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Cheong KW, Shen M, Wang DY, Tey HL, Ren EC, Oon HH. Psychosocial impact and treatment trends of hidradenitis suppurativa in Singapore. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2022; 51:318-320. [PMID: 35658158 DOI: 10.47102/annals-acadmedsg.2021477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
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2
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Sachdeva M, Kim P, Mufti A, Maliyar K, Sibbald C, Alavi A. Biologic Use in Pediatric Patients With Hidradenitis Suppurativa: A Systematic Review. J Cutan Med Surg 2021; 26:176-180. [PMID: 34587768 PMCID: PMC8978460 DOI: 10.1177/12034754211049711] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND There is currently at least 1 biologic (adalimumab) approved in North America for treatment of Hidradenitis Suppurativa in the pediatric population. However, no reviews or clinical trials have specifically analyzed the effectiveness and safety data of biologic use in this population. The objective of this systematic review is to identify and summarize the outcomes of biologic therapy in pediatric patients with HS. METHODS MEDLINE and EMBASE databases were used to conduct the search on Sept 18, 2020. RESULTS The 15 included studies consisted of 26 patients, with the mean age of 15 ± 2.3 years. Females accounted for 53.8% (n = 14/26) of cases. The mean duration of HS prior to biologic initiation was 3.5 ± 2.9 years, with the majority having Hurley Stage II. The 26 patients received 34 biologics in total: 85.3% treated with TNF alpha inhibitors (adalimumab n = 17, infliximab n = 10, etanercept n = 1, unspecified n = 1), 5.9% with IL-12/23 inhibitors (ustekinumab n = 2), 5.9% with IL-1 inhibitors (i.e., anakinra n = 2) and 2.9% received IL-23 inhibitors (i.e., guselkumab n = 1) biologics. Of the 26 patients, 23.1% (n = 6/26) experienced complete resolution (CR), 73.1% (n = 19/26) experienced partial resolution (PR), and 3.8% (n = 1/26) had no resolution outcomes reported. The time to resolution of HS lesions after biologic initiation ranged from 10 days to 11.5 months (mean: 5.1 months). No adverse events were reported in the studies. CONCLUSION Although anti-TNF alpha were the most common biologics used for HS in pediatric cases, large-scale trials specific to pediatric patients with HS are needed to confirm these findings.
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Affiliation(s)
| | - Patrick Kim
- Michael G. DeGroote School of Medicine, McMaster
University, Hamilton, Canada
| | - Asfandyar Mufti
- Division of Dermatology, Department of Medicine, University
of Toronto, Canada
| | | | - Cathryn Sibbald
- Division of Dermatology, Department of Medicine, University
of Toronto, Canada
- Section of Dermatology, Division of Pediatric Medicine,
The Hospital for Sick Children, University of Toronto, Toronto, ON,
Canada
| | - Afsaneh Alavi
- Faculty of Medicine, University of Toronto, Canada
- Department of Dermatology, Mayo Clinic, Rochester, MN,
USA
- Afsaneh Alavi, Department of
Dermatology, Mayo Clinic, Rochester, MN 55905, USA;
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3
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Anduquia-Garay F, Rodríguez-Gutiérrez MM, Poveda-Castillo IT, Valdes-Moreno PL, Agudelo-Rios DA, Benavides-Moreno JS, Lozada-Martínez ID, Bolaño-Romero MP, Borraez-Segura B, Rahman S. Hidradenitis suppurativa: Basic considerations for its approach: A narrative review. Ann Med Surg (Lond) 2021; 68:102679. [PMID: 34401142 PMCID: PMC8353381 DOI: 10.1016/j.amsu.2021.102679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/30/2021] [Accepted: 08/03/2021] [Indexed: 01/18/2023] Open
Abstract
Hidradenitis suppurativa is a chronic and debilitating skin disease, whose lesions can range from inflammatory nodules to abscesses and fistulas in the armpits, groin, perineum, inframammary region. Diagnosis can be confused with a large number of clinical pictures, and although studies on hidradenitis suppurativa are not so scarce in the literature, doctors are often unaware of this disease and therefore its diagnosis is often late. Pharmacological treatment ranges from retinoids to immunosuppression and radiation therapy, and surgical treatment ranges from incision and drainage to more complete excisions and laser therapies. Hidradenitis suppurativa is a disease seen and treated mainly by dermatologists and general surgeons, however, it is necessary for general practitioners to have basic knowledge about this entity, as they are the first line of care in the health system. Hidradenitis suppurativa is an entity of necessary recognition by the surgeon. It is a preventable and treatable condition with a good prognosis. This condition should be managed by a multidisciplinary team.
