L’asthme professionnel aux poussières de bois

Wood-related work has been recognized during the past thirty years as a source of respiratory diseases. The prevalence of occupational asthma has been estimated to be between 5 and 15% of all asthma, but its frequency is difficult to evaluate because it is underestimated. Indeed, there is no simple, specific diagnostic test, and monitoring of workers is difficult. The pathophysiology of these reactions is diverse and has not been elucidated for certain types of wood. The case that will be presented illustrates the importance of early diagnosis of occupational asthma. It was possible as a result of teamwork between the occupational physician, the respiratory specialist/allergist and the attending physician.     

Abcès cutanés aseptiques récidivants atypiques révélateurs d’une maladie de Crohn

Introduction

We report here a case of chronic inflammatory bowel disease revealed by multiple large cutaneous aseptic distal necrotic ulcers.

Case report

A 44-year-old male presented with high fever at 40 °C associated with multiple necrotic abcesses located on the distal part of his limbs. They were treated successfully by debridment and dressings associated with antibiotics allowing complete healing after 1 month. Six months later, the patient relapsed on his left hand with a short episode of diarrhoea. A total coloscopy revealed a Crohn's disease. Systemic corticotherapy and azathioprine were administered and complete remission was obtained with a 1-year follow-up.

Conclusion

Skin manifestations that this patient presented were atypical because of their number, size, and location, exclusively distally on the limbs. This report illustrates an unusual presentation of Crohn's disease with multiple necrotic ulcers only located on the patient extremities.