Dermatology PA Jenny Laminack talks with Dr. Jenny Clark of the University of Utah School of Medicine about recognizing cutaneous manifestations of inflammatory bowel disease in daily practice.

In this video

Dr. Clark describes what she considers one of the best parts of dermatology: looking at the skin and recognizing a manifestation that points to a new diagnosis like inflammatory bowel disease. With IBD affecting roughly 1-2% of the US population, she notes that patients feel "heard and validated" when a clinician connects their skin findings to their gut disease, and points out that many conditions dermatology treats routinely — severe acne, rosacea, and psoriasis — are seen more commonly in patients with IBD.

She walks through the practical next steps: some manifestations are highly specific but uncommon, like pyoderma gangrenosum, while others, such as aphthous stomatitis, are seen all the time. A quick review of systems — abdominal pain, family history of Crohn's or ulcerative colitis, diarrhea, blood in the stool — takes only a few seconds. Positive answers warrant further pursuit, whether a gastroenterology referral for endoscopy or a simple fecal calprotectin stool test that, if negative, lowers the likelihood of IBD and offers more comfort before prescribing a drug like an IL-17 inhibitor, which can worsen the disease. As she puts it, dermatology is often so focused on the skin that the reminder is to care for "the entire health of our patients."

  • IBD is common (about 1-2% of the US population), and conditions dermatology treats daily — severe acne, rosacea, and psoriasis — are seen more often in these patients.
  • Pyoderma gangrenosum is highly specific to IBD but uncommon; aphthous stomatitis is far more frequent and worth noting.
  • A few-second review of systems — abdominal pain, family history of Crohn's/ulcerative colitis, diarrhea, blood in stool — can flag patients who need further workup.
  • Positive findings warrant a gastroenterology referral for endoscopy or a simple fecal calprotectin stool test.
  • A negative fecal calprotectin lowers the likelihood of IBD and offers more comfort before prescribing an IL-17 inhibitor, which may worsen inflammatory bowel disease.