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Affiliation(s)
- Felipe Anduquia-Garay
- Future Surgeons Chapter, Colombian Surgery Association, Bogotá, Colombia
- School of Medicine, Universidad Tecnológica de Pereira, Pereira, Colombia
| | - María Manuela Rodríguez-Gutiérrez
- Future Surgeons Chapter, Colombian Surgery Association, Bogotá, Colombia
- Medical and Surgical Research Center, School of Medicine, Fundación Universitaria Autónoma de las Americas, Pereira, Colombia
| | | | | | | | | | - Ivan David Lozada-Martínez
- Future Surgeons Chapter, Colombian Surgery Association, Bogotá, Colombia
- Medical and Surgical Research Center, University of Cartagena, Cartagena, Colombia
| | | | | | - Sabrina Rahman
- Department of Public Health, Independent University-Bangladesh, Dhaka, Bangladesh
- Corresponding author.
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Krajewski PK, Szukała W, Lichawska-Cieślar A, Matusiak Ł, Jura J, Szepietowski JC. MCPIP1/Regnase-1 Expression in Keratinocytes of Patients with Hidradenitis Suppurativa: Preliminary Results. Int J Mol Sci 2021; 22:ijms22147241. [PMID: 34298861 PMCID: PMC8307415 DOI: 10.3390/ijms22147241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/02/2021] [Accepted: 07/04/2021] [Indexed: 11/16/2022] Open
Abstract
The pathogenesis of hidradenitis suppurativa (HS) is yet to be fully understood. However, inflammation is a key element in the development of skin lesions. The aim of this study was to evaluate the expression of monocyte chemotactic protein-1-induced protein-1 (MCPIP1) in the skin of patients suffering from HS. Skin biopsies of 15 patients with HS and 15 healthy controls were obtained and processed for immunohistochemistry, western blot, and real time PCR. The highest mean MCPIP1 mRNA expression was found in the inflammatory lesional skin of HS patients. It was significantly higher than MCPIP1 mRNA expression in the biopsies from both healthy controls and non-lesional skin of HS patients. Western blot analysis indicated that expression of MCPIP1 was elevated within both lesional and non-lesional skin compared to the healthy control. The increased MCPIP1 mRNA and protein expression level in HS lesions may indicate its possible role in the disease pathogenesis.
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Affiliation(s)
- Piotr K. Krajewski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Chalubinskiego 1, 50-368 Wroclaw, Poland; (P.K.K.); (Ł.M.)
| | - Weronika Szukała
- Department of General Biochemistry, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Gronostajowa 7, 30-392 Krakow, Poland; (W.S.); (J.J.)
| | - Agata Lichawska-Cieślar
- Department of General Biochemistry, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Gronostajowa 7, 30-392 Krakow, Poland; (W.S.); (J.J.)
- Correspondence: (A.L.-C.); (J.C.S.)
| | - Łukasz Matusiak
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Chalubinskiego 1, 50-368 Wroclaw, Poland; (P.K.K.); (Ł.M.)
| | - Jolanta Jura
- Department of General Biochemistry, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Gronostajowa 7, 30-392 Krakow, Poland; (W.S.); (J.J.)
| | - Jacek C. Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Chalubinskiego 1, 50-368 Wroclaw, Poland; (P.K.K.); (Ł.M.)
- Correspondence: (A.L.-C.); (J.C.S.)
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5
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Lindsø Andersen P, Kromann C, Fonvig CE, Theut Riis P, Jemec GBE, Holm JC. Hidradenitis suppurativa in a cohort of overweight and obese children and adolescents. Int J Dermatol 2020; 59:47-51. [PMID: 31498890 DOI: 10.1111/ijd.14639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 06/03/2019] [Accepted: 08/08/2019] [Indexed: 01/24/2023]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is a chronic, inflammatory, and recurring disease mainly observed in adults. Obesity is considered an important independent factor in HS development and is associated with a higher prevalence of HS in children. We aimed to characterize the clinical presentation of HS in overweight and obese children and adolescents. METHODS We performed a cross-sectional observational study during January 2007-April 2015. Overweight and obese patients (5-17 years of age, BMI> 90th percentile) referred to The Children's Obesity Clinic, Department of Paediatrics, Copenhagen University Hospital Holbaek, Denmark, underwent screening for dermatological conditions. A dermatologist ascertained the diagnosis of HS, and disease severity was assessed using Hurley staging and Sartorius score. Tobacco smoke exposure, body mass index (BMI) standard deviation score (SDS), and psychiatric comorbidities were recorded. Our cohort was compared with a reference cohort recruited in a previous study. RESULTS A total of 195 children and adolescents underwent screening for dermatological conditions. Nine patients screened positive, and six of these patients were available for examination of whom five presented with HS. All HS cases were mild (median Sartorius score of 9). Four of the five patients (with varying constellations) reported tobacco exposure, a positive family history of HS, and exhibited psychiatric comorbidities. CONCLUSION Our findings support that the presence of pediatric HS is correlated with familial disposition to HS and psychiatric comorbidities.
