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In nosological terms, there is a striking pathophysiological resemblance between certain subgroups of skin and gastrointestinal diseases, probably as a result of the overall structural similarity of the two systems. Despite the fact that the term "idiopathic inflammatory disease of the skin" is neither formal nor widely used in current medical literature, it could be applied as an umbrella designation for a group of dermatic disorders with disease characteristics similar to those which define the idiopathic inflammatory bowel diseases (IBD). Interdisciplinary research on these similarities may prove a particularly fruitful field of cooperation for gastroenterologists and dermatologists. In addition, certain skin disorders can mimic symptoms of IBD, such as herpes zoster of the lower thoracic cavity and the abdominal area, which presents with abdominal pain. Awareness of skin conditions masquerading as an IBD relapse is mandatory to the gastroenterologist who monitors patients with established IBD. Appropriate recognition and prevention of potential dermatic side effects of treatment for IBD, and early identification of gastroenterological side effects of treatment given for dermatological disorders in patients with IBD are of capital importance for their optimal care. The possible sequelae of cosmetic preparations in patients with IBD are an emerging medical field with many questions still to be addressed and clarified. All these issues may benefit from collaboration between dermatologists and gastroenterologists. In this review these relevant issues are summarized in the hope of contributing to the continuing promising scientific dialogue between gastroenterologists and dermatologists in the interrelated fields of the "idiopathic inflammatory bowel" and skin disorders. [ABSTRACT FROM AUTHOR]

Skin manifestations are frequent in patients with inflammatory bowel disease (IBD); approximately 10% of patients are initially referred because of a skin condition related to IBD, while 20% of patients develop a dermatological problem requiring specific diagnosis and treatment during the course of the disease. From the practical point of view, dermatological manifestations may be diagnosed at any time during the IBD disease course and they can be classified in many ways: "disease-specific" or "non-specific", in relation to the baseline IBD diagnosis, ulcerative colitis (UC) or Crohn's disease (CD), or in relation to the initial consultant physician, who may be either a gastroenterologist or a dermatologist, especially in cases where the skin manifestations precede the symptoms of bowel disease. The detailed pathogenetic mechanisms of the disease-specific dermatological manifestations in IBD have not yet been elucidated. It is probable that a cross reaction in immunological-related epitopes of bowel epithelium and skin occurs in some of the patients. The non disease specific dermatological manifestations in IBD represent a relatively rare group of non-specific, hyper-allergic immunologically derived conditions. Increased prevalence of skin problems has been noted with all disease manifestations across the whole spectrum of IBD, but with different frequencies for UC and CD. The skin manifestations commonly seen in IBD are: erythema nodosum, pyoderma gangrenosum, Sweet's syndrome, relapsing apthous stomatitis, colostomy/ileostomy dermatitis and neutrophilic dermatitis. In addition, several forms of skin vasculitis may occur, including small vessel vasculitis and dermatic polyarteritis nodosa. The pathognomonic muco-cutaneous manifestations of UC are dermatitis bullosa and pyostomatitis vegetans. The pathognomonic manifestations of CD are fistulas and perianal fissures, and the so-called "metastatic" Crohn's disease in cases where the skin disease is clearly separated from healthy normal tissue, oro-facial CD and Melkersson-Rosenthal granulomatous cheilitis. There are also some specific associations between IBD and idiopathic inflammatory skin diseases such as between CD and psoriasis and hidradenitis suppurativa and between UC and atopic eczema. Skin manifestations may be related to malnutrition and to enteral and parenteral nutrition. Nail and hair abnormalities are also a feature of IBD [ABSTRACT FROM AUTHOR]