Atypical histopathology in bowel-associated dermatosis-arthritis syndrome: A case report

Dermatol Online J. 2009 Mar 15;15(3):3.


Bowel-associated dermatosis-arthritis syndrome (BADAS) is characterized by a prodrome of fever, chills, and flu-like symptoms with subsequent skin eruptions, myalgias, and polyarthralgias. The syndrome was initially described following jejunoileal bypass surgery for weight loss. Histopathology of the skin lesions present in BADAS is described in the literature as identical to that of Sweet syndrome. We present a patient whose clinical history and physical exam were consistent with the diagnosis of BADAS. Dermatopathology in this case demonstrated a large subcorneal pustule without a significant dermal neutrophilic infiltrate. The histologic differential included subcorneal pustular dermatosis, bullous impetigo, or IgA pemphigus. The histology in BADAS may not necessarily be identical to Sweet syndrome, and the clinical picture alone plays an important role in diagnosis. The correct diagnosis of BADAS prevents a myriad of laboratory tests and allows for more effective symptom management in this chronic condition.

Publication types

  • Case Reports

MeSH terms

  • Antigens, Bacterial / immunology
  • Arthralgia / diagnosis
  • Arthralgia / etiology
  • Arthralgia / immunology
  • Arthralgia / pathology*
  • Arthritis / diagnosis
  • Arthritis / etiology
  • Arthritis / immunology
  • Arthritis / pathology*
  • Chills / etiology
  • Diagnosis, Differential
  • Erythema / diagnosis
  • Erythema / etiology
  • Erythema / immunology
  • Erythema / pathology*
  • Female
  • Fever / etiology
  • Gastric Bypass*
  • Humans
  • Impetigo / diagnosis
  • Intestines / microbiology
  • Middle Aged
  • Neutrophils / pathology
  • Pemphigus / diagnosis
  • Postoperative Complications / etiology
  • Postoperative Complications / immunology
  • Postoperative Complications / pathology*
  • Skin Diseases, Vesiculobullous / diagnosis
  • Sweet Syndrome / diagnosis


  • Antigens, Bacterial