Abstract
Background
Dermatologic manifestations of inflammatory bowel disease (IBD) are common and cause a significant burden on patients’ quality of life. More than 10% of IBD patients present cutaneous manifestation at the time of diagnosis; however, less than one in 10 IBD patients seeks dermatologic care. In up to 30% of cases, intense skin reactions mandate treatment discontinuation. There is growing evidence that the treatment of IBD patients improves when given by a multidisciplinary team yet data on combined IBD dermatology clinics is scarce. The aim was to describe our experience in this approach.
Methods
A retrospective descriptive study of a 2-year multidisciplinary IBD-dermatology clinic in a tertiary hospital in Israel, performed by an IBD expert and a senior dermatologist.
Results
Eighty-six visits (52 patients, of whom 50% males) were documented. Patients included Crohn’s disease (n = 41) and ulcerative colitis (n = 11) at an average age of 43.1 ±16.1 years. Rash was the most common referral aetiology, accounting for 60.4% (52/86) of clinic visits. A preexisting skin disorder occurred in 65.3% (34/52) of patients. Psoriasis, the most common diagnosis, was diagnosed in 19 patients. Additional extra-intestinal manifestations occurred in 38.4% of patients (20/52). Majority of patients, 92.3% (48/52), were under medical treatment: 77% (40/52) of the cohort received biologic therapy, mostly (61.5%) anti-TNFα agents
Visits included preventive measures (mole assessment), diagnostic tests (skin biopsy) and therapeutic procedures (needle cauterisation, phototherapy). In 65.1% (56/86) of visits– topical treatment was advised. Among 21 re-visits, skin improvement was observed in 57.1%. Treatment-related skin symptoms were suspected in 34.6% of patients (18/52): in 38.8% (7/18), biological treatment was changed and in 13 patients, topical therapy was added, resulting in dermatologic improvement in 12 patients.
Conclusion
The IBD-dermatology clinic appears to improve IBD patient care. This clinic sets a new standard of treatment for IBD patients with dermatological issues
BI25: Lessons learnt: our experience of a specialist surveillance dermatology clinic for immunosuppressed patients at a UK tertiary centre
