*3.1.3 Cutaneous Crohn's disease*

Skin manifestations of Crohn's disease (CD) have been classified into three principal classes: granulomatous or CD specific, reactive, and secondary to nutritional deficiency [72]. CD-specific lesions account for the majority of lesions

**79**

**Figure 14.**

*Metastatic Crohn's disease.*

*Clinical Manifestations of Sarcoidosis and Granulomatous Disorders*

observed. The best recognized are perianal and peristomal fissures and fistulae and oral disease [73]. Skin lesions commonly complicate CD with reported prevalence rates as high as 44% [74–76]. The characteristic lesions of metastatic Crohn's diseases are erythematous plaques and nodules and cutaneous ulceration. Secondary features like scale or crust may present [73] (**Figure 14**). Lesions involving intertriginous and genital skin usually ulcerate, owing to friction [77]. Lesions may be solitary or multiple, usually asymptomatic, but may be tender on palpation [77]. The oral manifestation of CD in the buccal mucosa is cobblestoning, while the gingival and alveolar mucosae often have tiny nodules. Linear ulcers are more common in sulci. The lips may become swollen, hardened, or ulcerated, especially at the angles of the mouth [78]. Genital lesions are the most common presentation of MCD in children; 85% of the cases present with swelling and/or induration of the genitals with or without erythema. In adults, the most frequent lesions are nodules and plaques, with or without ulceration on the arms and legs, followed by ulcers on

The term orofacial granulomatosis (OFG) includes a group of disorders showing chronic, noncaseating granulomatous lesions involving the perioral tissue of the face and oral mucosa [79]. Possible systemic diseases, such as tuberculosis, sarcoidosis, and other diseases with the same clinical findings are to be excluded before to diagnose orofacial granuloma [80]. Clinically, OFG generally presents as swelling of upper and/lower lip, even the whole orofacial region including the chin, cheeks, periorbital and zygomatic tissues, eyelids, and forehead, unilaterally or bilaterally, either alone or in combination, though classic presentation is that of a non-tender recurrent labial swelling that may eventually become persistent [79] (**Figure 15**). Furthermore, manifestations include angular cheilitis, mucosal ulcerations, vertical fissures of the lips, mucosal tags, and lingua plicata [81]. However, the clinical

*DOI: http://dx.doi.org/10.5772/intechopen.92236*

the genitals [77].

*3.1.4 Orofacial granulomatosis*

**Figure 13.** *Granulomatous rosacea.*

### *Clinical Manifestations of Sarcoidosis and Granulomatous Disorders DOI: http://dx.doi.org/10.5772/intechopen.92236*

observed. The best recognized are perianal and peristomal fissures and fistulae and oral disease [73]. Skin lesions commonly complicate CD with reported prevalence rates as high as 44% [74–76]. The characteristic lesions of metastatic Crohn's diseases are erythematous plaques and nodules and cutaneous ulceration. Secondary features like scale or crust may present [73] (**Figure 14**). Lesions involving intertriginous and genital skin usually ulcerate, owing to friction [77]. Lesions may be solitary or multiple, usually asymptomatic, but may be tender on palpation [77]. The oral manifestation of CD in the buccal mucosa is cobblestoning, while the gingival and alveolar mucosae often have tiny nodules. Linear ulcers are more common in sulci. The lips may become swollen, hardened, or ulcerated, especially at the angles of the mouth [78]. Genital lesions are the most common presentation of MCD in children; 85% of the cases present with swelling and/or induration of the genitals with or without erythema. In adults, the most frequent lesions are nodules and plaques, with or without ulceration on the arms and legs, followed by ulcers on the genitals [77].
