Genital granulomatosis in male and female patients with Crohn's disease: Clinical presentation and treatment outcomes

, Frank Dederichs, Igor Iesalnieks, Malgrozata Sladek, Christos Tzivinikos, Richard Hansen, Carmen Muñoz, Paul Pavli, Mayran Cavicchi, Vered Abitbol, Jean Francois Rahier, Stephan Vavricka, Konstantinos Katsanos, Eugeni Domènech

    Research output: Contribution to journalArticlepeer-review

    9 Citations (Scopus)


    Background: Genital granulomatosis [GG] is a metastatic form of Crohn's disease [CD], characterised by granulomatous inflammation of the genital skin without contact with the gastrointestinal tract. Little is known about GG, as most publications are case reports or small series, and only sporadic in male cases. 

    Methods and Aims: Cases of GG were retrospectively collected through the Collaborative Network For Exceptionally Rare case reports project of the European Crohn's and Colitis Organisation. 

    Results: A total of 43 patients [9 males, 34 females] were diagnosed as having GG, mostly as oedema and/or ulcers. Histological confirmation of granulomas was obtained in 70% of the cases. CD location was colonic or ileocolonic in 97% and perianal disease was documented in 57%. There was no significant difference between males and females in CD phenotype or genital lesions. GG was the first manifestation of inflammatory bowel disease [IBD] in one-third of the patients; these patients were younger at the time of GG occurrence and they all were non-smokers. GG occurred in the absence of gastrointestinal disease activity in 30% of the cases. Ten out of 11 patients [91%] responded to systemic corticosteroid treatment, 5/9 patients responded to immunomodulators, and 9/11 patients responded to anti-tumour necrosis factor alpha [TNF-α] agents. 

    Conclusions: GG is a rare extraintestinal manifestation of CD. It mainly occurs among women, in the setting of colonic involvement of CD, and perianal disease is often associated. Most cases are successfully managed with systemic corticosteroids or anti-TNF agents.

    Original languageEnglish
    Article numberjjx131
    Pages (from-to)197-203
    Number of pages7
    JournalJournal of Crohn's and Colitis
    Issue number2
    Early online date27 Sept 2017
    Publication statusPublished - Feb 2018


    • Crohn's disease
    • Genital granulomatosis
    • Penile
    • Scrotal
    • Vulvar

    ASJC Scopus subject areas

    • Gastroenterology


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