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Case Reports
. 2024 Mar 29;5(1):27-34.
doi: 10.36518/2689-0216.1468. eCollection 2024.

Bowel-Associated Dermatosis-Arthritis Syndrome: A Case Report

Christian J Scheufele  1 , Leisa Hodges  2 , Aya Hasan  3 , Ashleigh E Workman  1 , Peter Malouf  4 , Stephen E Weis  1   3   5
Affiliations
Case Reports

Bowel-Associated Dermatosis-Arthritis Syndrome: A Case Report

Christian J Scheufele et al. HCA Healthc J Med. .

Abstract

Introduction: Gastric bypass surgery is an effective surgical intervention for morbid obesity. However, it is not without risk. Gastric bypass surgery may produce malabsorptive or surgical complications, which can result in nutritional deficiencies as well as syndromes related to bacterial overgrowth in the blind loops of the bowel.

Case presentation: Severe nutritional deficiencies may occur due to patient noncompliance with the prescribed regimen, or arise secondary to malabsorptive or mechanical surgical complications. We describe a case of a 37-year-old female who underwent gastric bypass surgery and experienced a recalcitrant eczematous eruption with sporadic subcutaneous, purulent nodules which completely resolved after the reversal of her bariatric procedure.

Conclusion: Since 2001, the number of morbidly obese patients who have undergone bariatric surgery has been increasing. As a result, clinicians can expect to more frequently encounter complications that can result from these procedures.

Keywords: BADAS; adverse effects; bariatric surgery; bowel-associated dermatosis-arthritis syndrome; case reports; gastric bypass; obesity; zinc deficiency.

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Conflict of interest statement

Conflicts of Interest: The authors declare they have no conflicts of interest.

Figures

Figure 1
Figure 1
Eczematous erythematous excoriated plaques appear on the bilateral buttocks with a bright red perianal erythema. bedside ultrasound of the pelvis, transverse plane, showed free fluid in the pelvis.
Figure 2
Figure 2
Bright red atrophic-appearing plaques are seen on the bilateral labia majora, extending to the mons pubis.
Figure 3
Figure 3
Erythema and edema are shown on the tongue, with fissuring of the oral commissure.
Figure 4
Figure 4
A complete loss of hair is shown in the left axilla.
Figure 5
Figure 5
An erythematous nodule was found on the occipital scalp. This nodule was biopsied with results consistent with bowel-associated dermatosis-arthritis syndrome.
Figure 6
Figure 6
The histopathology of bowel-associated dermatosis-arthritis syndrome (10x magnification) is shown as taken from a punch scalp biopsy, which revealed a diffuse infiltrate of neutrophils throughout the dermis and psoriasiform hyperplasia.
Figure 7
Figure 7
The histopathology of bowel-associated dermatosis-arthritis syndrome (20x magnification) is shown in a scalp punch biopsy, which revealed a diffuse infiltrate of neutrophils.
See this image and copyright information in PMC

References

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