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Affiliation(s)
- Pernille Lindsø Andersen
- Department of Dermatology, Zealand University Hospital, Roskilde, Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Immunology, Naestved Hospital, Naestved, Denmark
| | - Charles Kromann
- Department of Dermatology, Zealand University Hospital, Roskilde, Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark
| | - Cilius E Fonvig
- The Children's Obesity Clinic, Department of Paediatrics, Copenhagen University Hospital Holbaek, Holbaek, Denmark.,The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Peter Theut Riis
- Department of Dermatology, Zealand University Hospital, Roskilde, Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark
| | - Gregor B E Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark
| | - Jens-Christian Holm
- The Children's Obesity Clinic, Department of Paediatrics, Copenhagen University Hospital Holbaek, Holbaek, Denmark.,The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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6
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Quinlan C, Kirby B, Hughes R. Spironolactone therapy for hidradenitis suppurativa. Clin Exp Dermatol 2019; 45:464-465. [DOI: 10.1111/ced.14119] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2019] [Indexed: 01/02/2023]
Affiliation(s)
- C. Quinlan
- Department of Dermatology St Vincent's University Hospital Dublin Ireland
| | - B. Kirby
- Department of Dermatology St Vincent's University Hospital Dublin Ireland
| | - R. Hughes
- Department of Dermatology St Vincent's University Hospital Dublin Ireland
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7
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Yao Y, Jørgensen AHR, Thomsen SF. Work productivity and activity impairment in patients with hidradenitis suppurativa: a cross-sectional study. Int J Dermatol 2019; 59:333-340. [PMID: 31736064 DOI: 10.1111/ijd.14706] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 10/16/2019] [Accepted: 10/20/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND The understanding of absenteeism, presenteeism, and impairments in daily activities among patients with hidradenitis suppurativa (HS) is limited. We examined the impact of disease-specific factors of HS on work and daily life among a cohort of outpatients in a tertiary hospital setting. METHODS Consecutive patients with HS were clinically evaluated and completed the Work Productivity and Activity Impairment (WPAI) questionnaire modified for HS. RESULTS A total of 100 patients were included. Among 57 (57.0%) patients who were employed, 21.2% reported missing work, and 60.4% reported loss of work productivity during the preceding week as a result of HS. The overall work productivity was reduced by 26.6%. Seventy-two percent reported daily activity impairment, averaging 32.7% reduction in daily activities. Moderate to strong correlations were observed between reduction in quality of life and the WPAI outcomes; presenteeism, overall work impairment, and activity impairment (r = 0.50-0.77). There were moderate correlations between disease severity and the same outcomes (r = 0.35-0.46). The mean rank of activity impairment among patients with Hurley stage I was 34.8, 60.1 for Hurley stage II, and 64.0 for Hurley stage III, P < 0.0001. Unemployed patients had higher activity impairment compared with employed patients (mean rank: 61.0 vs. 42.6, P = 0.001). CONCLUSION There are considerable rates of presenteeism, overall work impairment, and activity impairment in HS patients. Presenteeism, loss of overall work productivity, and activity impairment are positively correlated with greater disease severity and reduction in quality of life.
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Affiliation(s)
- Yiqiu Yao
- Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark
| | | | - Simon Francis Thomsen
- Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
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8
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Schneider-Burrus S, Arpa E, Kors C, Stavermann T, Sabat R, Kokolakis G. [Drug therapy of acne inversa]. Hautarzt 2019; 69:58-63. [PMID: 29234829 DOI: 10.1007/s00105-017-4094-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Acne inversa is a chronic inflammatory destructive skin disease that affects about 1% of the population. The therapy should be personalized and consists of surgical and conservative procedures. Antibiotics are administered either topically or systemically. Combination therapy with clindamycin and rifampicin for 10-12 weeks can be very effective. Furthermore, TNF-α inhibitors show adequate efficacy and can be recommended. Adalimumab is the only approved drug product for systemic treatment of acne inversa. The efficacy of retinoids is controversial. Isotretinoin cannot be recommended for the treatment of acne inversa; however, acitretin has been proven to be more effective. Immune-modulating substances, like dapsone, cyclosporine A, methotrexate, colchicine, or corticosteroids, can be considered; however, the study data are insufficient for recommendation. Hormonal therapies can influence the course of the disease. Antiseptics are applied independent of the stage of disease. Patients should be informed about triggering factors.
