Pyoderma gangrenosum, acne and suppurative hidradenitis syndrome following bowel bypass surgery

Hidradenitis suppurativa Research


Author(s): Marzano AV, Ishak RS, Colombo A, Caroli F, Crosti C

The clinical triad of pyoderma gangrenosum (PG), acne and suppurative hidradenitis (PASH) has recently been described as a new disease entity within the spectrum of autoinflammatory syndromes, which are an emerging group of inflammatory diseases distinct from autoimmune, allergic and infectious disorders. PASH syndrome is similar to PAPA (pyogenic arthritis, acne and PG), but it differs in lacking the associated arthritis and on a genetic basis. PAPA syndrome is caused by mutations in a gene involved in the regulation of innate immune responses, the PSTPIP1, while no mutations have been detected to date in patients with PASH syndrome. We report a young male patient who developed coexisting disseminated PG, typical suppurative hidradenitis and acneiform eruption on the face, after he had undergone bowel bypass surgery for obesity. The cutaneous manifestations associated with bowel bypass syndrome often mimic PG or other neutrophilic dermatoses, suggesting a pathogenesis related to neutrophil-mediated inflammation for this condition. This is the first report describing PASH syndrome after bariatric surgery, and we propose to include such neutrophilic dermatoses in the list of complications occurring after bowel bypass surgery. Extensive genetic studies may help to clarify the etiopathogenesis of PASH as well as of autoinflammatory diseases in general.


Dermatology Journal and/or Publisher

Journal Name: Dermatology (Basel, Switzerland)
Journal Abbreviation: Dermatology (Basel)
Journal Date Published: 2013-01-24


National Center for Biotechnology Information

PMID: 23171584
Article Source: http://www.ncbi.nlm.nih.gov/pubmed/23171584
Lasted Revision: 2013-01-24


Abstract Source: National Center for Biotechnology Information, U.S. National Library of Medicine Abstract Query for Hidradenitis suppurativa (HS).


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