An Atypical Association of Cutaneous Crohn’s Disease with Hidradenitis Suppurativa without Clinically or Endoscopically Apparent Bowel Involvement

Abstract

Cutaneous Crohn’s disease (CD) usually manifests with underlying inflammatory bowel disease (IBD) and may precede, present simultaneously, or even manifest years later to the IBD. Cutaneous involvement in CD may be due to metastatic or contiguous spread from the underlying focus. Cutaneous manifestations of CD may be specific with histopathologically consistent diagnosis or nonspecific reactive processes. Specific cutaneous findings may be considered sine qua non of the diagnosis. Hidradenitis suppurativa (HS) is a disease of follicular occlusion found to be associated with IBD, especially CD. The concurrence of cutaneous Crohn’s (CC) without apparent bowel involvement and HS simultaneously or sequentially as two independent processes has rarely been reported. When either of the diseases clinically superimposes on the other, the judgment of the clinician regarding diagnosis is often jeopardized due to almost similar spectrum of cutaneous lesions in both diseases. Herein, we are reporting a rare clinical scenario where there is co-occurrence of CC without apparent bowel involvement and HS.