The Bowel-Associated Arthritis-Dermatosis Syndrome (BADAS): A Systematic Review

被引:2
作者
Aromolo, Italo Francesco [1 ,2 ]
Simeoli, Domenico [1 ,2 ]
Maronese, Carlo Alberto [1 ,2 ]
Altomare, Andrea [3 ]
Noviello, Daniele [2 ,4 ]
Caprioli, Flavio [2 ,4 ]
Marzano, Angelo Valerio [1 ,2 ]
机构
[1] Hospitalizat & Healthcare Ca Granda Osped Maggiore, Sci Inst Res, Dermatol Unit, I-20122 Milan, Italy
[2] Univ Milan, Dept Pathophysiol & Transplantat, I-20122 Milan, Italy
[3] Hospitalizat & Healthcare Ist Ortoped Galeazzi, Sci Inst Res, I-20122 Milan, Italy
[4] Hospitalizat & Healthcare Ca Granda Osped Maggiore, Fdn Sci Inst Res, Gastroenterol & Endoscopy Unit, I-20122 Milan, Italy
关键词
bowel; dermatosis; arthritis; neutrophilic dermatoses; inflammatory bowel diseases; LOW-FODMAP DIET; INTESTINAL-BYPASS ARTHRITIS; VESICULOPUSTULAR ERUPTION; JEJUNOILEAL BYPASS; ULCERATIVE-COLITIS; PUSTULAR ERUPTION; IMMUNE-COMPLEXES; CROHNS-DISEASE; PATIENT; SKIN;
D O I
10.3390/metabo13070790
中图分类号
Q5 [生物化学]; Q7 [分子生物学];
学科分类号
071010 ; 081704 ;
摘要
Bowel-associated arthritis-dermatosis syndrome (BADAS) is a rare neutrophilic dermatosis that was first described in 1971 in patients who underwent bypass surgery for obesity. Over the years, the number of reported cases associated with medical gastroenterological conditions, particularly inflammatory bowel disease (IBD), has progressively increased. To date, there are no systematic reviews in the literature on BADAS. The design of an a priori protocol was based on PRISMA guidelines, and a search of PubMed and Scopus databases was conducted for articles published between 1971 and 2023 related to the topic. Fifty-one articles including 113 patients with BADAS were analyzed in this systematic review. Bariatric surgery and IBD were the most frequently reported causes of BADAS, accounting for 63.7% and 24.7% of all cases, respectively. A total of 85% of cases displayed the typical dermatological presentation, including urticarial maculopapular lesions centered by a vesicopustule, with the majority of lesions located on the upper limbs (73.5%). Polyarthralgia or localized arthritis were always present. Atypical presentations included cellulitis-like, erythema-nodosum-like, Sweet-syndrome-like and pyoderma-gangrenosum-like manifestations. Gastrointestinal symptoms were frequently observed in IBD-related cases (67.9%). The histopathology showed a neutrophilic infiltrate (96.6%). The most commonly used treatment regimens consisted of systemic corticosteroids, metronidazole and tetracyclines, either alone or in combination. A relapsing-remitting course was observed in 52.1% of patients. In conclusion, BADAS is a neutrophilic dermatosis that presents with a wide variety of cutaneous manifestations, both typical and atypical. Gastrointestinal symptoms are frequently observed, particularly in cases related to IBD. The histopathology is clear but not specific compared with other neutrophilic dermatoses. The diagnosis can be challenging, but the relapsing-remitting course and the strong association with polyarthralgia and gastrointestinal disease can aid in the diagnosis.
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