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The Side Effect of Crohn's Disease I Never Expected

About a year ago, I noticed what looked like a sore on my arm. I figured it must have been a mosquito bite or some sort of bug that bit me. The next day, it looked a little bigger and very red. I tried cortisone cream to get the inflammation under control, but it didn’t work, as several more appeared on the other arm and my abdomen. It grew every day to where it opened up and had drainage coming from it.

I went to the doctor and he had no clue what was causing the spread of the tiny wounds. He ordered a swab, which showed I had a staph infection.  He prescribed antibiotics accordingly and then I was told to come back for a follow-up. Several weeks went by and I thought I was in the clear. The lab work was normal, and my skin was normal — or so I thought.

It turned out that the sores returned — but this time it started on my shoulders and spread to my arms, hands, legs, abdomen and back. Another swab was done, but this time it was negative for infection.  The only thing my primary doctor could do was refer me to a dermatologist. When I saw the RNNP, she had a biopsy done on an area and prescribed antibiotic ointment. A few weeks later, the results showed inflammation but the ointment didn’t heal the skin. It took several months for the affected areas to scar over.  After that, I thought the skin issue was gone forever, but I was wrong.

At the beginning of this year, I noticed the tiny pinpricks again, but the dermatologist and PA couldn’t identify what was happening to the skin. Then I wound up at a wound care clinic due to lacerating both knees from two falls. When the nurse was done cleaning and bandaging them up, Dr. R. noticed the open sores on my arms and neck. He asked me if they’ve ever been treated, and I told him that ointments and antibiotics were tried but failed to work, especially last year. Out of the blue, he tells me that I have pyoderma, which is an inflammatory skin disease he sees on Crohn’s patients. Even though he ordered home care assistance to change the dressings on my knee and shin wounds, he had the RN put a specific cream on used to treat inflammatory skin problems.

It seems like such a long time for the treatment to work, but the visiting nurse and I have noticed a difference in the size and skin color after a month. Three times a week my RN, Hayli, will come to my home, do vitals, and check the sores for inflammation or anything that doesn’t look right. She is my physician’s eyes when I don’t have an office appointment.

I’m very fortunate to have an RN who’s well versed in wound care. She’s always answered my questions, and if I had any problems with my skin, she’d alert the wound doctor to get further instructions. I can tell that she’s very dedicated to her job and enjoy what she does. She makes me feel like a part of “the team” because we are working together towards the same outcome.

Recently, I decided to do more research on Crohn’s disease and skin problems because I’ve only heard about erythema nodosum and pyoderma gangrenosum. I found it interesting, per the CCFA webpage, that complications such as skin disorders affect up to 20% of those who have IBD.

The most common are:

–    skin tags
–    enter-cutaneous fistulas
–    anal fissures
–    canker sores

Treatments such as steroidal cream, immunosuppressives, anti-TNF agents, antibiotics, topical ointments, or injections are used to treat the extraintestinal complication by a wound care specialist and/or a dermatologist.

I never thought that I’d be one of the 20% who would develop another side effect of Crohn’s. I’m very fortunate to have found an excellent wound care clinic to take care of me, as well as an amazing RN who’s well versed in getting her patients on the road to recovery.

Getty image by Siriporn Lin.

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