Perianal Skin Tags in a Patient With Crohn Disease and a Subclinical Rectal Stricture

A 21-year-old female-to-male transgender individual with a history of Crohn disease presented with enlarging perianal papules that initially were misdiagnosed as condyloma acuminatum. A biopsy specimen demonstrated granulomatous inflammation characteristic of Crohn disease. Although the patient's Crohn disease had been quiescent for years, a subsequent evaluation revealed the presence of a rectal stricture that was then dilated. Perianal skin tags with granulomatous inflammation are one of many perianal manifestations of Crohn disease. Increasing numbers or size of these lesions may herald worsening of more proximal Crohn disease, as in our patient. We review the epidemiology, classification, and management of perianal skin tags in patients with Crohn disease.