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What is the topic of this study?

Crohn’s disease (CD) is a form of inflammatory bowel disease (IBD) that can affect anywhere from the mouth to the bottom. CD is a lifelong incurable disease that can be managed with medication, or in some cases surgery. While CD is often thought of as a disease that mainly affects the bowel, as many as 4 in 10 patients with CD have skin manifestations of their disease and a small group of these patients have genital CD.

Genital CD is an under reported and often unrecognised form of CD that causes painful swelling (inflammation) and damage to the skin around the genitals, back passage and groin. This has a devastating impact on physical and mental health, resulting in inability to work, exercise or have an active sex life. The research team have looked at what has been published previously on genital Crohn’s and this has shown that young women are disproportionately affected and can experience debilitating symptoms for years before they are diagnosed. Currently, little is known about how best to diagnose or treat this condition.

What are the aims of this study?

IBD is caused by the immune system reacting in the wrong way to the bacteria that live in our bowel. However, doctors don’t yet know what causes the skin inflammation that some people with IBD get. By looking at the immune response in the skin and the types of bacteria on the swollen and ulcerated genital skin, the team will be able to identify potentially harmful bacteria that may be contributing to the development of this type of CD. The team have access to a unique collection of skin samples to study and have identified recently diagnosed patients for recruitment to the studies. Thus, the research team are extraordinarily well placed to study the immunology and microbiology of the condition. This information will be used to determine better ways to diagnose this condition and identify which treatments are most likely to be effective.

This work has two important implications for people with genital CD. First, it will improve our knowledge and understanding of genital CD and why the skin becomes inflamed. Second, it will provide evidence to identify and investigate which treatments may be effective for genital CD in order to inform a larger study where these can be tested with patients.

The research team

This research team is led by Ms Laura Hancock, Consultant General and Colorectal Surgeon and Honorary Senior Lecturer at the University of Manchester.