nach oben

Erschienen in:

25.09.2017 | Review

Vulvar involvement in pediatric Crohn’s disease: a systematic review

verfasst von: Roberta Granese, Gloria Calagna, Giuliana Morabito, Carmine Carriero, Antonio Perino, Gabriele Tonni, Claudio Romano

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 1/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The aim of the study is to report a systematic review (from 2000 to 2017) of all pediatric cases of vulvar Crohn’s disease (VCD) and to highlight the key-points for a correct diagnosis and management of this rare condition.

Methods

An electronic search using the Pubmed/Medline, Scopus, EMBASE, Cochrane database and Google Scholar database was performed according to PRISMA guidelines.

Results

Twenty pediatric studies and 22 cases of VCD were included for analysis. All the articles reported a single case, except two articles where two cases, respectively, are described. Clinical vulvar examination showed the following main manifestations: vulvar erythema (9/22 cases, 40.9%), vulvar swelling (8/22 cases, 36.4%), vulvar edema (8/22 cases, 36.4%), vulvar ulcers (4/22 cases, 18.2%). Perianal and/or anal involvement (fissures, vegetations, skin tags, erythema, papules, nodules) were recorded in ten cases (45.4%). Steroids per os and/or topical administration were the most prescribed treatment, achieving clinical remission in 11 cases (50%), used alone or in combination with metronidazole or 5-aminosalicylic acid, azathioprine or sulphasalazine/mesalazine.

Conclusions

This review shows that pediatric VCD is an uncommon disease, difficult to be diagnosed as either symptoms or clinical lesions are not specific. A multidisciplinary approach is advised to reach a correct diagnosis and plan clinical treatment.

Nakao A, Iwagaki H, Kanagawa T, Jikuhara A, Matsubara N, Takakura N, Isozaki H, Tanaka N (2000) Crohn’s disease mimicking as bowel endometriosis. Are the symptoms reduced by nafarelin acetate? Arch Gynecol Obstet 263(3):131–133CrossRefPubMed

Cardile S, Randazzo A, Valenti S, Romano C (2015) Pancreatic involvement in pediatric inflammatory bowel diseases. World J Pediatr 11:207–211. doi:10.1007/s12519-015-0029-z CrossRefPubMed

Vaid RM, Cohen BA (2010) Cutaneous Crohn’s disease in the pediatric population. Pediatr Dermatol 27:279–281. doi:10.1111/j.1525-1470.2010.01138.x CrossRefPubMed

Palamaras I, El-Jabbour J, Pietropaolo N, Thomson P, Mann S, Robles W, Stevens HP (2008) Metastatic Crohn’s disease: a review. J Eur Acad Dermatol Venereol 22:1033–1043. doi:10.1111/j.1468-3083.2008.02741.x CrossRefPubMed

Shum DT, Guenther L (1990) Metastatic Crohn’s disease: case report and review of the literature. Arch Dermatol 126:645–648CrossRefPubMed

Parks AG, Morson BC, Pegum JS (1965) Crohn’s disease with cutaneous involvement. Proc R Soc Med. 58:241–242PubMedPubMedCentral

Barret M, de Parades V, Battistella M, Sokol H, Lemarchand N, Marteau P (2014) Crohn’s disease of the vulva. J Crohns Colitis 8:563–570. doi:10.1016/j.crohns.2013.10.009 CrossRefPubMed

Buckley C, Bayoumi AH, Sarkany I (1990) Metastatic Crohn’s disease. Clin Exp Dermatol 15:131CrossRefPubMed

Zorzela L, Loke YK, Ioannidis JP et al (2016) PRISMA harms checklist: improving harms reporting in systematic reviews. BMJ 352:i157. doi:10.1136/bmj.i157 CrossRefPubMed

10.

Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Open Med 3:e123-30PubMed

11.

