Management of cutaneous side effects of inflammatory bowel disease therapy: A dermatologic viewpoint.

Medications used in the treatment of inflammatory bowel disease cause a wide range of dermatologic side effects, and minimal guidance exists on how to manage them. The intention of this review article is to summarize common dermatologic adverse reactions related to inflammatory bowel disease therapy and to provide evidence-based guidance on management. We conducted a scoping review using PubMed and Google Scholar to identify studies reporting clinical information on dermatologic side effects of medications used in the treatment of inflammatory bowel disease. The most commonly reported dermatological adverse effects from inflammatory bowel disease therapy were cutaneous malignancy and cutaneous infections. Thiopurines, methotrexate, tumor necrosis factor (TNF) inhibitors, interleukin (IL)-12/23 inhibitors, and integrin inhibitors can be continued if nonmelanoma skin cancer arises during therapy and the malignancy should be surgically excised. TNF inhibitors and IL-12/23 inhibitors can be continued in the setting of stage I surgically resectable melanoma but should be discontinued in advanced melanoma. For complicated cutaneous bacterial infections, methotrexate and TNF inhibitors should be halted, and IV antibiotics should be administered. Complicated herpes zoster infection warrants discontinuation of TNF inhibitors, whereas IL-12/23 and JAK inhibitors can be continued. Inflammatory bowel disease therapies are associated with several dermatological adverse effects, and management options vary by agent. Certain agents may require discontinuation in the setting of nonmelanoma skin cancer, melanoma, and cutaneous infections. Many other dermatological adverse effects from inflammatory bowel disease therapy require specialized management or referral to dermatology.

Social Media Use for Inflammatory Bowel Disease in a Rural Appalachian Population.

Background: Social media use is prevalent in our society and has become widely used in the health care community. Inflammatory bowel disease (IBD) patients constitute one of the patient populations that benefit from social media use to obtain information on their diseases. West Virginia (WV) is a rural Appalachian state with barriers to internet access and health care and we examined the role that social media plays in patients' lives in this state, which could be reflective of other rural states. Methods: Our patient population consisted of patients, 18-65 years old, who live in WV with a diagnosis of IBD. A 17-question survey was sent to 2,131 patients over a course of 4 weeks through an application called REDCap. Results: We received 624 responses with a 29% response rate. Approximately 30% of patients reported that they used Facebook for IBD-related information, while 4.3% used Instagram. While most (92%) patients preferred information coming from their physician, the majority judged information from the internet to be reliable (39.3%) or neutral (44.9%). Most patients believed that social media had no impact on their disease management (67%), while 30.3% believed it had a positive impact. Almost 45% of patients stated that they wished their physician had a social media account for IBD. Conclusions: Our study shows that patients are interested in obtaining health-related information from social media resources. As physicians, it is our job to point them in the right direction to be able to find reliable information.