Crohn’s Disease Skin Rashes: What are They?
The most common skin manifestation of Crohn’s disease is dermatitis herpetiformis (DH). DH is a type of itchy red rash that occurs on the palms, soles, scalp, armpits and groin area. The rash may appear anywhere from one day to several weeks after exposure to an allergen or irritant. Most often, the rash appears first on these areas and then spreads to other parts of the body. The rash usually begins with small blisters which heal within a few days. However, some patients have persistent rashes even years after their initial contact with an allergen or irritant.
Other skin manifestations of Crohn’s disease include erythema multiforme (EM), which is characterized by redness and swelling of the affected areas; pruritus, which is itching sensations in the affected areas; and urticaria, which causes burning sensation in the affected areas. All of these skin rashes are usually the result of an allergic reaction to food, medication or stress.
Crohn’s disease also affects the nails and causes them to become thin and brittle. This can lead to a condition called onycholysis, which is a separation of the nail from the bed.
What is the relationship between Crohn’s disease and skin conditions?
The relationship between inflammatory bowel disease and skin conditions is not fully understood by medical science. Researchers have found that some people may develop skin conditions as a result of malnutrition from the disease or due to the effects of drugs used to control their inflammatory bowel disease. These skin conditions can include fungal infections, psoriasis, itchy skin rashes and perhaps even skin lesions similar to eczema.
What is dyshidrotic eczema?
Dyshidrotic eczema or dyshidrotic dermatitis is a skin rash that primarily affects the fingers and toes. This skin rash is more common in the summer months and may cause itching, burning, stinging and/or swelling of the affected areas. The rash usually appears as small, itchy blisters on the fingers and toes. These blisters are prone to cracking and bleeding easily.
Dyshidrotic eczema is also known as “pompholyx” or vesicular palmar dermatitis. This condition most often affects children, pregnant women and people who are under a great deal of stress. It is also more common in people who work with abrasive powders or soaps, in people with skin that is sensitive to heat and in people that have a history of allergies or atopic conditions such as hay fever, asthma or hives.
Some medical professionals also think that dyshidrotic eczema may be triggered by contact with nickel, which is a common component of jewelry and watch straps.
What should you do if you think you may have dyshidrotic eczema?
If you think you may be experiencing the symptoms of dyshidrotic eczema, it is important that you see your doctor for a diagnosis. Your doctor will want to perform an examination of the affected areas to rule out skin conditions that are not dyshidrotic eczema. If you have recently started a new medication or changed your cleaning products, this could also be the cause of the rash.
Your doctor may refer you to a dermatologist, a doctor who specializes in the treatment of conditions affecting the skin, hair and nails. A dermatologist can perform tests to rule out other skin conditions that may be causing your symptoms.
How is dyshidrotic eczema treated?
Treatment for dyshidrotic eczema is aimed at relieving the burning and itching sensations. Your doctor may recommend that you take an antihistamine to control your allergic reaction and reduce the itch. Your doctor may also recommend that you apply a topical steroid or calcineurin inhibitor cream, ointment or lotion to ease discomfort.
If you are experiencing severe skin cracking or bleeding of the skin, your doctor may recommend that you wear gloves until the condition has improved. When wearing gloves, it is important to change them regularly and wash them daily since you are more prone to getting fungal or bacterial infections.
It is also important to keep your hands and feet moisturized and avoid working with any substance that may irritate your skin.
If dyshidrotic eczema is caused by contact with an allergen or irritant, you should avoid contact with whatever is causing the reaction. If you wear leather or cotton gloves or socks and change them daily, this may help stop the allergic reaction. You should also avoid working with any irritants, such as soaps, chemicals or cleaning products.
Severe dyshidrotic eczema may require the use of immunosuppressant drugs if the above treatments are ineffective or if the symptoms are severe.
What is the prognosis?
The prognosis for dyshidrotic eczema is generally good. Most people make a full recovery within two weeks, but there is a chance that your skin condition may be exacerbated by stress or weather changes. In this case, the condition should respond well to treatment.
If the condition does not improve in two weeks, see your doctor for a different treatment or you may need to see a dermatologist if the condition becomes severe or painful.
Sources & references used in this article:
Cutaneous manifestations of Crohn’s disease by W Burgdorf – Journal of the American Academy of Dermatology, 1981 – jaad.org
Further evidence for an association between psoriasis, Crohn’s disease and ulcerative colitis by V M. YATES, G Watkinson… – British Journal of …, 1982 – Wiley Online Library
Etanercept for active Crohn’s disease: a randomized, double-blind, placebo-controlled trial by WJ Sandborn, SB Hanauer, S Katz, M Safdi, DG Wolf… – Gastroenterology, 2001 – Elsevier
Skin complications associated with inflammatory bowel disease by F Tavarela Veloso – Alimentary pharmacology & therapeutics, 2004 – Wiley Online Library