Mun JK, Kim SH, Jung DS, Ko HC, Kim MB, Kwon KS (2011) Unilateral, non-tender, vulvar swelling as the presenting sign of Crohn’s disease: a case report and our suggestion for early diagnosis. J Dermatol 38:303–307. doi:10.1111/j.1346-8138.2010.00991.x CrossRefPubMed

12.

Corbett SL, Walsh CM, Spitzer RF, Ngan BY, Kives S, Zachos M (2010) Vulvar inflammation as the only clinical manifestation of Crohn disease in an 8-year-old girl. Pediatrics 125:e1518–e1522. doi:10.1542/peds.2009-1829 CrossRefPubMed

13.

Nabatian AS, Shah KN, Iofel E, Rosenberg S, Javidian P, Pappert A, Milgraum SS (2011) Asymptomatic granulomatous vulvitis and granulomatous cheilitis in childhood: the need for Crohn disease workup. J Pediatr Gastroenterol Nutr 53:100–101. doi:10.1097/MPG.0b013e31820bcff9 CrossRefPubMed

14.

Kuloğlu Z, Kansu A, Demirçeken F, Bozkır M, Bingöl-Koloğlu NKM, Girgin N (2008) Crohn’s disease of the vulva in a 10-year-old girl. Turk J Pediatr 50:197–199PubMed

15.

Pinna AL, Atzori L, Ferreli C, Aste N (2006) Cutaneous Crohn disease in a child. Pediatr Dermatol 23:49–52. doi:10.1111/j.1525-1470.2006.00170.x CrossRefPubMed

16.

Foo WC, Papalas JA, Robboy SJ, Selim MA (2011) Vulvar manifestations of Crohn’s disease. The American Journal of dermatopathology 33:588–593. doi:10.1097/DAD.0b013e31820a2635 CrossRefPubMed

17.

Will MA, Smith YR, McCarthy JD, Quint EH (2010) Topical therapy for severe refractory Crohn’s disease of the vulva in a prepubertal female. J Pediatric Adolescent Gynecol. doi:10.1016/j.jpag.2010.01.040

18.

Rani U, Russell A, Tanaka S, Correa H, Nicholson M (2016) Urogenital manifestations of metastatic Crohn’s disease in children: case series and review of the literature. Urology. doi:10.1016/j.urology.2016.02.026 PubMed

19.

Porzionato A, Alaggio R, Aprile A (2005) Perianal and vulvar Crohn’s disease presenting as suspected abuse. Forensic Sci Int 155:24–27. doi:10.1016/j.forsciint.2004.10.022 CrossRefPubMed

20.

Casson DH, Eltumi M, Tomlin S, Walker- Smith JA, Murch SH (2000) Topical tacrolimus may be effective in the treatment of oral and perineal Crohn’s disease. Gut 47:436–440CrossRefPubMedPubMedCentral

21.

Pai D, Dillman JR, Mahani MG, Strouse PJ (2011) MRI of vulvar Crohn disease. Pediatr Radiol 41:537–541. doi:10.1007/s00247-010-1892-3 CrossRefPubMed

22.

Warsi QA, Kunduru M, Karjoo M, Beg M (2016) Genital involvement in pre-pubertal pediatric population: a rare aspect of Crohn’s disease. Int J Pediatrics 4:3399–3404. doi:10.22038/ijp.2016.7334

23.

Yu JT, Chong LY, Lee KC (2006) Metastatic Crohn’s disease in a Chinese girl. Hong Kong Med J 12:467–469PubMed

24.

Panackel C, John J, Krishnadas D, Vinayakumar KR (2008) Metastatic Crohn’s disease of external genitalia. Indian J Dermatol 53:146–148. doi:10.4103/0019-5154.43207 CrossRefPubMedPubMedCentral

25.

Aounallah A, Ghariani Fetoui N, Ksiaa M, Boussofara L, Saidi W, Mokni S, Sriha B, Belajouza C, Denguezli M, Ghariani N, Nouira R (2017) Chronic vulvar lymphedema revealing Crohn disease in a teenage girl. Arch Pediatr 24(4):346–349CrossRefPubMed

26.

