Bowel-Associated Dermatosis and Arthritis Syndrome (BADAS) – A Literature Review With Diagnostic and Therapeutic Implications and a Report of Two Cases of BADAS Associated With Inflammatory Bowel Disease
References
- Ahn C, Negus D, Huang W (2018) Pyoderma gangrenosum: A review of pathogenesis and treatment. Expert Rev Clin Immunol 14:225–233.
https://doi.org/10.1080/1744666X.2018.1438269 - Alshahrani KS, Almohaya AM, Hussein RS et al. (2022) Enthesitis in bowel-associated dermatosis-arthritis syndrome in an ulcerative colitis patient. Case Rep Rheumatol 2022:4556250.
https://doi.org/10.1155/2022/4556250 - Antonelli E, Bassotti G, Tramontana M et al. (2021) Dermatological manifestations in inflammatory bowel diseases. J Clin Med 10:364.
https://doi.org/10.3390/jcm10020364 - Aounallah A, Zerriaa S, Ksiaa M et al. (2016) [Bowel-associated dermatosis-arthritis syndrome during ulcerative colitis: A rare extra-intestinal sign of inflammatory bowel disease]. Ann Dermatol Venereol 143:377–381.
https://doi.org/10.1016/j.annder.2016.02.009 - Aromolo IF, Simeoli D, Maronese CA et al. (2023) The bowel-associated arthritis-dermatosis syndrome (BADAS): A systematic review. Metabolites 13:790.
https://doi.org/10.3390/metabo13070790 - Ashchyan HJ, Nelson CA, Stephen S et al. (2018) Neutrophilic dermatoses: Pyoderma gangrenosum and other bowel- and arthritis-associated neutrophilic dermatoses. J Am Acad Dermatol 79:1009–1022.
https://doi.org/10.1016/j.jaad.2017.11.063 - Ashok D, Kiely P (2007) Bowel associated dermatosis - arthritis syndrome: A case report. J Med Case Rep 1:81.
https://doi.org/10.1186/1752-1947-1-81 - Barland A, Blackmon J, Fraga G et al. (2016) Bowel-associated dermatosis-arthritis syndrome in a patient with Crohn disease. Cutis 97:E1–3.
- Caro RDC, Prete MDI, Didona D et al. (2021) Bowel-associated dermatosis arthritis syndrome and palisading neutrophilic granulomatous dermatitis as presentation of ulcerative colitis. Ital J Dermatol Venereol 156(Suppl. 1):7–8.
https://doi.org/10.23736/S2784-8671.19.06198-4 - Carubbi F, Ruscitti P, Pantano I et al. (2013) Jejunoileal bypass as the main procedure in the onset of immune-related conditions: The model of BADAS. Expert Rev Clin Immunol 9:441–452.
https://doi.org/10.1586/eci.13.26 - Chen ST, Song P, Zimarowski MJ et al. (2016) Leg pain and rash in a man with prior bariatric surgery. Int J Dermatol 55:509–511.
https://doi.org/10.1111/ijd.12949 - Czajkowski R, Lipska P, Watoła W et al. (2023) Bowel-associated dermatosis-arthritis syndrome (BADAS): A narrative review. Postepy Dermatol Alergol 40:355–361.
https://doi.org/10.5114/ada.2023.129101 - DeFilippis EM, Magro C, Jorizzo JL (2014) Bowel-associated dermatosis - arthritis syndrome in a patient with ulcerative colitis: An extraintestinal manifestation of inflammatory bowel disease. Clin J Gastroenterol 7:410–413.
https://doi.org/10.1007/s12328-014-0529-8 - Delaney TA, Clay CD, Randell PL (1989) The bowel-associated dermatosis – arthritis syndrome. Australas J Dermatol 30:23–27.
https://doi.org/10.1111/j.1440-0960.1989.tb00402.x - Dicken CH (1986) Bowel-associated dermatosis-arthritis syndrome: bowel bypass syndrome without bowel bypass. J Am Acad Dermatol 14:792–796.
https://doi.org/10.1016/s0190-9622(86)70095-9 - Ely PH (1980) The bowel bypass syndrome: A response to bacterial peptidoglycans. J Am Acad Dermatol 2:473–487.
https://doi.org/10.1016/s0190-9622(80)80148-4 - Fenske NA, Gern JE, Pierce D, Vasey FB (1983) Vesiculopustular eruption of ulcerative colitis. Arch Dermatol 119:664–669.
https://doi.org/10.1001/archderm.1983.01650320038013 - Förström L, Winkelmann RK (1977) Acute panniculitis: A clinical and histopathologic study of 34 cases. Arch Dermatol 113:909–917.
