Exploring the IBD-Dermatology Connection

Alexandra P. Charrow, MD, FAAD

Understanding the big picture in patient care is essential, as dermatological issues may be interacting with medical comorbidities, explained Alexandra P. Charrow, MD, FAAD, in an interview about her presentation at the 2025 American Academy of Dermatology Annual Meeting.¹ Charrow, director of the Hidradenitis Suppurativa and Neutrophilic Dermatosis Clinic, director of the Crohn’s and Ulcerative Colitis Dermatology Program, and assistant professor of dermatology at Harvard Medical School, discussed the relationship between irritable bowel syndrome (IBD) and hidradenitis suppurativa (HS) and other dermatological disorders.

Charrow noted that shared pathways may partially explain the prevalence of IBD, especially Crohn’s disease, among patients with dermatology disease. Similarly, she pointed to the dermatological manifestations of IBD, like pyoderma, erythema nodosum and pustular conditions. Patients with Crohn’s and ulcerative colitis are also more prone to some dermatological conditions, like rosacea and severe acne. “It may be one of the reasons that for a long time people thought Accutane [isotretinoin] caused inflammatory bowel disease because patients with irritable bowel disease actually have a higher rate of acne,” told Dermatology Times.²

Patients can also develop paradoxical rashes from the medications that they receive, like tumor necrosis factor (TNF) inhibitors. Patients can also develop acne from high dose JAK inhibitors, which are sometimes prescribed for IBD, she added.

Charrow and her team are working on research on cutaneous Crohn’s/metastatic cutaneous Crohn’s, in which patients develop Crohn’s disease in skin. “These are areas that are not contiguous … with the GI tract. So not just sinus tracts that go from the perianal area to the skin but actual inflammation that looks a lot like Crohn’s disease when you look at histology,” she said. The team has leveraged a Delphi panel to work on the diagnostic criteria as well as the risk factors associated with development of metastatic cutaneous Crohn’s disease.

“Very exciting work that our group is doing, and I’m very thankful for the incredible team of people we have working with us to help develop some of that research and get it out the door and have all of you see it soon,” she told Dermatology Times.

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References

1. Charrow A. Complex medical dermatology cases: pearls and pitfalls. Presented at 2025 AAD Annual Meeting; March 7-11, 2025. Orlando, Florida.

2. Miqdad MA, Alatta L, Abdelsamad A, Fouda S, Cherukuri ASS, Eltanany M, Albogami F, Al Draiweesh S, Abdelrahman N. Isotretinoin-Induced Inflammatory Bowel Disease: Is There a Real Association? Cureus. 2022 Oct 2;14(10):e29825. doi: 10.7759/cureus.29825.