Bicette R, Tenjarla G, Kugathasan S, Alazraki A, Haddad L (2014) A 14-year-old girl with recurrent vulvar abscess. J Pediatr Adolesc Gynecol 27:e83–e86. doi:10.1016/j.jpag.2013.07.010 CrossRefPubMed

27.

Ferreira C, Soares J, Maia T, Pardal J, Nogueira A, Tavares M, Trinidade E, Dias JA (2016) Vulvar inflammation: a presentation of Crohn’s disease. Arch Dis Child. doi:10.1136/archdischild-2016-311806 PubMed

28.

Madnani NA, Desai D, Gandhi N, Khan KJ (2011) Isolated Crohn’s disease of the vulva. Indian J Dermatol Venereol Leprol 77:342–344. doi:10.4103/0378-6323.79724 CrossRefPubMed

29.

González-Bugatto F, Añón-Requena MJ, López-Guerrero MA, Báez-Perea JM, Bartha JL, Hervías-Vivancos B (2009) Vulvar leiomyosarcoma in Bartholin’s gland area: a case report and literature review. Arch Gynecol Obstet 279:171–174. doi:10.1007/s00404-008-0652-1 CrossRefPubMed

30.

Decavalas G, Adonakis G, Androutsopoulos G, Gkermpesi M, Kourounis G (2007) Sarcoidosis of the vulva: a case report. Arch Gynecol Obstet 275:203–205. doi:10.1007/s00404-006-0210-7 CrossRefPubMed

31.

Li J, Shi Y, Zhou C, Lin J (2015) Diagnosis and treatment of perineal endometriosis: review of 17 cases. Arch Gynecol Obstet 292:1295–1299. doi:10.1007/s00404-015-3756-4 CrossRefPubMed

32.

Feller ER, Ribaudo S, Jackson ND (2001) Gynecologic aspects of Crohn’s disease. Am Fam Physician 64:1725–1728PubMed

33.

Ishida M, Iwai M, Yoshida K, Kagotani A, Okabe H (2013) Metastatic Crohn’s disease accompanying granulomatous vasculitis and lymphangitis in the vulva. Int J Clin Exp Pathol 6:2263–2266PubMedPubMedCentral

34.

Lynch PJ, Moyal-Barracco M, Scurry J, Stockdale C (2012) 2011 ISSVD terminology and classification of vulvar dermatological disorders: an approach to clinical diagnosis. J Low Genit Tract Dis 16:339–344. doi:10.1097/LGT.0b013e3182494e8c CrossRefPubMed

35.

Lynch PJ, Moyal-Barracco M, Bogliatto F, Micheletti L, Scurry J (2007) 2006 ISSVD classification of vulvar dermatoses. Pathological subsets and their clinical correlates. J Reprod Med 52:3–9PubMed

36.

Hey F, Buchan PC, Littlewood JM, Hall RI (1987) Differential diagnosis in child sexual abuse. Lancet 1:283CrossRefPubMed

37.

Keiler S, Tyson P, Tamburro J (2009) Metastatic cutaneous Crohn’s disease in children: case report and review of the literature. Pediatr Dermatol 26:604–609. doi:10.1111/j.1525-1470.2008.00861.x CrossRefPubMed

38.

Di Spiezio Sardo A, Zizolfi B, Calagna G, Florio P, Nappi C, Di Carlo C (2016) Vaginohysteroscopy for the diagnosis and treatment of vaginal lesions. Int J Gynaecol Obstet 133:146–151. doi:10.1016/j.ijgo.2015.09.018 CrossRef

39.

