Is it bowel-associated dermatosis-arthritis syndrome induced by small intestinal bacteria overgrowth?

Abstract

IntroductionBowel-associated dermatosis-arthritis syndrome is rare systemic diseases characterized by a prodrome of fever, chills, and influenza-like symptoms with subsequent skin eruptions, myalgias, and polyarthralgias. It is reported to be occurred in Intestinal bypass surgery and inflammatory bowel disease.Case descriptionHerein, we described a 29-years-old man with Bowel-associated dermatosis-arthritis syndrome. He had no history of gastrointestinal surgery and inflammatory bowel disease. Distribution of the gut bacterial flora showed small intestinal bacterial overgrowth.Discussion and EvaluationIt is rarely form as Non-intestinal bypass road and non-inflammatory bowel disease was induced by small intestinal bacteria overgrowth.ConclusionsWe concluded that Immuno-inflammatory response to overgrowth of intestinal bacterial antigen induce the clinical symptoms of bowel-associated dermatosis-arthritis syndrome.

Bowel-associated dermatosis arthritis syndrome: A case report with first positron emission tomography analysis

“…Indeed, in animal models, similar skin lesions were induced after administration of purified peptidoglycan 7 . A similar clinical presentation of BADAS was in a 29-year-old patient with a small intestine bacterial overgrowth, 8 which is another argument implying a bacterial overgrowth in the pathophysiology.…”

The Influence of Small Intestinal Bacterial Overgrowth in Digestive and Extra-Intestinal Disorders

“…Usually, this disorder is reported to occur in intestinal bypass surgery and inflammatory bowel disease. However, a case of BADAS with SIBO in a patient without history of intestinal surgery or chronic inflammation has been described [113]. Of note, the development of immune complex is a key step in the pathogenesis of BADAS.…”

“…Of note, the development of immune complex is a key step in the pathogenesis of BADAS. Therefore, SIBO-related bacterial translocation and consequent immune-inflammatory response could play a role in the onset of this condition [113].…”

Bowel‐associated dermatosis–arthritis syndrome (BADAS)

“…Small intestinal bacterial overgrowth, together with an excessive immune response to gut bacteria, is thought to lead to a transmural release of bacterial antigens (peptidoglycans) into the circulation. 2,3 Peptidoglycans might form circulating immunocomplexes, which are transported and deposited into joints and skin causing inflammation. 2,3,4 Onset of small intestinal bacterial overgrowth can also present in the course of inflammatory bowel disease, diverticulitis or appendicitis and even without intestinal inflammation or surgery.…”

“…2,3,4 Onset of small intestinal bacterial overgrowth can also present in the course of inflammatory bowel disease, diverticulitis or appendicitis and even without intestinal inflammation or surgery. For this reason, the term bowel-associated dermatosis-arthritis syndrome (BADAS) was proposed by Jorizzo et al 1,3,4,5 Treatment options for BADAS include antibiotics, systemic corticosteroids, dapsone and sulphapyridines, as well as the reconstitution of normal anatomy of intestine by surgery. 1 This case shows the importance of a complete medical and surgical history in the dermatological practice, as it may help in revealing clues to diagnose skin lesions related to internal condition and disease.…”