Oral Crohn Disease - Clinical characteristics and long-term follow-up of 9cases

Background: Oral localization of Crohn disease is uncommon and must be diff erentiated from nonspecific lesions. Its natural course and its long-term p rognosis are unknown. Observations: We studied 9 patients (8 male, 1 female; age range, 7-52 year s; median age, 16 years) with Crohn disease and specific oral lesions, incl uding deep linear ulcers, pseudopolyps, and/or labial or buccal swelling an d induration. The prevalence of such lesions was 0.5%. The median follow-up was 11 years. Oral localization developed before (n = 2), at the same time as (n = 2), or after (n = 5) the onset of the digestive disease. Noticeabl e associated localizations were observed in the anoperineum (n = 8) and the esophagus (n = 3). The median duration of the oral lesions was 4 years (ra nge, 1-13 years), without necessary parallelism with the digestive localiza tion. Five patients had complete healing after a median delay of 2 years. Conclusions: Oral localization of Crohn disease is characterized by a marke d male predominance, a young age at onset of Crohn disease, and a very prot racted course. The high prevalence of associated anal and esophageal involv ement suggests that Crohn lesions have a particular trophicity for squamous cell epithelium.