Management of patients with inflammatory bowel diseases and extra-intestinal skin manifestations

Abstract

Introduction. Clinical manifestations of inflammatory bowel diseases (IBD) are limited not only by the gastrointestinal tract syndromes, but also by a wide range of extra-intestinal manifestations, which include skin manifestations. Skin lesions in IBD occur in different forms. Some of them are associated with the activity of the main process, for example, gangrenous pyoderma. Others, such as psoriasis, are combined with pathogenetic factors common to IBD. Materials and methods. Three clinical observations of patients with IBD and extra-intestinal manifestations are presented: gangrenous pyoderma (case 1) and psoriasis (cases 2, 3). The stages of differential diagnostic search and treatment are described. The interleukin 12/23 inhibitor ustekinumab is prescribed to both bionaive patients (observations 1, 2), and to the patient who (observation 3) had high activity of the inflammatory process in the intestine and had received early treatment with GEBD. The extension of indications for use ustekinumab (ulcerative colitis, Crohn’s disease, psoriasis, psoriatic arthritis) of allows for its wider use in the treatment of patients. Conclusion. The interleukin 12/23 inhibitor ustekinumab has broad indications for use; its use allows to achieve a positive clinical, laboratory and endoscopic effect at the early stages of use. This effect has spread to skin manifestations, the reduction of which occurs in parallel with the healing of the intestinal mucosa.