A Japanese woman in her 20s who complained diarrhea and bloody stools was diagnosed as ulcerative colitis (UC) and treated with Mesalazine.
She was referred to our hospital three years later with worsening symptoms and a vulvar ulcer. The colonoscopy image and pathological finding was compatible with UC from the rectum to the sigmoid. However there were small deep ulcerations like Crohn's disease (CD) or Behçet disease (BD) in the transverse colon. Prednisolone improved the symptoms.
The vulvar ulcer is common in BD but it is an extremely rare extraintestinal manifestation (EIM) in UC. This case was considered unclassified inflammatory bowel disease (IBDU) and the diagnosis may be confirmed with the change of the endoscopic finding and appearance of EIM in the future.
