P5463 - Comparative Analysis of Non-Malignant Skin Lesions in Crohn’s Disease and Ulcerative Colitis: Results From a Population-Based Study

Nawaf Alhazmi, MD¹, Abdulrahman Ibn Awadh, MD¹, Onoja-Frederick Okwori, MD, MPH¹, Randa Albloushy, MD¹, Mariam Chalhoub, MD¹, Gregory S. Cooper, MD², Jeffry A.. Katz, MD¹, Preetika Sinh, MD³, Fabio Cominelli, MD, PhD¹, Miguel Regueiro, MD⁴, Emad Mansoor, MD¹, Jaime A. Perez, PhD¹, Elleson Harper, BS¹
1University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH; 2Digestive Health Institute, University Hospitals Cleveland Medical Center, Cleveland, OH; 3Medical College of Wisconsin, Cleveland, OH; 4Cleveland Clinic, Cleveland, OH

Introduction: Cutaneous manifestations are common extraintestinal findings in inflammatory bowel disease (IBD); however, comparative data between Crohn’s disease (CD) and ulcerative colitis (UC) remain limited. We aimed to assess the prevalence and demographic associations with inflammatory bowel disease (IBD) using a large, real-world cohort.

Methods: A cross-sectional analysis was performed using TriNetX, a federated, de-identified electronic health record network. Adults (≥18 years) with at least two instances of ICD-10 codes for CD (K50) or UC (K51) were included. Patients with dual diagnoses or malignancies were excluded. Non-malignant skin lesions were identified through the use of ICD-10 codes for psoriasis, hidradenitis suppurativa, erythema nodosum, pyoderma gangrenosum, vitiligo, oral aphthae, Sweet syndrome, and skin tags. Comparisons were made using chi-square and t-tests.

Results: Among 108,775 CD and 121,035 UC patients, 7.7% and 8.4%, respectively, had non-malignant skin lesions. CD patients were younger (mean 48.6 vs. 54.5 years, p< 0.001), with more patients aged< 40 years (32.7% vs. 21.2%), whereas UC patients had more patients aged ≥65 (31.9% vs.19.5%, p< 0.001). The majority of the IBD patients with non-malignant skin lesions in both cohorts were White (71% CD vs 70% UC). Skin tags were the most common cutaneous manifestation (59.6% CD, 68.8% UC), followed by hidradenitis suppurativa, oral aphthae, and psoriasis. Patients with CD were more likely to have pyoderma gangrenosum (3.9%), hidradenitis suppurativa (12.4%), and erythema nodosum (3.4%), whereas patients with UC were more likely to have vitiligo (2.5%). There was no difference in prevalence between CD and UC for recurrent oral aphthae, psoriasis vulgaris, or febrile neutrophilic dermatosis.

Discussion: The non-malignant cutaneous manifestations are common in IBD and differ in CD and UC. These findings emphasize the importance of appropriate characterization and management of skin lesions in this population.


Figure: Table 1. Characteristics between Crohn’s disease (CD) and Ulcerative colitis (UC) in patients with non-malignant skin lesions


Figure: Table 2. Prevalence of Non-Malignant Skin Lesions in CD vs UC Patients

Disclosures:
Nawaf Alhazmi indicated no relevant financial relationships.
Abdulrahman Ibn Awadh indicated no relevant financial relationships.
Onoja-Frederick Okwori indicated no relevant financial relationships.
Randa Albloushy indicated no relevant financial relationships.
Mariam Chalhoub indicated no relevant financial relationships.
Gregory Cooper indicated no relevant financial relationships.
Jeffry Katz indicated no relevant financial relationships.
Preetika Sinh indicated no relevant financial relationships.
Fabio Cominelli indicated no relevant financial relationships.
Miguel Regueiro: AbbVie – Advisory Committee/Board Member, Consultant. Amgen – Advisory Committee/Board Member, Consultant. BMS – Advisory Committee/Board Member, Consultant. Boehringer Ingelheim Pharmaceuticals Inc. – Advisory Committee/Board Member, Consultant. Celegene – Advisory Committee/Board Member, Consultant. Eli Lilly and Company – Advisory Committee/Board Member, Consultant. Genentech – Advisory Committee/Board Member, Consultant. Gilead – Advisory Committee/Board Member, Consultant. Janssen – Advisory Committee/Board Member, Consultant. Organon – Advisory Committee/Board Member, Consultant. Pfizer – Advisory Committee/Board Member, Consultant. Prometheus – Advisory Committee/Board Member, Consultant. Salix – Advisory Committee/Board Member, Consultant. Takeda – Advisory Committee/Board Member, Consultant. UCB – Advisory Committee/Board Member, Consultant.
Emad Mansoor: Lilly – Speakers Bureau. Takeda – Speakers Bureau.
Jaime Perez indicated no relevant financial relationships.
Elleson Harper indicated no relevant financial relationships.

Nawaf Alhazmi, MD¹, Abdulrahman Ibn Awadh, MD¹, Onoja-Frederick Okwori, MD, MPH¹, Randa Albloushy, MD¹, Mariam Chalhoub, MD¹, Gregory S. Cooper, MD², Jeffry A.. Katz, MD¹, Preetika Sinh, MD³, Fabio Cominelli, MD, PhD¹, Miguel Regueiro, MD⁴, Emad Mansoor, MD¹, Jaime A. Perez, PhD¹, Elleson Harper, BS¹. P5463 - Comparative Analysis of Non-Malignant Skin Lesions in Crohn’s Disease and Ulcerative Colitis: Results From a Population-Based Study, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.