Cutaneous penile and perianal Crohn's disease treated with a combination of medical and surgical interventions.

A 73-year-old man presented with fistulizing cutaneous Crohn's disease of the penis and perianal area without involvement of the gastrointestinal tract. The disease failed to respond to topical clobetasol propionate and oral cyclosporin and methotrexate. A combination treatment of minocycline, thalidomide and prednisolone brought the disease under control and induced remission. Surgery with excision and skin grafting were required to produce cure.