ArticleTechniques in coloproctology2026
Surgical management of metastatic cutaneous Crohn's disease: a case series from a tertiary centre in the United Kingdom.
Article in Techniques in coloproctology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND AND
aimsMetastatic Crohn's disease (MCD) is a rare extra-intestinal manifestation (EIM) of Crohn's disease (CD), defined by granulomatous inflammation of skin non-contiguous to the gastrointestinal tract. This study describes the clinical features, surgical management and wound healing outcomes of the largest national surgical cohort of patients with severe MCD, a topic that remains poorly represented in the literature.
methodsThis retrospective single-centre case series included adults (> 18 years) undergoing surgical management for MCD from 2019 to 2024. Diagnosis was confirmed by expert clinical and histopathological assessment. We describe pre-operative optimisation, individualised surgical approaches and post-operative management delivered by a multi-disciplinary team led by consultant colorectal and plastic surgeons. Wound healing was assessed clinically in a specialist complex wounds clinic at 6 and 12 months and at final long-term follow-up.
resultsEleven female patients (median age 37 years) underwent surgical intervention. At 6 and 12 months, 45.5% achieved complete healing, improving to 81.8% by final follow-up (median 36 months). Most underwent a combined medical and surgical approach with proctocolectomy and tailored perineal reconstruction. Persistent lesions and non-healing ulcers required additional adjuncts to treatment which included topical tacrolimus, hyperbaric oxygen therapy and surgical re-excision to improve healing outcomes.
conclusionsMCD is a challenging condition requiring surgical treatment in refractory cases despite medical therapy. Our study highlights the need for multidisciplinary working alongside meticulous pre-operative optimisation and close post-operative follow-up to improve long-term wound healing outcomes for patients with this rare and complex disease.
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