Vulvar Crohn's disease
Introduction
Introduction to vulvar Crohn's disease Crohn's disease, also known as localized enteritis, occurs in the genital area of the vulva and is a multiple ulcer. It is a chronic inflammatory disease of the gastrointestinal tract with unknown etiology. It is characterized by segmental specific lesions from the oral cavity to the digestive tract of the anus. . Clinically, abdominal pain, diarrhea, abdominal mass, fistula formation and intestinal obstruction are characterized by fever, anemia, nutritional disorders and extraintestinal manifestations of joints, skin, eyes, oral mucosa and liver. basic knowledge Sickness ratio: 0.05% Susceptible people: women Mode of infection: non-infectious Complications: vulvar rickets
Cause
Cause of vulvar Crohn's disease
(1) Causes of the disease
The cause of the disease is not fully defined and may be related to the following factors:
1. Genetic susceptibility: The disease has a high incidence rate in the same family, and the incidence rate is different among different ethnic groups. The incidence rate among Jews is significantly higher than that of other races, suggesting that its occurrence may be related to genetic factors, but Crohn's disease is found. Specific histocompatibility antigens are present.
2. Bacterial, fungal and viral infections may be associated with the onset of Crohn's disease, but there is no direct evidence to date.
3. Immunity factors.
(two) pathogenesis
The characteristic lesion of vulvar Crohn's disease is the infiltration of subcutaneous tissue without cheese granuloma, and the expansion to subcutaneous fat, which is characterized by tissue hyperplasia, hypertrophy and ulcer formation. The granuloma is mainly composed of epithelial cells and multiple giant cells with infiltrating lymphocytes. The structure is similar to granulomatous perivascular inflammation. The pathological manifestations of granuloma are consistent with those of intestinal lesions. Typical histological features include inflammatory cell infiltration, ulceration and abscess formation, which can be found in 10% to 25% of diseased tissues. Non-case granuloma, 22% to 75% of patients with Crohn's disease have associated mucosal skin symptoms, Crohn's disease involving the vagina is rare, Burgdorf et al. classify Crohn's disease extraintestinal damage into four categories:
1. Skin granuloma includes the sinus around the anorectal rectum, and the fistula is formed.
2. Oral mucosa with aphthous ulcers.
3. Nutritional changes such as zinc, iron and folic acid deficiency.
4. Idiopathic lesions: multiple erythema, acquired bullous epidermolysis, necrotizing vasculitis, which is most common in perianal skin lesions. In 25% of Crohn's disease, the first symptom is liver week. Lesion.
Prevention
Vulvar Crohn's disease prevention
1, regular physical examination, early detection, early treatment.
2, usually in life, pay attention to the cleaning and care of the vulva.
Complication
Vulvar Crohn's disease complications Complications vulvar rickets
Infectious lesions such as vulvar rickets.
Symptom
Vulvar Crohn's disease symptoms Common symptoms Hardened pharyngeal ulcer Abscess Skin cleft palate Diarrhea Abdominal pain Vulvar swelling Nodular vulvar tenderness Abdominal mass
Most vaginal Crohn's disease is associated with colitis or a history of bowel resection. Crohn's disease can be manifested as vulvar swelling, vulvar tenderness, perineal ulcer, skin cleft palate, skin sputum, other rare symptoms and bilateral or Unilateral vulvar hypertrophy, multiple erythema, vulvar abscess, perineal fistula or sinus formation, Crohn's disease vulvar lesions are diverse and easily misdiagnosed, especially when there are no intestinal symptoms as the first symptom of Crohn's disease, about half The above patients may also have menstrual abnormalities.
Common symptoms are fever, abdominal pain, diarrhea and fatigue. Some patients have abdominal distension and lower abdominal mass. 14% to 17% of patients have perianal fistula and sinus. 21% of the fistula and abdominal cavity are connected, and extraintestinal damage includes joints. , skin, liver and gallbladder, etc., can be expressed as arthritis, fatty liver, small bile duct inflammation, sclerosing cholangitis, perihepatic abscess, other rare symptoms of nodular erythema, gangrenous pyoderma, malabsorption syndrome , glossitis, pharyngeal ulcers, etc.
Examine
Examination of vulvar Crohn's disease
Blood trace element examination, blood routine examination, erythrocyte sedimentation rate, etc., and other areas with lesions need to be checked to assist in the examination. In addition, pathological examination of living tissue is required.
Diagnosis
Diagnosis and diagnosis of vulvar disease
diagnosis
Young women have the above-mentioned manifestations of the vulva of the intestine Crohn's disease. Considering that Crohn's disease involves the vulva, biopsy tissue is found to have non-caseal granuloma, and other diseases can be ruled out to confirm the diagnosis.
Differential diagnosis
Should be identified with the following diseases: vulvar skin erosion, sarcoidosis, sexually transmitted lymphogranuloma, suppurative sweat gland inflammation, deep fungal infections and actinomycosis, vulvar tuberculosis.
