Drenick E J, Ahmed A R, Greenway F, Olerud J E
Ann Intern Med. 1980 Oct;93(4):557-9. doi: 10.7326/0003-4819-93-4-557.
Twenty-three of 81 intestinal bypass patients with episodes of bypass enteropathy had papulopustular or nodular skin lesions. Histologic examination of the dermal lesions showed various forms of vasculitis in nine of 14 subjects. In six of 11 patients examined by immunofluorescent microscopy, both the lesions and uninvolved sun-exposed skin areas had immunoglobulin and complement deposits in linear or granular patterns in the dermoepidermal line, giving the appearance of a positive lupus band test. Skin lesions resolved with spontaneous improvement of bypass enteropathy or in response to metronidazole therapy. After the bypass was dismantled, the eruptions disappeared permanently, and previously positive lupus band tests became negative. The skin lesions were frequently observed in association with arthritis, suggesting an immune-complex mechanism, probably originating in "blind loop" bacterial overgrowth.
81例患有旁路性肠病发作的肠道旁路手术患者中有23例出现丘疹脓疱或结节性皮肤病变。对14名受试者中的9名进行的皮肤病变组织学检查显示出各种形式的血管炎。在11名接受免疫荧光显微镜检查的患者中，有6名患者的病变部位和未受累的阳光暴露皮肤区域在真皮表皮交界处有免疫球蛋白和补体呈线性或颗粒状沉积，呈现出狼疮带试验阳性的表现。皮肤病变随着旁路性肠病的自发改善或对甲硝唑治疗的反应而消退。在拆除旁路后，皮疹永久消失，先前阳性的狼疮带试验变为阴性。皮肤病变常与关节炎相关，提示可能源于“盲袢”细菌过度生长的免疫复合物机制。
