External ear dermatitis in a Crohn’s disease patient

Inflammatory bowel disease often begins during adolescence, but may also affect younger children. Associated lesions of the skin or oral and/or perianal mucosa are not uncommon [1]. Especially Crohn’s disease may be associated with many different typical and atypical cutaneous manifestations [2]. Occasionally, cutaneous alterations may precede the onset of signs or symptoms in the gastrointestinal tract. Erythema nodosum and pyoderma gangrenosum are the most commonly associated skin lesions, but numerous others may be found. Although treating Crohn’s disease often leads to a remission of these skin lesions, additional therapy, varying from corticosteroid to anti-tumor necrosis factor agents, may be required [3]. A 19-year-old patient diagnosed two years ago with fistulizing Crohn’s disease presented with an erythematous plaque behind his right ear (Figure 1). The plaque was accompanied by edema of the surrounding skin with signs of vasculitis. The patient recovered with topical corticosteroids the lesion healed and was left with a flat hypertrophic scar.