Cutaneous Manifestations and Dermatologic Adverse Events in IBD: A Clinical Update

Inflammatory bowel diseases (IBDs), including Crohn's disease and ulcerative colitis, are immune-mediated disorders characterized by chronic gastrointestinal inflammation and a broad spectrum of extraintestinal manifestations. Among these, dermatological manifestations significantly impact patients' quality of life (QoL), presenting as conditions linked to IBD itself or IBD-related medical therapy. This comprehensive review underscores the relationship between IBD and cutaneous manifestations, with particular emphasis on erythema nodosum, pyoderma gangrenosum, Sweet syndrome, and hidradenitis suppurativa, alongside autoimmune conditions like psoriasis and vitiligo. The influence of biologic therapies, including both paradoxical skin reactions mimicking extraintestinal manifestations and nonspecific rashes, is also discussed, with a focus on the pathophysiological mechanisms and therapeutic approaches. Emerging evidence highlights the bidirectional interplay of gut-skin axis, with shared genetic, microbial, and immune pathways. Special considerations, such as pregnancy-related dermatoses, are included to provide a holistic view of this complex relationship. Improved comprehension of these manifestations not only emphasizes the necessity for interdisciplinary care, but also informs tailored therapies to address systemic inflammation while minimizing dermatological complications. This update offers practical insights and emerging evidence to guide clinicians in optimizing patient outcomes.