Bowel-Associated Dermatosis–Arthritis Syndrome

  • Liam Zakko
  • Justin Finch
  • Marti J. Rothe
  • Jane M. Grant-Kels


Clinical signs and features include:

Seen in up to 20 % of patients with jejunal-ileal bypass 3 months to 5 years following surgery; also associated with biliopancreatic diversion, Billroth II gastrectomy, occasionally inflammatory bowel disease (IBD), and rarely after laparoscopic gastric bypass surgery

Presents with flu-like symptoms of fevers, myalgia, and tenosynovitis with symmetrical small joint polyarthritis without deformities

Painful skin rash develops 12–36 h after flu-like symptoms with crops of small erythematous purpuric macules often on the upper trunk and extremities that progress to indurated, urticarial purpuric papules and then vesiculopustular lesions over the next 24–48 h. The lesions heal without scarring over the next 2 weeks.


Celiac Disease Anorexia Nervosa Biliopancreatic Diversion Short Bowel Syndrome Pyoderma Gangrenosum 
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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Liam Zakko
    • 1
  • Justin Finch
    • 2
  • Marti J. Rothe
    • 2
  • Jane M. Grant-Kels
    • 2
  1. 1.Yale Department of Internal MedicineYale New Haven HospitalNew HavenUSA
  2. 2.Department of DermatologyUniversity of Connecticut Health CenterFarmingtonUSA

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