Crohns Disease

Anogenital lesions occur in about 30% of patients with intestinal Crohn's, either as a direct extension of active intestinal disease or as a secondary disease. Vulvar disease

Table 4 Zoon's Vulvitis

Diagnosis

Symptoms

Clinical Differential appearance diagnosis

Therapy

Zoon's Asymptomatic, itch, Glassy red VIN, lichen or burning erythema planus

Rx underlying condition; topical lidocaine and barrier ointments

Crohn And Labia Fissures
Figure 10 (A) Lichen aureus—lichen aureus is in the differential diagnosis of a band-like dermal infiltrate of chronic inflammatory cells. (B) Lichen aureus—increased numbers of dermal vessels (left) and hemosiderin (right) are seen.

may present many years before intestinal involvement and in some cases there is vulvar edema and lymphangiectasia only, with no evidence of granulomatous inflammation (Fig. 11C) (16,17). The more usual presentation is ulceration, abscess, sinus, and fistula formation with a granulomatous histology. There may be deep linear fissures (knife cut sign) along the skin creases (Table 6).

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