Erythema nodosum and pyoderma gangrenosum: DISCUSSION (Part 3)
Interestingly, estrogen-mediated effects on adipose tissue cytokines have also been observed by others and modulatory effects of estrogen on cytokines involved in murine models of colitis have been described . Further investigative studies to explore the role of sex steroids, particularly female hormones, including exogenous sources (eg, contraceptive medication) on the clinical expression of Crohn’s disease and mechanisms involved in the inflammatory process per se are needed.
The present study also explored the relationship of these dermatological disorders to Crohn’s disease site and disease behaviour. By employing the Vienna classification here for the first time with these disorders, this evaluation confirmed descriptions in earlier reports showing colonic involvement with or without ileal disease . In addition, in one patient, erythema nodosum developed in the presence of extensive small intestinal disease but without detectable colonic disease, emphasizing that these dermatological disorders cannot be relied upon solely as a phenotypic clinical marker of underlying colonic disease. Interestingly, most patients developed complex disease; particularly, perforating complications. This finding suggests that these dermatological disorders, particularly erythema nodosum, known to usually occur in the early clinical course of the disease, may eventually serve as a useful clinical predictor of later, more complex, Crohn’s disease, particularly perforating disease complications. Glad you are finally going to spend less time and money shopping for the treatment you need? Our canadian family pharmacy will be glad to give you that and a lot more when you become a customer, because health is very important to us.