Skip granulomatous lesions are seen in-
Ulcerative colitis
Crohn's disease
Whipple's disease
Reiter's disease
Ans. is 4b' i.e., Crohn's diseaseSkip lesions are characteristic of Crohn's disease.o This pt. is suffering with Crohn's ds.o The characterstics of Crohn's ds and their comparison with Ulcerative colitis are given -Once you know them the answer becomes obvious.FeaturesUlcerative colitisCrohn's dso Rectal involvemento Distribution of lesionso Mucosal appearanceo Associated ileal>90%ContinuousFriable, diffusely involved 10%, mild, terminal ileal InflammationRectum spared in > 50%Skip lesionsCobblestone appearance 50% have combined ileal and colonic involvement.o Perianal abcess, fistulaso Intestinal strictures & obstructiono Intestinal fistulaso Fissures (Radiological)o Toxic megacolono Extraintestinal Manifestation -RareNot seen Not seen Not seenRare but more than crohns dsCommonCommonCommonCommonVery rarey Sclerosing pericholangitisy Uveitis & Arthritisy Pyoderma gangrenosumCommonCommonCommonRareCommonRarePathological Features o Depth of inflammationo Creeping mesentric fato Fibrous thickening of wallo Pseudopolypso Granulomaso Dysplasiao CarcinomaMucosalNot seenCommon (lead pipe)CommonNot seenCommon10%TransmuralCommonRareRareCommonRareRare
Skin