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Affiliation(s)
- S Schneider-Burrus
- Zentrum für Dermatochirurgie, Havelklinik, Gatower Str. 191, 13595, Berlin, Deutschland. .,Interdisziplinäre Gruppe Molekulare Immunpathologie, Dermatologie/Med. Immunologie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland.
| | - E Arpa
- Zentrum für Dermatochirurgie, Havelklinik, Gatower Str. 191, 13595, Berlin, Deutschland
| | - C Kors
- Hautzentrum Weißensee, Berlin, Deutschland
| | - T Stavermann
- Hautzentrum Gropiuspassagen, Berlin, Deutschland
| | - R Sabat
- Interdisziplinäre Gruppe Molekulare Immunpathologie, Dermatologie/Med. Immunologie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland.,Psoriasis Forschungs- und BehandlungsCentrum, Klinik für Dermatologie, Venerologie und Allergologie und Institut für Medizinische Immunologie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - G Kokolakis
- Interdisziplinäre Gruppe Molekulare Immunpathologie, Dermatologie/Med. Immunologie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland.,Psoriasis Forschungs- und BehandlungsCentrum, Klinik für Dermatologie, Venerologie und Allergologie und Institut für Medizinische Immunologie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
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9
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Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by recurrent inflammatory nodules mostly located in the armpits and groin. Over the years multiple treatments for HS have been proposed; however, to date a cure is still lacking. In this update we provide an overview of most drug treatments reported on for HS, where possible with their mode of action and side effects. In mild cases, clindamycin lotion or resorcinol cream have proven effective. Tetracyclines are a first-line systemic option in more widespread or severe cases, followed by the combination of clindamycin and rifampicin. However, the recurrence rate is high after discontinuation of clindamycin plus rifampicin combination therapy. Long-term treatment with retinoids, especially acitretin is feasible, although teratogenicity has to be taken into account in females of reproductive age. Multiple anti-inflammatory drugs have been suggested for HS, such as dapsone, fumarates or cyclosporine. However, their effectiveness in HS is based on small case series with varying results. If most common treatments have failed, biologics (e.g., infliximab or adalimumab) are the next step. Although not addressed in this review, surgical interventions are often needed to achieve remission.
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Affiliation(s)
- I E Deckers
- Department of Dermatology, Erasmus University Medical Center, Burg. s' Jacobplein 51, 3015 CA, Rotterdam, The Netherlands.
| | - E P Prens
- Department of Dermatology, Erasmus University Medical Center, Burg. s' Jacobplein 51, 3015 CA, Rotterdam, The Netherlands.
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10
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Prens E, Deckers I. Pathophysiology of hidradenitis suppurativa: An update. J Am Acad Dermatol 2016; 73:S8-11. [PMID: 26470623 DOI: 10.1016/j.jaad.2015.07.045] [Citation(s) in RCA: 139] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Accepted: 07/16/2015] [Indexed: 02/08/2023]
Abstract
The pathogenesis of hidradenitis suppurativa (HS) or acne inversa is not completely understood. Recent research has led to greater insight into the mechanisms involved in the disease. The primary defect in HS pathophysiology rests with the hair follicle. Follicular occlusion, followed by follicular rupture, and a foreign body-type immune response are necessary conditions for the development of clinical HS. A specific genetic signature and environmental factors, such as cigarette smoking, microbial colonization, and adiposity, all contribute to the HS phenotype. Translational research focused on the inflammatory mechanisms involved in HS is needed to develop novel therapeutic options for this debilitating disease.
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Affiliation(s)
- Errol Prens
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands.
| | - Inge Deckers
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands
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Boer J, Nazary M, Riis PT. The Role of Mechanical Stress in Hidradenitis Suppurativa. Dermatol Clin 2016; 34:37-43. [DOI: 10.1016/j.det.2015.08.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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12
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Kromann C, Deckers I, Esmann S, Boer J, Prens E, Jemec G. Risk factors, clinical course and long‐term prognosis in hidradenitis suppurativa: a cross‐sectional study. Br J Dermatol 2014; 171:819-24. [DOI: 10.1111/bjd.13090] [Citation(s) in RCA: 116] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2014] [Indexed: 12/31/2022]
Affiliation(s)
- C.B. Kromann
- Department of Dermatology Health Sciences Faculty Roskilde Hospital University of Copenhagen Copenhagen Denmark
| | - I.E. Deckers
- Department of Dermatology Erasmus MC University Medical Center Rotterdam The Netherlands
| | - S. Esmann
- Department of Dermatology Health Sciences Faculty Roskilde Hospital University of Copenhagen Copenhagen Denmark
| | - J. Boer
- Department of Dermatology Deventer Hospital Deventer The Netherlands
| | - E.P. Prens
- Department of Dermatology Erasmus MC University Medical Center Rotterdam The Netherlands
| | - G.B.E. Jemec
- Department of Dermatology Health Sciences Faculty Roskilde Hospital University of Copenhagen Copenhagen Denmark
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