Anyone who has Inflammatory Bowel Disease (IBD) knows how painful it can be. IBD is inflammation of the digestive tract, and medical professionals are not sure about the exact cause of this condition. Ulcerative colitis is a type of IBD that not only affects your digestive tract (the large intestine) but can also cause many skin issues. These skin issues can further aggravate your overall discomfort and pain. Let’s find out how ulcerative colitis can affect your skin.
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What Is Ulcerative Colitis?
Ulcerative colitis (UC) is inflammation of the large intestine. It might affect some parts of the entire large intestine. If the inflammation affects the entire large intestine, it is known as pancolitis. This is a chronic or long-lasting condition that causes open sores or ulcers in the innermost linings of the large intestine. Ulcerative colitis often causes symptoms such as:
- Abdominal cramps and pain
- Reduced appetite
- Weight loss
- Blood in your stool
This condition can make you extremely weak, and if not appropriately addressed, it can become life-threatening. The chronic inflammation inside your body can also cause many skin conditions that worsen during flare-ups.
10 Skin Issues Caused By Ulcerative Colitis
1. Erythema nodosum
This is the most common skin condition that people with ulcerative colitis may experience. About 3% to 10% of the people with this condition may develop Erythema nodosum in any part of the body. This is a condition in which you develop red and tender nodules on the skin. The lesions may have a bruise-like appearance, and they can appear anywhere there is subcutaneous fat (the type of fat that sits right under the skin). The most common areas where you can develop Erythema nodosum are ankles, arms, shin area, knees, and the trunk (1).
2. Pyoderma gangrenosum
This is the next most common skin condition that affects people with ulcerative colitis (1). A study conducted in 2011 involving 950 patients demonstrated that about 2% of them developed Pyoderma gangrenosum (2).
This condition causes noninfectious nodules (blisters) on your skin. These eventually spread and develop into deep ulcers with wound edges. They can appear anywhere on your skin but mostly occur on the extensor surface of the legs (the side opposite to the joints), such as the shins and ankles. They may also appear on extensor surfaces of your arms.
This condition is thought to be caused by abnormal functioning of your immune system. Usually, high doses of corticosteroids and other drugs are used to suppress your immune system to heal these wounds (1).
Hives are raised bump-like rashes on the skin that are itchy. These usually occur as a side effect of certain medicines that you might be taking for ulcerative colitis. These can appear on any body part. If you feel that any medication is causing these reactions, consult the doctor immediately and ask for an alternative.
Psoriasis is a condition in which the production of skin cells speeds up, causing an excess build-up of cells on the skin surface. As a result, your skin looks scaly with red patches all over the affected area. This is an autoimmune condition and can also be triggered by ulcerative colitis (3).
Another study conducted in 1982 also found a prevalence of psoriasis in 5.7% of 88 patients with ulcerative colitis (4).
Ulcerative colitis may also give you cystic acne. This is the most severe form of acne and can be painful. A study found that using isotretinoin for cystic acne may aggravate the symptoms of ulcerative colitis (5).
In other words, if you have ulcerative colitis or are at risk of developing this condition, and if you have cystic acne, taking this drug may worsen the symptoms of ulcerative colitis.
This is a condition in which your skin loses its color. The cells (melanocytes) that produce melanin and are responsible for your skin color start dying or stop functioning. As a result, you get white patches on the affected area.
According to a study led by Richard Spritz, M.D., Director of the Human Medical Genetics Program, University of Colorado, the onset of vitiligo is “very highly associated” with other autoimmune diseases (6), (1).
7. Sweet’s Syndrome
This is a very rare skin condition. You get painful skin lesions along with fever. The lesions look like red patches or clusters of red, painful bumps. These mostly appear on your head, neck, trunk, and arms. The exact cause of this skin disease is unknown. There are very rare cases (approximately 40) where researches found a link between ulcerative colitis and Sweet’s syndrome (7), (8).
8. Pyodermatitis And Pyostomatitis vegetans
These are two different skin conditions – pyodermatitis vegetans and pyostomatitis vegetans.
Pyodermatitis vegetans is a very rare skin disorder in which you develop red pustules on the skin, which can rupture very easily and form plaques or patches. It usually occurs in your skin folds, such as your groin area or the armpits.
Similarly, in pyostomatitis vegetans, you get pustules in the mouth. The symptoms of both these conditions appear after you have had ulcerative colitis for a few years (1).
9. Bowel-Associated Dermatosis-Arthritis-Syndrome (BADAS)
This is a condition in which you develop lesions or pustules in areas such as the arms, upper chest, and legs. If you have Inflammatory Bowel Disease (either Crohn’s disease or ulcerative colitis), you are more likely to develop BADAS (9), (10).
10. Leukocytoclastic vasculitis
In this condition, the small blood vessels under your skin become inflamed. As a result, they burst and create a pool of blood under your skin. This creates reddish-purple spots on your skin, which are also known as purpura. These are usually found on your legs and ankles. Typically, these spots go away once your symptoms of ulcerative colitis are gone.
These skin rashes are usually caused due to inflammation within your body. However, some skin issues are caused as a side effect of the medicines you are taking for ulcerative colitis.
But is there any way to manage these issues?
How To Manage The Rashes
All the above skin issues are related to ulcerative colitis, so the best way to manage them is to treat the underlying condition. Most of the time, you get skin rashes only during ulcerative colitis flare-ups. So, it’s best to keep the condition in control to avoid getting these associated skin issues.
Usually, doctors prescribe corticosteroids for managing skin inflammation. During a flare-up, you can take these measures to avoid skin issues:
- Take the prescribed corticosteroid to reduce the inflammation.
- Keep your skin or the affected area clean. This help to reduce the chances of infection.
- Follow a well-balanced diet. Vitamins and nutrients are essential for your skin.
- If you have open wounds or lesions or patches (due to the skin disorder), keep them covered with bandages.
- Use a doctor-prescribed topical ointment or pain medication to manage the discomfort.
And, of course, don’t miss any appointment with your doctor. They can help diagnose your condition properly and suggest the best way to manage it.
If you have any further doubts or questions in your mind, post them in the comments section below.
- “Skin Manifestations of Inflammatory Bowel Disease” Frontiers in Physiology, US National Library of Medicine.
- “Frequency and risk factors for extraintestinal manifestations…” The American Journal of Gastroenterology, US National Library of Medicine.
- “Psoriasis and Inflammatory Bowel Disease…” Journal of Crohn’s and Colitis.
- “Further evidence for an association between psoriasis…” The Britihs Journal of Dermatology.
- “Isotretinoin Use and the Risk of Inflammatory Bowel Disease…” American Journal of Gastroenterology, US National Library of Medicine.
- “Scientists Implicate Gene in Vitiligo…” National Institutes of Health.
- “Ulcerative colitis and Sweet’s syndrome…” Canadian Journal of Gastroenterology.
- “Sweet’s Syndrome complicating…” The BMJ.
- “Bowel-associated dermatosis…” JAAD Case Report.
- “Bowel-associated dermatosis-arthritis syndrome during…” Annales de dermatologie et venereologie, US National Library of Medicine.