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Starita-Fajardo G, Lucena-López D, Ballester-Martínez MA, Fernández-Guarino M, González-García A. Treatment Strategies in Neutrophilic Dermatoses: A Comprehensive Review. Int J Mol Sci 2023; 24:15622. [PMID: 37958609 PMCID: PMC10649056 DOI: 10.3390/ijms242115622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023] Open
Abstract
Neutrophilic dermatoses (NDs) are a group of noninfectious disorders characterized by the presence of a sterile neutrophilic infiltrate without vasculitis histopathology. Their physiopathology is not fully understood. The association between neutrophilic dermatoses and autoinflammatory diseases has led some authors to propose that both are part of the same spectrum of diseases. The classification of NDs depends on clinical and histopathological features. This review focuses on the recent developments of treatments in these pathologies.
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Affiliation(s)
- Grisell Starita-Fajardo
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain; (G.S.-F.); (D.L.-L.)
| | - David Lucena-López
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain; (G.S.-F.); (D.L.-L.)
| | | | | | - Andrés González-García
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain; (G.S.-F.); (D.L.-L.)
- Faculty of Medicine and Health Sciences, Universidad de Alcalá (UAH), 28801 Alcalá de Henares, Spain
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López Riquelme I, Fernández Ballesteros MD, Perea Polak A, Serrano Ordoñez A, Martínez Pilar L. Azathioprine in hidradenitis suppurativa with inflammatory phenotype: a case series of 11 patients. Int J Dermatol 2023; 62:1300-1303. [PMID: 37548251 DOI: 10.1111/ijd.16804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 05/30/2023] [Accepted: 07/14/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is a chronic inflammatory disease that negatively impacts the quality of life of patients. It presents as deep-seated nodules, abscesses, fistulae, sinus tracts, and scars in the axilla, inguinal area, submammary folds, and perianal area. Recently, two phenotypes have been described: a follicular phenotype and an inflammatory phenotype. Numerous medical treatments are available for hidradenitis suppurativa, with particular importance of antitumor necrosis factor antibodies. Due to the association of HS with other conditions with a pro-inflammatory state, particularly Crohn's disease, it has been suggested that azathioprine may have a role in the treatment of HS. OBJECTIVE To assess the effectiveness of azathioprine monotherapy in patients with moderate-severe HS. METHODS We retrospectively studied patients with HS treated with azathioprine in monotherapy. We performed both clinical and ultrasound evaluation at baseline as well as in the follow-up visits. Their baseline score on the iHS4 and DLQI scales and 12-16 weeks after starting the treatment were compared. We also registered the number of patients who achieved HiSCR. RESULTS Six patients presented significant improvement, reducing their score in iHS4 and DLQI scales and achieving HiSCR. Another patient had clinical improvement, meaning reduction in iHS4 and DLQI, but without achieving HiSCR. Two patients stopped the treatment before week 12 because of adverse events. The remaining two patients presented no improvement. The median (Q3-Q1) baseline iHS4 score was 6 (12-6), and follow-up iHS4 score, 4 (6-2), being these differences statistically significant (P = 0.006). Median (Q3-Q1) baseline DLQI scores and 12-16 weeks after treatment were 17 (23-11) and 14 (18-9) although statistically nonsignificant (P = 0.099). CONCLUSION We present a case series of 11 patients treated with azathioprine with good clinical and ultrasonographic response. We suggest that azathioprine may benefit a certain patient profile with the inflammatory phenotype.
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Affiliation(s)
- Irene López Riquelme
- Dermatology Department, Hospital Regional Universitario de Málaga, Malaga, Spain
| | | | | | - Ana Serrano Ordoñez
- Dermatology Department, Hospital Regional Universitario de Málaga, Malaga, Spain
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López Sanz P, Guzmán Pérez M, Azaña Defez JM, Guerrero Ramírez C, Manso Córdoba S, Alfaro Martínez ME. Paradoxical hidradenitis suppurativa due to anti-interleukin-1 agents for mevalonate kinase deficiency successfully treated with the addition of ustekinumab. Clin Exp Dermatol 2023; 48:535-536. [PMID: 36763700 DOI: 10.1093/ced/llad003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 01/26/2023] [Indexed: 01/09/2023]
Abstract
Hidradenitis suppurativa (HS) as a paradoxical adverse event (PAE) from using anti-interleukin (IL)-1 has not been reported in the literature, to our knowledge. We herein report a case of paradoxical HS as a result of use of anti-IL-1 agents for mevalonate kinase deficiency disease that was successfully treated with the addition of ustekinumab.
