Clinical Journal of Gastroenterology

, Volume 12, Issue 6, pp 501–510 | Cite as

Current clinical issue of skin lesions in patients with inflammatory bowel disease

  • Tomoya Iida
  • Tokimasa Hida
  • Minoru Matsuura
  • Hisashi Uhara
  • Hiroshi NakaseEmail author
Clinical Review


Inflammatory bowel disease (IBD) is associated with a number of extraintestinal complications, including skin lesions. Most reports have shown that skin lesions are found in 10–15% of IBD cases, although this depends on the definition of skin lesions. The representative skin lesions in patients with IBD are erythema nodosum, pyoderma gangrenosum, Sweet’s syndrome, and so on. These lesions are often associated with IBD progression, and intestinal lesions in particular require appropriate treatment. Recently, another clinical issue regarding skin lesions in patients with IBD, a so-called paradoxical reaction, during the treatment with anti-tumor necrosis factor (TNF)-α agents has emerged. These reactions are termed paradoxical reactions because the skin lesions sometimes resemble psoriasis, although the anti-TNF-α agents have been historically used to treat psoriasis. Paradoxical reactions are reportedly found in approximately 5–10% of patients using anti-TNF-α agents and are no longer rare. Now that the use of biologics is at its culmination, reports regarding paradoxical reactions are predicted to increase in number; thus, we must recognize skin lesions with IBD patients including this type of adverse events and manage them appropriately while consulting with dermatologists.


Inflammatory bowel disease Extraintestinal Skin lesion Paradoxical reaction Anti-tumor necrosis factor 



This work was partly supported by Health and Labour Sciences Research Grants for research on intractable diseases from the Ministry of Health, Labour and Welfare of Japan (Investigation and Research for intractable Inflammatory Bowel Disease) (to H.N.), and Japan Society for the Promotion of Science (JSPS) Grants-in-Aid for Scientific Research (KAKENHI) Grant Number JP17J02428 (to T.I.) and JP18H02799 (to H.N.). The funders of the study had no role in the study design, data collection, data analysis, data interpretation, or writing of the report.

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

Human rights statement

All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

Informed consent was obtained from all patients for being included in the study.


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Copyright information

© Japanese Society of Gastroenterology 2019

Authors and Affiliations

  1. 1.Department of Gastroenterology and HepatologySapporo Medical University School of MedicineSapporoJapan
  2. 2.Department of DermatologySapporo Medical University School of MedicineSapporoJapan
  3. 3.Department of Gastroenterology and HepatologyKyoto University Graduate School of MedicineKyotoJapan

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