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| Content Provider | African Journals Online (AJOL) |
|---|---|
| Author | Adil Ibrahimi Khaoula Jellali Ihsane Mellouki |
| Abstract | De nombreuses affections du tube digestif comportent des manifestations cutanées qui peuvent être révélatrices, ce qui place le dermatologue en première ligne pour orienter le patient vers la consultation de gastroentérologie. A l’inverse, le gastroentérologue est souvent confronté à des lésions cutanéo-muqueuses pour lesquelles se pose la question d'une éventuelle relation avec une maladie digestive déjà connue. Les maladies inflammatoires chroniques de l'intestin représentent l’exemple type de cette nécessaire collaboration entre les deux spécialités. Nous rapportons un cas de maladie de crohn révélée par une Chéilite granulomateuse. Il s'agit d'une patiente âgée de 30 ans. Suivie en dermatologie pour une chéilite granulomateuse. L’examen somatique était sans particularité mise à part les lésions dermatologiques (un œdème facio-labiale blanc, induré et une gingivite diffuse). La biopsie de la lésion labiale a objectivé des granulomes épithélioides et gigantocellulaire à disposition péri-vasculaire sans nécrose caséeuse. Devant la suspicion d’une colite inflammatoire une iléo-coloscopie a été réalisée ayant objectivé une valvule de Bauhin béante et ulcérée avec une muqueuse iléale légèrement érythémateuse, dont l’étude anatomopathologique avait révélé un aspect histologique en faveur d'une maladie inflammatoire chronique de l’intestin type crohn iléo-colique. L’évolution était marquée par l'installation, 6 mois après, de quelques épisodes de réctorragies avec lésions ano-périnéales: large fissure anale antérieure avec une ulcération aphtoide à 5 cm de la marge anale, compliquée quelques semaines après par l'installation d'un abcès péri-anale fistulisé ayant nécessité un drainage chirurgicale avec mise en place de Sétons, d’où l’indication de démarrer un traitement de fond de sa maladie de crohn après assèchement de l’abcès. Les lésions dermatologiques observées lors des MICI sont très variées. Dans certains cas, elles apparaissent au cours d'une MICI connue alors que, dans d'autres, elles précédent ou accompagnent les manifestations digestive, permettant le diagnostic d'une affection intestinale parfois cliniquement latente. |
| File Format | |
| e-ISSN | 19378688 |
| Journal | Pan African Medical Journal |
| Issue Number | 1 |
| Volume Number | 30 |
| Language | English French |
| Publisher Date | 2021-06-24 |
| Access Restriction | Open |
| Subject Keyword | General Science Humanities Health Maladie de chron cheilite granulomateuse diagnostic |
| Content Type | Text |
| Resource Type | Article |
| Subject | Medicine Decision Sciences |
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