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A woman in her 50s with a history of Crohn disease (CD) was referred for evaluation of painful perianal skin growths. The growths had been present for 1 year. Physical examination revealed a tender perianal plaque with a papular, cobblestone-like surface (Figure, A). She was taking no medications and had not had active gastrointestinal symptoms of CD in several years. A biopsy specimen from the perianal plaque was obtained (Figure, B and C).
Gonzalez CD, Chung CG, Clarke JT. Painful Perianal Papules in a Middle-Aged Woman. JAMA Dermatol. 2016;152(7):833-835. doi:10.1001/jamadermatol.2016.0143