Author information

1 a Department of Surgical and Experimental Medical Sciences , University of Sassari , Italy.

2 b Baylor College of Medicine , Houston , TX , USA.

Abstract

BACKGROUND: Inflammatory bowel diseases (IBDs) are autoimmune disorders of the gastrointestinal tract often associated with extra‒intestinal manifestations (EIMs) including skin lesions. The intestinal microflora plays a key role in the development and course of IBD. Investigations on the association between probiotic use and skin lesions in IBD are still missing.

AIM: To examine for the first time the efficacy of probiotics and the occurrence of skin lesions in patients with IBD.

METHODS: IBD patients followed up in the Gastro-Intestinal section of the University of Sassari, Italy, participated in the study. The occurrence of skin lesions was analyzed according to demographic, anthropometrics, clinical features, treatments and probiotic use. The amount of probiotic use was expressed as the ratio of disease duration under probiotic treatment and the total disease duration. The diagnosis of cutaneous EIMs was based on dermatology examination.

RESULTS: Data from 170 IBD patients (59.4% women; UC: 61.2%) were retrieved. At least one skin lesion was present in 14 (8.2%) of them at the moment of diagnosis and in 52 patients (30.6%) developed during the follow up. Psoriasis, erythema nodosum and pyoderma gangrenosum were the most frequent. An inverse linear trend was observed at multivariable analysis between use of probiotics and skin lesions occurrence after adjusting for all variables including conventional treatment for IBD. The risk of developing at least one skin lesion for a probiotic use in the range 5-19% and more than 50% of the time of IBD duration, was 1.40 and 0.3, respectively.

CONCLUSION: The findings of the present study suggest that body mass index, the IBD Crohn phenotype, married status and the potency of conventional treatment were all significant predictors for developing skin lesions. The use of probiotic, although not reaching significance, was inversely correlated with the occurrence of cutaneous manifestations.