A 26-year-old patient who attended the gastroenterology outpatient clinic for evaluation of lesions that have recently appeared on the preputial skin.
The patient had a family history of Crohn's disease in a twin brother. Within his personal history, he had been diagnosed with Crohn's disease six years earlier. He had severe-intensity sprouts that required treatment with corticosteroids.
In one of these sprouts a surgical intervention was necessary, in which a total colectomy and ileostomy according to Brooke technique were performed.
The immediate postoperative course was satisfactory.
In the months after the intervention she developed a severe granulomatous rectus, treated with tapering of the rectal mucosa and rectal table eczema.
The patient is also being studied by the Department of Endocrinology due to persistently elongated activated partial thromboplastin time (APTT).
It is sent to us from the outpatient clinic of Digestive for presenting a lesion in the preputial skin of a year and a half evolution, in the form of erythematous and ulcerated plaque.
She had been treated with topical corticosteroids with the diagnosis of suspected pyoderma gangrenosum, not progressing satisfactorily.
In addition, the patient reported pruritus and some suppuration, so a sample is taken for culture, in which there is growth of urethral colonizing flora without pathological significance.
It was decided to perform a circumcision, sending the preputial skin to the pathology department with the following result: non-caseating granuloma, with ulceration, typical of metastatic Crohn's disease.
1.
After excision of the lesion, no recurrence was observed in one year of follow-up.
