PDF(Pubmed)
Abstract：
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.
摘要：
肠相关性关节炎-皮肤病综合征（BADAS）是一种罕见的嗜中性皮肤病，于1971年首次在因肥胖而接受搭桥手术的患者中被描述。多年来,与医学胃肠病相关的报告病例数，特别是炎症性肠病（IBD），逐步增加。迄今为止,文献中没有关于BADAS的系统综述。先验协议的设计基于PRISMA指南，并对PubMed和Scopus数据库进行了搜索，以查找1971年至2023年之间发表的与该主题相关的文章。本系统综述分析了51篇文献，包括113例BADAS患者。减肥手术和IBD是BADAS最常见的原因，占所有病例的63.7%和24.7%，分别。总共85%的病例表现出典型的皮肤病学表现，包括以膀胱柱为中心的荨麻疹斑丘疹性病变，大部分病变位于上肢（73.5%）。多发性关节痛或局部关节炎总是存在。非典型的表现包括蜂窝织炎，结节性红斑样,甜综合征样和脓皮病-坏疽样表现。在IBD相关病例中经常观察到胃肠道症状(67.9%)。组织病理学显示嗜中性粒细胞浸润（96.6%）。最常用的治疗方案包括全身性皮质类固醇，甲硝唑和四环素，单独或组合。在52.1％的患者中观察到复发缓解过程。总之,BADAS是一种中性粒细胞性皮肤病，表现为多种皮肤表现，既典型又非典型。经常观察到胃肠道症状，尤其是与IBD相关的病例。与其他嗜中性皮肤病相比，组织病理学清晰但不特异。诊断可能具有挑战性，但是复发-缓解过程以及与多关节痛和胃肠道疾病的强烈关联可以帮助诊断。
