{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:11:00Z","timestamp":1787015460463,"version":"build-2736575974"},"reference-count":17,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2018,6,27]],"date-time":"2018-06-27T00:00:00Z","timestamp":1530057600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Vulval Crohn's disease (VCD) is a rare extra\u2010intestinal cutaneous manifestation of Crohn's disease. VCD is often unrecognized and misdiagnosed and can be difficult to treat. The aim of the study was to describe the clinical presentation, associated features, and response to treatment modalities in patients with VCD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective review of patients with VCD who were referred to our specialist dermatology clinic from 2003 to 2017 was performed. Data on age at diagnosis, presenting signs, associated features, and response to treatment were collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty\u2010one patients with a median age of 40\u00a0years (range 13\u201366\u00a0years) were identified. VCD manifested most frequently with vulval edema (77%), ulceration (35%), and fissures (39%). Eighty\u2010one percent had active gastrointestinal disease. Oral involvement and pyoderma gangrenosum were present in 13% and 19%, respectively. Topical therapy was effective in mild VCD. Tumor necrosis factor\u2010\u03b1 inhibitors were the most effective second\u2010line therapy, with 53% achieving complete clinical remission. Additionally, we have found compression garments and shorts to be useful adjuncts in treating vulval edema.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Vulval Crohn's disease is a diagnostic and therapeutic challenge. We recommend consideration of tumor necrosis factor\u2010\u03b1 inhibitors at an early stage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgh.14291","type":"journal-article","created":{"date-parts":[[2018,5,29]],"date-time":"2018-05-29T22:40:15Z","timestamp":1527633615000},"page":"1969-1974","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Crohn's disease of the vulva: A prospective study"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1123-6882","authenticated-orcid":false,"given":"Bevin","family":"Bhoyrul","sequence":"first","affiliation":[{"name":"Department of Dermatology York Hospital  York UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Calum","family":"Lyon","sequence":"additional","affiliation":[{"name":"Department of Dermatology York Hospital  York UK"},{"name":"Department of Dermatology Salford Royal NHS Foundation Trust  Salford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,6,27]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1932.02740680019005"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(81)70130-0"},{"key":"e_1_2_6_4_1","first-page":"241","article-title":"Crohn's disease with cutaneous involvement","volume":"58","author":"Parks AG","year":"1965","journal-title":"Proc. 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