https://doi.org/10.1001/archderm.1977.01640070043003 - Gevers D, Kugathasan S, Denson LA et al. (2014) The treatment-naive microbiome in new-onset Crohn’s disease. Cell Host Microbe 15:382–392.
https://doi.org/10.1016/j.chom.2014.02.005 - Gubatan J, Moss AC (2018) Vitamin D in inflammatory bowel disease: More than just a supplement. Curr Opin Gastroenterol 34:217–225.
https://doi.org/10.1097/MOG.0000000000000449 - Guerre-Schmidt AR, Pelletier F, Carbonnel F et al. (2006) [Dermatosis-arthritis syndrome associated with Crohn’s disease in a teenager]. Rev Med Interne 27:874–877.
https://doi.org/10.1016/j.revmed.2006.07.017 - Hassold N, Jelin G, Palazzo E et al. (2019) Bowel-associated dermatosis arthritis syndrome: A case report with first positron emission tomography analysis. JAAD Case Rep 5:140–143.
https://doi.org/10.1016/j.jdcr.2018.10.025 - Havele SA, Clark AK, Oboite M et al. (2021) Bowel-associated dermatosis-arthritis syndrome in a child with very early onset inflammatory bowel disease. Pediatr Dermatol 38:697–698.
https://doi.org/10.1111/pde.14544 - Heard M, Zhang M, Jorizzo JL (2020) A case of bowel-associated dermatosis-arthritis syndrome treated with ustekinumab: The importance of targeting underlying gastrointestinal disease. JAAD Case Rep 6:506–508.
https://doi.org/10.1016/j.jdcr.2020.04.001 - Hirano A, Umeno J, Okamoto Y et al. (2018) Comparison of the microbial community structure between inflamed and non-inflamed sites in patients with ulcerative colitis. J Gastroenterol Hepatol 33:1590–1597.
https://doi.org/10.1111/jgh.14129 - Jockenhöfer F, Wollina U, Salva KA et al. (2019) The PARACELSUS score: A novel diagnostic tool for pyoderma gangrenosum. Br J Dermatol 180:615–620.
https://doi.org/10.1111/bjd.16401 - Jorizzo JL, Apisarnthanarax P, Subrt P et al. (1983) Bowel-bypass syndrome without bowel bypass. Bowel-associated dermatosis-arthritis syndrome. Arch Intern Med 143:457–461.
https://doi.org/10.1001/archinte.1983.00350030071013 - Jorizzo JL, Schmalstieg FC, Dinehart SM et al. (1984) Bowel-associated dermatosis-arthritis syndrome. Immune complex-mediated vessel damage and increased neutrophil migration. Arch Intern Med 144:738–740.
https://doi.org/10.1001/archinte.144.4.738 - Keyal U, Liu Y, Bhatta AK (2018) Dermatologic manifestations of inflammatory bowel disease: A review. Discov Med 25: 225–233.
- Kinyó Á, Farkas K, Molnár T et al. (2011) Bowel-associated dermatosis-arthritis syndrome – a relapsing, extremely rare extraintestinal sign of acute flare-up in Crohn’s disease. Eur J Dermatol 21:443–445.
https://doi.org/10.1684/ejd.2011.1346 - Kurtzman D, Vleugels RA, Callen J (2016) Approach to and management of the neutrophilic dermatoses. Curr Dermatol Rep 5:18–29.
https://doi.org/10.1007/s13671-016-0129-6 - Lacey BW, You D, Speziale A (2011) Pustular skin eruption in a patient with ulcerative colitis. Clin Gastroenterol Hepatol 9:e43–44.
https://doi.org/10.1016/j.cgh.2010.11.035 - Linares R, Francés R, Gutiérrez A et al. (2021) Bacterial translocation as inflammatory driver in Crohn’s disease. Front Cell Dev Biol 9:703310.
https://doi.org/10.3389/fcell.2021.703310 - Matheson BK, Gilbertson EO, Eichenfield LF (1996) Vesiculopustular eruption of Crohn’s disease. Pediatric Dermatol 13:127–130.
https://doi.org/10.1111/j.1525-1470.1996.tb01418.x - Maverakis E, Marzano AV, Le ST et al. (2020) Pyoderma gangrenosum. Nat Rev Dis Primers 6:81.
https://doi.org/10.1038/s41572-020-0213-x - Maverakis E, Ma C, Shinkai K et al. (2018) Diagnostic criteria of ulcerative pyoderma gangrenosum: A delphi consensus of international experts. JAMA Dermatol 154:461–466.
https://doi.org/10.1001/jamadermatol.2017.5980 - Mendoza JL, García-Paredes J, Peña AS et al. (2003) A continuous spectrum of neutrophilic dermatoses in Crohn’s disease. Rev Esp Enferm Dig 95:233–236,229–232.
