Ulcerative colitis in the large intestine and the rectum is a long-term condition that causes inflammation. It may cause problems with the skin as well.
This article discusses how ulcerative colitis (UC), a form of inflammatory bowel disease, is linked to skin conditions (IBD).
During a flare-up, it also considers how to minimize skin conditions and when to see a doctor.
There are a variety of skin conditions associated with UC that are different. These are explored below.
1. Erythema nodosum
For individuals who also have UC, Erythema nodosum is the most common skin problem. Erythema nodosum may grow in up to 10 percent of people with UC.
Erythema nodosum on the arms or legs of an individual causes tender red nodules to appear. It is likely that these nodules appear like bruises.
In people with UC, during a flare-up, this skin rash tends to appear and go away while UC is in remission.
2. Pyoderma gangrenosum
Pyoderma gangrenosum is the second most common skin issue that can affect individuals with UC, according to this 2012 study.
This skin rash starts out on the shins, ankles, or arms as a cluster of blisters. It also spreads and deep ulcers can form. It may become contaminated if it is not kept clean.
Researchers conclude that an issue with the immune system that could be related to the cause of UC is causing this disease.
Psoriasis is a skin condition triggered by an immune system problem. It contributes to red, patchy skin, covered with dead skin cell build-up.
Psoriasis also affects many individuals with UC and other forms of IBD.
This 2015 study showed that the genes that cause IBD and those that cause psoriasis have certain genetic ties. In order to understand these relations fully, further research is required.
Hives are red raised patches which can occur anywhere on the body as a rash. Due to a reaction in the immune system, they form.
Individuals often react to the medicine they take for UC, which can cause chronic hives.
A study conducted in 2011 found a correlation between taking a drug to treat cystic acne (isotretinoin) and the development of UC. To understand this relation better, further research is needed.
6. Bowel-associated dermatosis-arthritis syndrome
In addition to other symptoms, bowel-associated dermatosis-arthritis syndrome (BADAS) is a condition in which tiny bumps develop on the upper chest and arms. Pustules may then form these bumps, causing discomfort. BADAS can also cause leg lesions.
Researchers do not completely understand the cause, but as a result of bacteria in the gut, they suspect it may lead to inflammation. Having IBD makes it more likely that BADAS will develop in an individual.
7. Pyodermatitis-pyostomatitis vegetans
Two skin disorders that are related are pyodermatitis vegetans and pyostomatitis vegetans.
Red pustules that burst and form scaly patches in the armpit or groin are caused by the former. Pustules in the mouth are involved in the latter.
The two conditions are typically categorized together and called pyodermatitis-pyostomatitis vegetans (PPV).
UC is associated with this disease, but it is rare. After a person has had UC for a few years, symptoms will usually occur. Sometimes, however, people are not diagnosed with UC until after PPV has been diagnosed by a doctor.
8. Sweet’s syndrome
Another disorder that is related to UC flare-ups is Sweet’s syndrome.
Small red or purple bumps on the skin grow into painful lesions when an individual has Sweet’s syndrome. Often on the upper limbs, face, and neck, they form.
Vitiligo is a skin disorder that destroys the pigment-producing cells in the skin. Vitiligo can result in anywhere on the body forming white patches.
Researchers think that an immune deficiency triggers vitiligo. Around 20 percent of people with vitiligo also have another immune deficiency, such as UC, according to the National Institute of Health (NIH).
10. Leukocytoclastic vasculitis
When small blood vessels under the skin become inflamed and die, leukocytoclastic vasculitis (hypersensitivity vasculitis) occurs. The inflammatory reaction leads to the development, called purpura, of purple spots on the skin of the legs or ankles.
The disorder results from inflammation and is associated with flare-ups of UC. When UC is in remission, leukocytoclastic vasculitis usually goes away.
Links between UC and skin rashes
UC can be an inflammatory disorder that is painful and unpleasant, affecting both the large intestine and the rectum.
When an individual has UC, the lining of their colon produces tiny ulcers. This can create pus and bleed.
UC’s key signs are:
- ongoing problems with diarrhea
- blood, mucus, or pus in stools
- the need to pass stool often
- extreme tiredness
- loss of appetite
- weight loss
Ulcerative colitis flare-ups
While UC is a long-term illness, a person with UC can be without symptoms for weeks or months. This is called remission.
Periods of remission may be followed by flare-ups, where the person experiences many UC symptoms.
An individual with UC can experience symptoms during a flare-up, in addition to those that affect the digestive system. They include:
- rashes or patches of red, swollen skin
- swollen or painful joints
- mouth ulcers
- red, irritated eyes
Why do skin rashes appear during flare-ups?
The inflammation that induces UC in the body can affect the skin as well. This may contribute to skin rashes that are swollen and painful.
Skin issues affect up to 15 percent of people with IBD, which includes people with UC, according to a 2015 survey.
Skin problems can also be caused by the medicine a person might take to manage their UC symptoms.
Reducing skin problems during a flare-up
People with UC often encounter skin problems during flare-ups, so treating UC itself is the best way to treat skin conditions related to UC.
A doctor will help find the right methods for their symptoms and lifestyle for a person with UC.
The following can help to decrease skin problems when flare-ups happen:
- Use of corticosteroids to decrease inflammation
- Eating a balanced diet to support healthy skin
- To keep the infected skin clean to minimize the risk of infection,
- covering the affected area with bandages
- taking over-the-counter pain relievers
When to see your physician
It is a good idea to consult with a doctor and get a correct diagnosis and the right treatment if a skin complaint is particularly troublesome.
It is a good idea to speak to a doctor about the best way to treat skin problems if they recur or get worse over time.
They may also assist a person with UC to find ways of treating their condition as a whole.
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- Fiorino, G., & Omodei P. D. (2015, September 1). Psoriasis and inflammatory bowel disease: Two sides of the same coin? Journal of Crohn’s and Colitis, 9(9), 697–698 (LINK)
- 10 rashes caused by ulcerative colitis (LINK)
- Huang, B. L., Chandra, S., & Shih, D. Q. (2012, February 6). Skin manifestations of inflammatory bowel disease. Frontiers in Physiology, 3(13)
- Scientists implicate gene in vitiligo and other autoimmune diseases. (2007, April 10)
- Vavricka, S. R., Schoepfer, A., Scharl, M., Lakatos, P. L., Navarini, A., & Rogler, G. (2015, August). Extraintestinal manifestations of inflammatory bowel disease. Inflammatory Bowel Disease, 21(8), 1982–1992