We report a 16-year-old Hispanic girl with gastrointestinal complaints and an unusual cutaneous eruption consisting of vesiculopustules and blanching erythematous plaques with peripheral scale. Diagnostic workup showed collections of neutrophils in the upper epidermis and subcorneal layer on the skin biopsy specimen, and deep ulcerations, crypt abscesses, and granulomas on endoscopy, diagnostic of Crohn disease. The skin findings are consistent with a vesiculopustular eruption without vasculitis, previously only reported in association with ulcerative colitis. This case broadens the spectrum of neutrophil-based cutaneous disorders associated with inflammatory bowel disease. Clinicians should be aware of the usual cutaneous manifestations of inflammatory bowel disease and consider the diagnosis of Crohn disease in the context of vesiculopustular dermatitis and abdominal symptomatology.
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