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Affiliation(s)
| | - Marta Guzmán Pérez
- Department of Internal Medicine, University General Hospital of Albacete, Albacete, Spain
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Cordero-Ramos J, Merino-Bohórquez V, Delgado-Valverde M, Barros-Tornay R, Cameán-Fenández M, Calleja-Hernández MÁ. Formulation, long-term physicochemical and microbiological stability of 15% topical resorcinol for hidradenitis suppurativa. Eur J Hosp Pharm 2022; 29:313-318. [PMID: 33328205 PMCID: PMC9614138 DOI: 10.1136/ejhpharm-2020-002534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 11/19/2020] [Accepted: 12/01/2020] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Topical resorcinol 15% is a self-treatment for painful hidradenitis suppurativa nodules and abscesses with good results in reducing pain and lesion duration. The aim of this study is to establish a 15% topical resorcinol formula, to develop a physicochemical and microbiological stability study and to further determine the compounding shelf-life in different package conditions following the European Pharmacopoeia (Ph. Eur.) specifications. METHODS Physicochemical and microbiological stability studies of the formulation were conducted for 12 months at room temperature (25°C±2°C) in different package conditions: aluminium tubes (aluminium A7-99.7% varnish DF-6172), plastic tubes (low density polyethylene) and amber plastic containers (polyethylene terephthalate). High performance liquid chromatography (HPLC) was developed as a method of indicating the stability of the resorcinol formulation. A microbiological growth assay was also validated according to the Ph. Eur. Physical properties were inspected to determine parameters such as odour, colour, pH, emulsion phase and extensibility index and its evolution. RESULTS The HPLC method was validated according to the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines. At day 365, visual inspection remained unchanged only for preparations packaged in aluminium tubes. The pH did not vary by more than 0.3 units in all conditions. The extensibility index decreased in the preparations packaged in plastic and amber plastic containers. HPLC analysis conducted over 1 year did not show a degradation greater than 7% of resorcinol in the preparation in plastic and aluminium packages. The ability of ATCC strains to grow in resorcinol formulation was confirmed under the suitability test. Resorcinol packed in aluminium tubes achieved microbiological stability at day 365. CONCLUSIONS Only the formulation package in aluminium tubes showed physicochemical and microbiological stability of resorcinol for 12 months at room temperature (25°C±2°C).
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Affiliation(s)
- Jaime Cordero-Ramos
- Pharmacy Unit, Hospital Universitario Virgen Macarena, Sevilla, Spain
- Department of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, Universidad de Sevilla, Sevilla, Spain
| | - Vicente Merino-Bohórquez
- Pharmacy Unit, Hospital Universitario Virgen Macarena, Sevilla, Spain
- Department of Pharmacology, Faculty of Pharmacy, Universidad de Sevilla, Sevilla, Spain
| | - Mercedes Delgado-Valverde
- Infectious Diseases, Clinical Microbiology and Preventative Medicine Unit, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen Macarena/CSIC/Universidad de Sevilla, Sevilla, Spain
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Markota Čagalj A, Marinović B, Bukvić Mokos Z. New and Emerging Targeted Therapies for Hidradenitis Suppurativa. Int J Mol Sci 2022; 23:ijms23073753. [PMID: 35409118 PMCID: PMC8998913 DOI: 10.3390/ijms23073753] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/20/2022] [Accepted: 03/25/2022] [Indexed: 12/24/2022] Open
Abstract
Hidradenitis suppurativa (HS) is a chronic, recurrent, inflammatory skin disease deriving from the hair follicles. The formation of inflammatory nodules, abscesses, fistulas, and sinus tracts is characterized by a large inflow of key pro-inflammatory mediators, such as IFN-γ, TNF-α, IL-1, IL-17, and IL-12/23. Adalimumab is currently the only Food and Drug Administration (FDA)- and European Medicines Agency (EMA)-approved biologic therapy for moderate to severe HS in adults and adolescents. However, the long-term effectiveness of this TNF-α inhibitor in HS patients has shown to be highly variable. This review aims to review the evidence for emerging therapies that target the main pro-inflammatory cytokines in HS pathogenesis. A review of the literature was conducted, using the PubMed and Google Scholar repositories, as well as Clinicaltrials.gov. Presently, the most promising biologics in phase III trials are anti-IL-17 antibodies, secukinumab, and bimekizumab. Furthermore, an anti-IL-1 biologic, bermekimab, is currently in phase II trials, and shows encouraging results. Overall, the clinical efficacies of all new targeted therapies published up to this point are limited. More studies need to be performed to clarify the precise molecular pathology, and assess the efficacy of biological therapies for HS.