- Molinelli E, Brisigotti V, Paolinelli M et al. (2021) Novel therapeutic approaches and targets for the treatment of neutrophilic dermatoses, management of patients with neutrophilic dermatoses and future directions in the era of biologic treatment. Curr Pharm Biotechnol 22:46–58.
https://doi.org/10.2174/1389201021666200503050803 - Mor F, Cohen IR (2013) Beta-lactam antibiotics modulate T-cell functions and gene expression via covalent binding to cellular albumin. Proc Natl Acad Sci USA 110:2981–2986.
https://doi.org/10.1073/pnas.1215722110 - Nelson CA, Stephen S, Ashchyan HJ et al. (2018) Neutrophilic dermatoses: Pathogenesis, sweet syndrome, neutrophilic eccrine hidradenitis, and Behçet disease. J Am Acad Dermatol 79:987–1006.
https://doi.org/10.1016/j.jaad.2017.11.064 - Oldfield CW, Heffernan-Stroud LA, Buehler-Bota TS et al. (2016) Bowel-associated dermatosis-arthritis syndrome (BADAS) in a pediatric patient. JAAD Case Rep 2:272–274.
https://doi.org/10.1016/j.jdcr.2016.05.012 - Richar NA, Bielsa I, Morillas V et al. (2021) Bowel-associated dermatosis–arthritis syndrome (BADAS). Australas J Dermatol 62:241–242.
https://doi.org/10.1111/ajd.13516 - Russell Johns H, Shetty N, Cash J et al. (2022) Bowel-associated-dermatosis-arthritis syndrome (BADAS) as early presentation of ulcerative colitis in an adolescent girl. Pediatr Dermatol 39:643–645.
https://doi.org/10.1111/pde.14954 - Shagrin JW, Frame B, Duncan H (1971) Polyarthritis in obese patients with intestinal bypass. Ann Internal Med 75:377–380.
https://doi.org/10.7326/0003-4819-75-3-377 - Su WPD, Davis MDP, Weenig RH et al. (2004) Pyoderma gangrenosum: Clinicopathologic correlation and proposed diagnostic criteria. Int J Dermatol 43:790–800.
https://doi.org/10.1111/j.1365-4632.2004.02128.x - Su WP, Liu HN (1986) Diagnostic criteria for Sweet’s syndrome. Cutis 37:167–174.
- Swidsinski A, Weber J, Loening-Baucke V et al. (2005) Spatial organization and composition of the mucosal flora in patients with inflammatory bowel disease. J Clin Microbiol 43:3380–3389.
https://doi.org/10.1128/JCM.43.7.3380-3389.2005 - Tharwat S, Eltoraby EE (2020) Pyodermatitis-pyostomatitis vegetans associated with autoimmune hepatitis: Unreported co-existence. Gastroenterol Hepatol Bed Bench 13:188–190.
- Truchuelo MT, Alcántara J, Vano-Galván S et al. (2013) Bowel-associated dermatosis-arthritis syndrome: Another cutaneous manifestation of inflammatory intestinal disease. Int J Dermatol 52:1596–1598.
https://doi.org/10.1111/j.1365-4632.2011.05149.x - Vázquez J, Almagro M, del Pozo J et al. (2003) Neutrophilic pustulosis and ulcerative colitis. J Eur Acad Dermatol Venereol 17: 77–79.
https://doi.org/10.1046/j.1468-3083.2003.00581.x - Verway M, Behr MA, White JH (2010) Vitamin D, NOD2, autophagy and Crohn’s disease. Expert Rev Clin Immunol 6:505–508.
https://doi.org/10.1586/eci.10.31 - Vich Vila A, Imhann F, Collij V et al. (2018) Gut microbiota composition and functional changes in inflammatory bowel disease and irritable bowel syndrome. Sci Transl Med 10:eaap8914.
https://doi.org/10.1126/scitranslmed.aap8914 - Yilmaz B, Juillerat P, Øyås O et al. (2019) Microbial network disturbances in relapsing refractory Crohn’s disease. Nat Med 25:323–336.
https://doi.org/10.1038/s41591-018-0308-z
DOI: https://doi.org/10.2478/aite-2026-0010 | Journal eISSN: 1661-4917
Language: English
Submitted on: Sep 10, 2025
Accepted on: Nov 21, 2025
Published on: Feb 21, 2026
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© 2026 Raman Nitskovich, Aleksandra Jóźwik, Piotr Sobolewski, Paweł Głuszak, Dagmara S. Mahadea, Irena Walecka, published by Hirszfeld Institute of Immunology and Experimental Therapy
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