The things my doctors never told me about Crohn’s Disease… until I asked.
White Spots or Lighter Skin Pigmentation: For as long as I can remember I have had a blemish on my left cheek. It’s approximately 2 shades lighter than the rest of my face. It has always bothered me as I have my dad’s olive complexion, but over the years I have largely ignored it. A couple of years ago, before I was Crohn’s diagnosed, I noted these white spots were appearing on the front of my legs in small, almost perfect circles; individually as well as in clusters. This year, I have noted these irregular patches on my upper arms. I am told there is no fear of my turning into Michael Jackson, but research is showing it can be progressive. There are a couple of schools of thought here, but nothing definitive.
Theory #1: Association between vitiligo and spondyloarthritis. (I have a form of Spondyloarthritis, which has been directly linked to the Crohn’s.)
Theory #2: Vitiligo or leukodermia is a chronic skin condition that causes loss of pigment, resulting in irregular white patches in skin. A disorder in which the immune system destroys pigment-making cells called melanocytes. The precise cause of Vitiligo is complex and not fully understood. There is some evidence suggesting it is caused by a combination of auto-immune, genetic, and environmental factors. The population incidence in the United States is considered to be between 1% and 2%. Vitiligo is not an infectious disease.
Skin Rashes: This was the worst! I was convinced that I had some sort of allergy to either a pet or something in my home. About a year before I became ill; most notably 5 months before I fell ill, I would come home at night and break out into a rash that would morph into ugly, large welts on on my legs, thighs, upper chest and back. It was brutal. It came with a horrendous itch, which could not be satisfied with any amount of scratching. I would become heated all over my skin and, at times, become nauseous. By morning, it would have disappeared. Finally, I took photographs of the rash and welts to show my family doctor. He was surprised by the mystery and said it looked like a reactionary rash to an allergen. He prescribed me antihistamines that never helped.
Pyoderma gangrenosum are painful, pus-filled sores or ulcerations that form on the legs (again mostly the shin and ankle areas) and arms of Crohn’s Disease patients. They can start as small blisters, but they can eventually cluster together causing larger ulcerous sores. Like erythema nodosum, their appearance usually coincides with disease activity. Pyoderma gangrenosum are treated with antibiotics, topical medications and some medications must be injected directly into the ulcer.
Skin Tags: This is annoying! I only get them around the circumference of my neck. Luckily, your doctor can remove these quickly in the office. It sounds brutal, but they snip them off and it really is painless. Although, once in a while it can sting on certain tags. The name ‘skin tags’ makes me want to gag.
Clinical Definition: Skin tags are a less severe manifestation of Crohn’s Disease on the skin. Most commonly, these small, extra-thickened flaps of skin (callous-like) form around inflamed areas of the anus, especially hemorrhoids. Good hygiene and skincare usually avoid complications to the skin tags and surgery is usually seen as too risky for a rather benign problem.
Red Bumps: They are on my arms and look like the beginning of a skin level mole. When my niece was small she called them “Banna’s jewlery”. I call them ugly and annoying.
Clinical Definition: Erythema nodosum is a Latin/medical term meaning, literally, “red bumps” or “red nodules.” These painful little red bumps are commonly known to appear on the arms and legs (usually the shin and ankle regions) of people with Crohn’s Disease. They generally only emerge during flare-ups in disease activity and are more common among women than men.