Topical tacrolimus for recurrent penile Crohn's disease.

Skin lesions are associated with Crohns disease (CD) in 22– 44% of patients. Metastatic Crohn's disease (MCD) is defined as granulomatous skin lesions occurring at sites separate from the gastrointestinal tract, mainly in the lower extremities and intertriginous areas.1 Genital MCD has been frequently described as refractory and usually begins as a non-healing ulcer, but can be shown as a papule, plaque or swelling.2 We describe the case of a 24-year-old male who presented with ulcers in the penile foreskin area two weeks before admission in the Urology department. He was diagnosed with colonic and perianal CD at 9 years old (A1L3B2p). He has had multiple exacerbations since then, which only responded partially to azathioprine, infliximab and adalimumab. He has had a right colostomy and left mucous fistula since 2008, treated with azathioprine. Two months before, the patient had clinical worsening due to tenesmus, mucus discharge from the rectal stump, abdominal pain, and weight loss, with a