Crohn's disease, skin changes), ulcerative colitis; skin symptoms in approx. 70% of patients):
  • Abscesses, fissures and fistulas
  • Erythema nodosum
  • Recurrent oral aphthae
  • Aggravation of psoriasis vulgaris
  • Lichen planus
  • Pyoderma gangraenosum
  • Pyostomatitis vegetans
  • Bowel bypass syndrome (Bowel-associated dermatosis-arthritis-syndrome)
  • NMSC (Nonmelanoma Skin Cancer; note: accumulation of NMSC due to ongoing immunosuppressive therapies).
  • Cheilitis granulomatosa
  • Sweet syndrome
  • Neutrophilic dermatosis of the back of the hand (minus variant of Sweet syndrome)

  • Aseptic abscess syndrome

• Bleeding from the intestines (from birth or early childhood):
  • Peutz-Jeghers syndrome
  • Teleangiectasia haemorrhagica hereditaria
  • Blue-Rubber-Bleb-Naevus syndrome
  • Ehlers-Danlos syndrome
  • Pseudoxanthoma elasticum
• Bleeding from the intestine (acquired):
  • Kaposi's sarcoma.
• Occlusion of intestinal vessels:
  • Leukocytoclastic vasculitis
  • Collagenoses (e.g. systemic scleroderma, systemic lupus erythematosus, dermatomyositis):
  • M. Behçet
  • Köhlmeier-Degos disease (malignant atrophic papulosis, vasculitic process with multiple infarcts in the gastrointestinal tract)
• Polyposis:
  • Peutz-Jeghers syndrome
  • Cronkhite-Canada syndrome.
• Malabsorption syndromes:
  • Avitaminoses (e.g. beri-beri, pellagra, scurvy, purpura, perleche)
  • Dermatitis herpetiformis Duhring (sprue?)
  • Zinc deficiency dermatoses
  • Acrodermatitis enteropathica.
  • Candidiasis
• Intestinal tumors:
  • Cutaneous paraneoplasia

IL-10 dampens intestinal inflammation and is a good candidate gene for IBD. Polymorphisms in the IL-10 receptor are also associated with ulcerative colitis, which occurs in early childhood. In addition, severe infantile enterocolitis , which is similar to Crohn's disease, is caused by LOF mutations in the interleukin-10 gene and the interleukin-10 receptor . The disease is associated with severe perianal abscesses and fistulas. Patients may also suffer from recurrent fever and respiratory tract infections. Cutaneous folliculitis and arthritis also occur in individuals with IL-10 receptor mutations. Hematopoietic stem cell transplantation is currently the only curative therapy.

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