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Relationship of erythema nodosum to other manifestations of Crohn's disease.

Department of Gastroenterology Erythema nodosum has been considered part of the clinical spectrum of inflammatory bowel disease (IBD) since Bargen reviewed 693 cases of ulcerative colitis in 1929. He, as well as Kelley and Logan, Samitz and Greenberg, Jacobs, and Brown et al noted that the skin lesions corresponded to intestinal and extra-intestinal manifestations of active ulcerative colitis. The same relationship for Crohn's disease and erythema nodosum can be inferred f rom their data. Many of these early reports included patients with segmental colitis or right-sided colon disease or both. Investigators who have specifically examined the relationship of active Crohn's disease and erythema nodosum have agreed that there is a positive correlation. Jacobs reported four cases and Sams and Winkelmann reported three cases of erythema nodosum and active Crohn's disease. Van Patter et al and Greenstein et al have reviewed various clinical manifestations of Crohn's disease and found that the typical patient had a parallel course of bowel disease and erythema nodosum. The current thinking is that a positive correlation exists between other manifestations of Crohn's disease activity and the appearance of erythema nodosum. However, as reported