- The incidence of cutaneous lesions associated with inflammatory bowel disease varies from 2 to 34% [1±5]. The most frequently described skin manifestations of IBD are pyoderma gangrenosum and erythema nodosum [1±5]. Metastatic Crohn's disease is a rare cutaneous manifestation of Crohn's disease. It is characterized by a non-caseating granulomatous skin reaction in Crohn patients with a clinical course that does not necessarily correspond to the severity of bowel lesions and is usually resistant to topical therapy [1±5]. We describe the case of a patient with MCD whose cutaneous lesions preceded the gastrointestinal manifestations of Crohn's disease by 13 months and responded fully to conventional therapy for IBD, i.e., oral metronidazole and rectal steroid and mesalamine suppositories at the first episode, and rectal steroid and mesalamine suppositories at a flare-up.