Mediterr J Rheumatol 2019;30(3):190-3
Α 40-Year-Old Woman with Asymmetric Arthritis and Skin Lesions
Authors Information
1Patras University Hospital, Department of Internal Medicine, Division of Rheumatology, Rion, Patras, Greece
2University of Patras Medical School, Rion, Patras, Greece
A 40-year old woman with recent asymmetric arthritis and fever was evaluated in our clinic.  NSAIDs were recommended, but a few days later she was admitted to our hospital because of worsening arthritis along with the appearance of new skin lesions in both feet.  Although she was treated with antibiotics and high dosages of steroids, her arthritis did not improve.  The skin lesions progressed from bullous initially to ulcerative finally pyoderma gangrenosum, so we suggested endoscopic examination of the colon which revealed Crohn’s disease. The patient received I.V. treatment with infliximab resulting in a remarkable response. Some patients with Crohn’s disease may present with extraintestinal manifestations well before the bowel disease is manifested and diagnosed.