GI consulted and upon further examination found presentation and physical exam findings concerning for cutaneous manifestation of Crohn’s disease. Labs were obtained and the patient was found to have normal CBC, CMP, ESR, CRP, uric acid, and LDH. Negative serum beta hCG. With unremarkable lab work, GI recommended outpatient follow-up and dermatology outpatient for the scrotal blisters. Punch biopsy was performed which showed noncaseating granulomas. The patient was started on Remicaide with improvement in genital swelling.

There are few reports of urogenital metastatic Chron’s disease in the pediatric population. Extraintestinal manifestations of Chron’s can exist in isolation of GI findings. Findings in males include, penoscrotal swelling, erythema, plaques, or ulcers in males. Findings in females include vulvar swelling, fissures, and ulcers.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2763745/#:~:text=Metastatic%20Crohn’s%20disease%20is%20characterized,a%20patient%20with%20Crohn’s%20disease.&text=Metastatic%20Crohn’s%20disease%20of%20the,documented%20cases%20in%20the%20literature.