Hidradenitis suppurativa
نویسنده
چکیده
Hidradenitis suppurativa is a chronic disease characterized by recurrent, painful, deep-seated, rounded nodules and abscesses of apocrine gland-bearing skin. Subsequent suppuration, sinus tracts and hypertrophic scarring are its main features. Onset is usually after puberty, although it is most common during the third decade and may persist in old age. The disease tends to be chronic and may develop to subcutaneous extension leading to indurations, sinus, and fistula having a profound impact on the quality of life. The prevalence is 1% in several studies. Axillary and inguinal involvement is more common in females; peri-anal and buttocks localizations are prevalent in males. The exact aetiology remains unknown. The primary event is a follicular occlusion with secondary inflammation, infection and destruction of the pilo-sebaceo-apocrine apparatus and extension to the adjacent sub-cutaneous tissue. Infection is common. Smoking may be a triggering factor. Obesity aggravates the discomfort. Differential diagnostic includes Crohn’s disease, nodular acne and furonculosis. The main complications are arthropathy, carcinoma. Treatment depends upon the stage of the disease. Early nodular lesions may be treated by antibiotics for acute stage; long-term antibiotics, zinc salts may be useful as maintenance treatment; anti-TNF drugs have been used in severe cases; systemic steroids, estrogens, antiandrogens, retinoids have been used as options with limited success. Surgical treatment includes incision with or without drainage for limited abscesses; limited excisions are used for locally recurring draining sinuses. Total wide excision and healing with secondary intention or flaps and grafts is the only curative procedure in case of advanced disease. Received: 27 March 2009; Accepted: 25 May 2009
منابع مشابه
Microbial profile and antibiotic susceptibility of bacteria isolated from patients with hidradenitis suppurativa
Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease of unknown etiology. There is evidence that bacteria may contribute to initiating the inflammatory response in HS patients. To date, data on bacteria found in HS lesions and their resistance rates are rare. Methods: The results of bacterial cultures and antibiotic susceptibility of the isolated bacteria obtained fr...
متن کاملHidradenitis suppurativa and Crohn's disease: two cases that support an association.
An association between Crohn's disease and hidradenitis suppurativa has been suggested. The presence of Crohn's disease generally precedes the diagnosis of hidradenitis suppurativa. We present two new cases in which hidradenitis lesions developed before Crohn's disease, suggesting an overlap and supporting an association. Furthermore, in one of these cases, treatment with infliximab resulted in...
متن کاملArthritis associated with hidradenitis suppurativa.
OBJECTIVE To review the presentation and clinical findings of arthritis associated with hidradenitis suppurativa. METHOD Medical records from the rheumatology clinics of two major teaching hospitals were reviewed for arthritis and hidradenitis suppurativa. The nine patient records fulfilling these criteria were reviewed and compared with 20 previous reports. RESULTS AND CONCLUSION The arthr...
متن کاملComorbidities of hidradenitis suppurativa (acne inversa).
Comorbidities of hidradenitis suppurativa (acne inversa) were reviewed by extracting original and review publications included in MEDLINE, EMBASE and COCHRANE libraries using the terms "hidradenitis," "Verneuil" and "acne inversa." Follicular occlusion disorders, inflammatory bowel diseases, especially Crohn disease, spondylarthropathy, other hyperergic diseases, genetic keratin disorders assoc...
متن کاملHidradenitis suppurativa as a presenting feature of premature adrenarche.
We report a girl with premature adrenarche, in whom the presenting feature was hidradenitis suppurativa. This association lends support to the view that hidradenitis suppurativa is an androgen-dependent disorder.
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