Patients with inflammatory bowel disease (IBD) who had dermatologic manifestations were found to be a distinct patient subgroup. These patients experienced more aggressive disease trajectories and reported lower quality of life. These findings were presented during the Digestive Disease Week annual meeting, held virtually, from May 21-23, 2021.
Researchers at the University of Pittsburgh School of Medicine analyzed a prospective, natural history registry of patients (N=4215) with IBD which included demographics, disease activity, treatment history, and biomarker status. Data were collected between 2009 and 2019. Crohn disease severity was assessed by the Harvey Bradshaw index and quality of life by the Short IBD Questionnaire.
The minority of patients (7.4%; n=313) presented with inflammatory dermatologic conditions. Patients presented with 1 (89.7%), 2 (9.3%), or 3 (1.0%) conditions, such as eczema (34.9%), psoriasis (23.9%), erythema nodosum (22.5%), pyoderma gangrenosum (11.8%), hidradenitis suppurativa (6.1%), and pemphigus/bullous pemphigoid (0.9%).
Inflammatory dermatologic comorbidities were associated with low albumin (P <.001) and hemoglobin (P <.001), elevated C-reactive protein (P <.001) and erythrocyte sedimentation rates (P <.001), more aggressive medical therapies (P <.001), history of intestinal resection (P <.001), peripheral blood eosinophilia (P <.001), peripheral blood monocytosis (P <.001), female sex (P <.001), low vitamin D (P =.008), lower quality of life (P =.013), Crohn disease (P =.03), and high Crohn disease activity (P =.003).
Among dermatologic manifestation subtypes, pemphigus/bullous pemphigoid was associated with peripheral blood monocytosis (P =.002) and elevated erythrocyte sedimentation rates (P =.002).
Additional studies among an independent cohort are needed to validate these findings.
The study authors concluded that patients who presented with inflammatory dermatologic conditions are a distinct subtype of patients with IBD. These patients are associated with more aggressive disease trajectories. Subtype-specific research is needed in order to determine which therapies may be most effective at slowing disease progression and reducing disease severity.
Patel BM, Rivers CR, Koutroumpakis F, et al. Dermatologic manifestations of IBD: association with natural history and biomarkers of severity. Poster presented at: Digestive Disease Week Annual Meeting; May 21-23, 2021. Abstract Sa487.
This article originally appeared on Gastroenterology Advisor