Metastatic vulval Crohn's disease and infliximab: a case report.

Background: Metastatic vulval Crohn's disease is uncommon, and diagnosis is frequently delayed. Topical therapy is often ineffective, and systemic immunosuppressive agents are required.

Case: A 32-year-old Caucasian female with known gastrointestinal Crohn's disease presented with a 7-year history of vulvitis. Perianal biopsy demonstrated typical granulomas. Her disease was resistant to treatment with prednisone and azathioprine; however, infliximab effected good control, and she remains well on 8 weekly infusions 1 year later.

Conclusion: Biopsy should be performed in patients with vulvitis who have Crohn's disease to rule out metastatic involvement. Infliximab was successfully used in this case to control Crohn's vulvitis.