Vulval Crohn’s Disease in Childhood
A 10-year-old girl presented to the dermatology department at York Hospital with a 12-month history of asymptomatic erythema and swelling of the vulva. The patient was systematically well, and had no gastrointestinal symptoms. There was no personal or family history of inflammatory bowel disease. On examination, the patient was a healthy-looking girl with normal height and weight for her age. Examination of the patient’s vulva revealed a “peau d’orange” appearance, with a large skin tag in the anterior peri-anal area (Fig. ). Examination of the oral mucosa, rectum, and the rest of the skin was unremarkable. Biopsy of the affected vulva showed non-caseating granulomata with negative Ziehl–Nielson stains and culture. The patient was treated with tacrolimus ointment 0.03% which resulted in good control of the disease. A year after the initial presentation, the patient developed mouth ulcers and bloody diarrhea. The patient was diagnosed with CD, confirmed on intestinal biopsies.