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Gray AN, Mital R, Minta A, Waters M, Almhana F, Hydol-Smith J, Kaffenberger BH. Quality of Life with Neutrophilic Dermatoses. Dermatol Clin 2024; 42:329-338. [PMID: 38423691 DOI: 10.1016/j.det.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Neutrophilic dermatoses (NDs) encompass a wide range of cutaneous and extracutaneous manifestations, many of which impair quality of life (QoL) and are difficult to treat. Although NDs are transient and mild, others are chronic, severely debilitating conditions with profound impacts on QoL, including pain, mental health, occupational limitations, and sexual health implications. Current literature lacks attention to these unique care challenges to the ND patient population. The authors aim to summarize what is currently known about QoL in NDs and identify which diseases would benefit from additional research and disease-specific QoL assessment.
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Affiliation(s)
- Ashley N Gray
- Department of Dermatology, Ohio State University Wexner Medical Center, 2012 Kenny Road, 2nd Floor, Columbus, OH 43221, USA; The Ohio State University College of Medicine, 2012 Kenny Road, 2nd Floor, Columbus, OH 43221, USA
| | - Rohan Mital
- Department of Dermatology, Ohio State University Wexner Medical Center, 2012 Kenny Road, 2nd Floor, Columbus, OH 43221, USA; The Ohio State University College of Medicine, 2012 Kenny Road, 2nd Floor, Columbus, OH 43221, USA
| | - Abena Minta
- Department of Dermatology, Ohio State University Wexner Medical Center, 2012 Kenny Road, 2nd Floor, Columbus, OH 43221, USA; The Ohio State University College of Medicine, 2012 Kenny Road, 2nd Floor, Columbus, OH 43221, USA
| | - Margo Waters
- The Ohio State University College of Medicine, 2012 Kenny Road, 2nd Floor, Columbus, OH 43221, USA
| | - Farah Almhana
- The Ohio State University College of Medicine, 2012 Kenny Road, 2nd Floor, Columbus, OH 43221, USA
| | - Jourdan Hydol-Smith
- Texas A&M University School of Medicine, 8447 Riverside Pkwy, Bryan, TX 77807, USA
| | - Benjamin H Kaffenberger
- Department of Dermatology, Ohio State University Wexner Medical Center, 2012 Kenny Road, 2nd Floor, Columbus, OH 43221, USA.
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Aromolo IF, Simeoli D, Maronese CA, Altomare A, Noviello D, Caprioli F, Marzano AV. The Bowel-Associated Arthritis-Dermatosis Syndrome (BADAS): A Systematic Review. Metabolites 2023; 13:790. [PMID: 37512497 PMCID: PMC10386568 DOI: 10.3390/metabo13070790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/11/2023] [Accepted: 06/21/2023] [Indexed: 07/30/2023] Open
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.
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Affiliation(s)
- Italo Francesco Aromolo
- Dermatology Unit, Scientific Institute for Research, Hospitalization and Healthcare Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Domenico Simeoli
- Dermatology Unit, Scientific Institute for Research, Hospitalization and Healthcare Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Carlo Alberto Maronese
- Dermatology Unit, Scientific Institute for Research, Hospitalization and Healthcare Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Andrea Altomare
- Scientific Institute for Research, Hospitalization and Healthcare Istituto Ortopedico Galeazzi, 20122 Milan, Italy
| | - Daniele Noviello
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
- Gastroenterology and Endoscopy Unit, Fondazione Scientific Institute for Research, Hospitalization and Healthcare Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Flavio Caprioli
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
- Gastroenterology and Endoscopy Unit, Fondazione Scientific Institute for Research, Hospitalization and Healthcare Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Angelo Valerio Marzano
- Dermatology Unit, Scientific Institute for Research, Hospitalization and Healthcare Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
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Enthesitis in Bowel-Associated Dermatosis-Arthritis Syndrome in an Ulcerative Colitis Patient. Case Rep Rheumatol 2022; 2022:4556250. [PMID: 35462852 PMCID: PMC9019431 DOI: 10.1155/2022/4556250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 03/18/2022] [Indexed: 11/17/2022] Open
Abstract
Bowel-associated dermatosis-arthritis syndrome (BADAS) is a rare and recurrent neutrophilic dermatosis condition. Due to the rarity of this syndrome and the difficulty of the disease recognition and management, there was no clear reported incidence rate of this syndrome. 20% of patients after ileojejunal bypass surgery for morbid obesity were reported, by Jorizzo et al., to have BADAS. The underlying etiology of BADAS is not fully understood; therefore, the diagnosis of this condition is difficult and the approach for the management as well. Herein, we report a case of BADAS with unusual musculoskeletal presentation.
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Havele SA, Clark AK, Oboite M, Conrad MA, Perman MJ, Rubin AI, Treat JR. Bowel-associated dermatosis-arthritis syndrome in a child with very early onset inflammatory bowel disease. Pediatr Dermatol 2021; 38:697-698. [PMID: 33749007 PMCID: PMC9014869 DOI: 10.1111/pde.14544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 01/23/2021] [Accepted: 01/28/2021] [Indexed: 11/27/2022]
Abstract
A 6-year-old boy with severe very early-onset inflammatory bowel disease (VEO-IBD) was admitted for 1 week of high fevers, loose stools, joint pains, and myalgias. He subsequently developed a progressive, papular, and vesiculopustular eruption on his face with rapid spread to his trunk and extremities. Histopathology demonstrated dense dermal neutrophilic inflammation. Findings were consistent with bowel-associated dermatosis-arthritis syndrome (BADAS), which is rarely reported in children and requires further characterization.
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Affiliation(s)
- Sonia A Havele
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ashley K Clark
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Michelle Oboite
- Section of Pediatric Dermatology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Máire A Conrad
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, PA, USA
| | - Marissa J Perman
- Section of Pediatric Dermatology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Adam I Rubin
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.,Section of Pediatric Dermatology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - James R Treat
- Section of Pediatric Dermatology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
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