In addition to mucosal manifestation in the gastrointestinal tract metastatic Crohn's disease also involves cutaneous sites. We report on a 33 year-old female suffering from diarrhea, aphthous ulceration and recurrent granulomatous abscesses on different cutaneous sites also involving the head neck region. Besides a general infection constellation, histologic examination of affected skin and mucosa revealed ulceration with chronic-granulomatous inflammation with Langerhans giant cells. Taking together the intestinal and cutaneous lesions and their histologic appearance as well as the clinical features lead to metastatic Crohn's disease. The patient recovered under immunosuppressive drugs. Metastastic Crohn's disease is a rare and severe form of the well known autoimmune disease which needs interdisciplinary diagnostic and therapy.