Ely P H
J Am Acad Dermatol. 1980 Jun;2(6):473-87. doi: 10.1016/s0190-9622(80)80148-4.
A characteristic intermittent neutrophilic dermatosis, associated with polyarthritis, tenosynovitis, malaise, fever, and cryoglobulinemia, occurs in 20% of patients who undergo ileojejunal bypass surgery for the treatment of morbid obesity. The clinical syndrome may mimic gonococcal sepsis. The histologic changes in the skin are those of Sweet's syndrome. The syndrome remits spontaneously in most cases, but it may recur intermittently over a period of years. Treatment with low-dose steroids, tetracycline, or metronidazole suppresses symptoms in most cases, and restoration of normal bowel anatomy is curative. Skin testing with Streptococcus pyogenes antigen causes an excerbation of symptoms, or may provoke the entire syndrome de novo. Bacterial peptidoglycans, especially those of group A streptococci, produce similar arthritis and skin lesions in animal models. Peptidoglycans from numerous intestinal bacteria share common structural and antigenic features with S. pyrogenes peptidoglycan and are suggested as causative of the toxic and immunologic features of this syndrome.
一种特征性的间歇性嗜中性皮病，与多关节炎、腱鞘炎、不适、发热和冷球蛋白血症相关，发生于20%接受回肠空肠旁路手术治疗病态肥胖的患者中。该临床综合征可能类似淋菌性败血症。皮肤的组织学改变为斯威特综合征的改变。该综合征在大多数情况下可自发缓解，但可能在数年期间间歇性复发。低剂量类固醇、四环素或甲硝唑治疗在大多数情况下可抑制症状，恢复正常肠道解剖结构可治愈。用化脓性链球菌抗原进行皮肤试验会使症状加重，或可能引发整个综合征。细菌肽聚糖，尤其是A组链球菌的肽聚糖，在动物模型中产生类似的关节炎和皮肤病变。来自众多肠道细菌的肽聚糖与化脓性链球菌肽聚糖具有共同的结构和抗原特征，并被认为是该综合征毒性和免疫特征的病因。