Boxhoorn L, Stoof TJ, de Meij T, Hoentjen F, Oldenburg B, Bouma G, Löwenberg M, van Bodegraven AA, de Boer NKH (2017) Dutch initiative on Crohn and Colitis. Clinical experience and diagnostic algorithm of vulval Crohn’s disease. Eur J Gastroenterol Hepatol 29:838–843. doi:10.1097/MEG.0000000000000879 CrossRefPubMed

40.

Andreani SM, Ratnasingham K, Dang HH, Gravante G, Giordano P (2010) Crohn’s disease of the vulva. Int J Surg 8:2–5. doi:10.1016/j.ijsu.2009.09.012 CrossRefPubMed

41.

Preston PW, Hudson N, Lewis FM (2006) Treatment of vulval Crohn’s disease with infliximab. Clin Exp Dermatol 31:378–380. doi:10.1111/j.1365-2230.2006.02079 CrossRefPubMed

42.

Bouzidi H, Chakiri R, Amraoui N, Krich S, Mernissi FZ, Belmahi R, Hida M (2014) Crohn’s disease presenting as vulvar edema in a 15-year-old girl. J Dermatol Case Rep 8:75–77. doi:10.3315/jdcr.2014.1180 CrossRefPubMedPubMedCentral

43.

Zhang AJ, Zhan SH, Chang H, Gao YQ, Li YQ (2015) Crohn disease of the vulva without gastrointestinal manifestations in a 16-year-old girl. J Cutan Med Surg 19:81–83. doi:10.2310/7750.2014.14005 CrossRefPubMed

Titel: Vulvar involvement in pediatric Crohn’s disease: a systematic review
verfasst von: Roberta Granese
Gloria Calagna
Giuliana Morabito
Carmine Carriero
Antonio Perino
Gabriele Tonni
Claudio Romano
Publikationsdatum: 25.09.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: Archives of Gynecology and Obstetrics / Ausgabe 1/2018
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-017-4539-x

Neu im Fachgebiet Gynäkologie und Geburtshilfe

Ambulantisierung: Erste Erfahrungen mit dem Hybrid-DRG

02.05.2024 DCK 2024 Kongressbericht

Die Hybrid-DRG-Verordnung soll dazu führen, dass mehr chirurgische Eingriffe ambulant durchgeführt werden, wie es in anderen Ländern schon länger üblich ist. Die gleiche Vergütung im ambulanten und stationären Sektor hatten Niedergelassene schon lange gefordert. Aber die Umsetzung bereitet ihnen doch Kopfzerbrechen.

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Harninkontinenz: Netz-Op. erfordert über lange Zeit intensive Nachsorge

30.04.2024 Harninkontinenz Nachrichten

Frauen mit Belastungsinkontinenz oder Organprolaps sind nach einer Netz-Operation keineswegs beschwerdefrei. Vielmehr scheint die Krankheitslast weiterhin hoch zu sein, sogar höher als von harninkontinenten Frauen, die sich nicht haben operieren lassen.

Welche Übungen helfen gegen Diastase recti abdominis?

30.04.2024 Schwangerenvorsorge Nachrichten

Die Autorinnen und Autoren einer aktuellen Studie aus Griechenland sind sich einig, dass Bewegungstherapie, einschließlich Übungen zur Stärkung der Bauchmuskulatur und zur Stabilisierung des Rumpfes, eine Diastase recti abdominis postpartum wirksam reduzieren kann. Doch vieles ist noch nicht eindeutig belegt.

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.

Newsletter bestellen

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 1/2018

The effect of prebiotic vaginal gel with adjuvant oral metronidazole tablets on treatment and recurrence of bacterial vaginosis: a triple-blind randomized controlled study

Knockdown of E-cadherin expression of endometrial epithelial cells may activate Wnt/β-catenin pathway in vitro

Reply to “Retained placenta accreta with marked vascularity, uterine artery pseudoaneurysm, and placental polyp: overlapping clinical entities?”

Investigation of the clinical features of lower uterine segment carcinoma: association with advanced stage disease and indication of poorer prognosis