International Journal of Colorectal Disease

, Volume 4, Issue 3, pp 197–199 | Cite as

The histology of anal skin tags in Crohn's disease: An aid to confirmation of the diagnosis

  • B. A. Taylor
  • G. T. Williams
  • L. E. Hughes
  • J. Rhodes
Original Articles


We have investigated excision biopsy of anal skin tags as an adjunct to rectal biopsy in the diagnosis of Crohn's disease. Twenty-six patients with proven Crohn's disease of the large and/or small bowel were studied. All had perianal skin tags removed under local anaesthesia as outpatients, when rectal biopsies were also obtained. Three sections from each skin tag and three from each rectal biopsy were examined for granulomas. The rectal biopsies were also examined for changes ‘suggestive’ of Crohn's disease. Anal skin tags from 26 patients without Crohn's disease acted as controls. Of the patients with Crohn's disease, granulomas were found in both anal skin tags and rectal biopsies in five patients, in anal skin tags only in four, and in rectal biopsies only in three. When present, granulomas were more plentiful in anal skin tags than in rectal biopsies, being seen in all 3 sections in 7 of 9 ‘positive’ tags (i. e.: in 31% of 78 sections), compared to only 1 of 8 ‘positive’ rectal biopsies (i. e.: in 13% of 78 sections). No granulomas were seen in control anal skin tags. The procedure provides a simple technique which is complementary to rectal biopsy, by which histological confirmation of Crohn's disease may be obtained.


Public Health Internal Medicine Small Bowel Local Anaesthesia Simple Technique 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Morson BC, Dawson IMP (1979) Gastrointestinal Pathology, 2nd edn. Blackwell Scientific Publications, Oxford, pp 293–312Google Scholar
  2. 2.
    Lennard-Jones JE, Lockhart-Mummery HE, Morson BC (1968) Clinical and pathological differentiation of Crohn's disease and proctocolitis. Gastroenterology 54:1162–1170Google Scholar
  3. 3.
    Korelitz BI, Sommers SC (1977) Rectal biopsy in patients with Crohn's disease: normal mucosa on sigmoidoscopic examination. JAMA 237:2742–2744Google Scholar
  4. 4.
    Hill RB, Kent TH, Hansen RN (1979) Clinical usefulness of rectal biopsy in Crohn's disease. Gastroenterology 77:938–944Google Scholar
  5. 5.
    Petri M, Poulsen SS, Christensen K, Jarnum S (1982) The incidence of granulomas in serial sections of rectal biopsies from patients with Crohn's disease. Acta Pathol Microbiol Immunol Scand (a) 90:145–147Google Scholar
  6. 6.
    Hughes LE (1978) Surgical pathology and management of anorectal Crohn's disease. J R Soc Med 71:644–651Google Scholar
  7. 7.
    Morson BC, Lockhart-Mummery HE (1959) Anal lesions in Crohn's disease. Lancet ii:1122–1123Google Scholar
  8. 8.
    Morson BC (1974) The technique and interpretation of rectal biopsies in inflammatory bowel disease. In: Somers SC (ed) Pathology Annual Prentice-Hall Englewood Cliffs, NJ, pp 209–230Google Scholar
  9. 9.
    Hadfield G (1939) The primary histological lesion of regional ileitis. Lancet ii:773–775Google Scholar
  10. 10.
    Fielding JF (1972) Perianal lesions in Crohn's disease. J R Coll Surg Edinb 17:32–37Google Scholar
  11. 11.
    Goligher JC (1984) Surgery of the anus, rectum and colon. 5th edn. Ballière Tindall, London, p 979Google Scholar
  12. 12.
    Gray BK, Lockhart-Mummery HE, Morson BC (1965) Crohn's disease of the anal region. Gut 6:515–524Google Scholar
  13. 13.
    Chambers TJ, Morson BC (1980) The relationship between course of Crohn's disease and the number of granulomas in involved bowel. In: Jones Williams W, Davies B (eds) Eighth International Conference on Sarcoidosis and other granulomatous disease. Alpha Omega Publishing, Cardiff, pp 750–757Google Scholar

Copyright information

© Springer-Verlag 1989

Authors and Affiliations

  • B. A. Taylor
    • 1
  • G. T. Williams
    • 1
  • L. E. Hughes
    • 1
  • J. Rhodes
    • 1
  1. 1.University Departments of Surgery, Gastroenterology and PathologyUniversity of Wales College of MedicineCardiffUK

Personalised recommendations