We report an unusual case of biopsy-proven orofacial Crohn's disease presenting as cutaneous malar plaques with almost a complete resolution with sulfasalazine treatment. Cases of metastatic disease presenting as malar plaques have been described in the North American literature, and all have had a poor response to treatment. Although this is not a newly described disease, this unusual presentation highlights the importance of Crohn's disease as a consideration in the differential diagnosis of facial plaques.
Report of a Case.
A 44-year-old woman presented by referral with a 14-month history of an erythematous facial eruption and intermittent lip swelling. The patient had a long-standing history of regional enteritis since the age of 20 years. A perioral biopsy specimen revealed multiple noncaseating granulomas thought to represent sarcoid. Treatment with intravenous and oral antibiotics produced partial clearance of the crusting, but the erythematous plaques, lip swelling, and pustulonodular lesions persisted. Isotretinoin therapy was
Kolansky G, Kimbrough-Green C, Dubin HV. Metastatic Crohn's Disease of the Face: An Uncommon Presentation. Arch Dermatol. 1993;129(10):1348-1349. doi:10.1001/archderm.1993.01680310120030