Definition
Crohn’s disease is a chronic inflammatory intestinal pathology which can be associated to different extra-digestive manifestations such as ano-genital granulomatosis, inguinal fistula with recurrent penile, and scrotal lymphedema.
Clinical Features
Recurrent genital lymphedema is associated or not with fever and gastrointestinal symptoms. Other symptoms are funiculitis or orchioepididymitis in patients with long-standing Crohn’s disease. Other times, the first manifestation of Crohn’s disease are inguinal fistulas (Reitsma et al. 2012), and especially in children, genital edema (Barrick et al. 2016).
Incidence
Genitourinary complications occur in 5–20% of patients with active Crohn’s disease. Isolated scrotal and penile lymphoedema as the presenting symptom of Crohn’s disease is quite unusual.
Age
At any age
Sex
Male
Treatment
Treatment with corticosteroids and azathioprine results in significant decrease of inflammatory genital lymphedema. Fistulous tracts should be...
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References and Further Reading
Alexakis, C., Gordon, K., Mellor, R., Chong, H., Mortimer, P., & Pollok, R. (2017). Ano-genital granulomatosis and Crohn’s disease: A case series of males presenting with genital lymphoedema. Journal of Crohn’s & Colitis, 11, 454–459.
Barrick, B. J., Tollefson, M. M., Schoch, J. J., McEvoy, M. T., Hand, J. L., Wieland, C. N., & Davis, D. M. (2016). Penile and scrotal swelling: An underrecognized presentation of Crohn’s disease. Pediatric Dermatology, 33, 172–177.
Garny de La Rivière, C., Caudron, A., Heyman, B., & Lok, C. (2015). Genital lymphedema associated with Crohn’s disease. La Revue de Médecine Interne, 36, 291–293.
Murphy, M. J., Kogan, B., & Carlson, J. A. (2001). Granulomatous lymphangitis of the scrotum and penis. Report of a case and review of the literature of genital swelling with sarcoidal granulomatous inflammation. Journal of Cutaneous Pathology, 28, 419–424.
Reitsma, W., Wiegman, M. J., & Damstra, R. J. (2012). Penile and scrotal lymphedema as an unusual presentation of Crohn’s disease: Case report and review of the literature. Lymphology, 45, 37–41.
Weinberg, A. E., Hazard, F. K., & Hsieh, M. H. (2012). A case of genitourinary Crohn’s disease. Urology, 80, 1132–1134.
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Nistal, M., González-Peramato, P. (2019). Crohn’s Disease in the Scrotum. In: van Krieken, J. (eds) Encyclopedia of Pathology. Encyclopedia of Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-28845-1_4796-1
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DOI: https://doi.org/10.1007/978-3-319-28845-1_4796-1
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