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Affiliation(s)
- Adela Markota Čagalj
- Department of Dermatology and Venereology, University Hospital Centre Split, Spinčićeva 1, 21000 Split, Croatia;
- School of Medicine, University of Split, Šoltanska 2, 21000 Split, Croatia
| | - Branka Marinović
- School of Medicine, University of Zagreb, Šalata 3, 10000 Zagreb, Croatia;
- Department of Dermatology and Venereology, European Reference Network (ERN), Skin Reference Centre, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
| | - Zrinka Bukvić Mokos
- School of Medicine, University of Zagreb, Šalata 3, 10000 Zagreb, Croatia;
- Department of Dermatology and Venereology, European Reference Network (ERN), Skin Reference Centre, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
- Correspondence: ; Tel.: +385-12368915
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Glatt S, Jemec GBE, Forman S, Sayed C, Schmieder G, Weisman J, Rolleri R, Seegobin S, Baeten D, Ionescu L, Zouboulis CC, Shaw S. Efficacy and Safety of Bimekizumab in Moderate to Severe Hidradenitis Suppurativa: A Phase 2, Double-blind, Placebo-Controlled Randomized Clinical Trial. JAMA Dermatol 2021; 157:1279-1288. [PMID: 34406364 PMCID: PMC8374742 DOI: 10.1001/jamadermatol.2021.2905] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Question What is the efficacy and safety of bimekizumab in individuals with moderate to severe hidradenitis suppurativa (HS)? Findings In this double-blind, placebo-controlled, phase 2 randomized clinical trial including 90 randomized patients with HS (73 completed the trial), bimekizumab demonstrated clinically meaningful and consistent improvements in participants with HS vs placebo across all assessed outcome measures. Serious adverse events occurred in 2 of 46 bimekizumab-treated participants (4%) and 2 of 21 placebo-treated participants (10%). Meaning These initial clinical efficacy and safety data suggest that dual inhibition of interleukin 17A and 17F by bimekizumab may be a viable treatment approach for HS, with the potential to achieve deep responses in clinical outcome measures, and support further evaluation. Importance Hidradenitis suppurativa (HS) is a chronic inflammatory disease with a high burden for patients and limited existing therapeutic options. Objective To evaluate the efficacy and safety of bimekizumab, a monoclonal IgG1 antibody that selectively inhibits interleukin 17A and 17F in individuals with moderate to severe HS. Design, Setting, and Participants This phase 2, double-blind, placebo-controlled randomized clinical trial with an active reference arm was performed from September 22, 2017, to February 21, 2019. The study included a 2- to 4-week screening period, a 12-week treatment period, and a 20-week safety follow-up. Of 167 participants screened at multiple centers, 90 were enrolled. Eligible participants were 18 to 70 years of age with a diagnosis of moderate to severe HS 12 months or more before baseline. Interventions Participants with HS were randomized 2:1:1 to receive bimekizumab (640 mg at week 0, 320 mg every 2 weeks), placebo, or reference arm adalimumab (160 mg at week 0, 80 mg at week 2, and 40 mg every week for weeks 4-10). Main Outcomes and Measures The prespecified primary efficacy variable was the proportion of participants with a 50% or greater reduction from baseline in the total abscess and inflammatory nodule count with no increase in abscess or draining fistula count (Hidradenitis Suppurativa Clinical Response [HiSCR] at week 12. Exploratory variables included proportion achieving a modified HiSCR with 75% reduction of HiSCR criteria (HiSCR75) or a modified HiSCR with 90% reduction of HiSCR criteria (HiSCR90), change in Patient’s Global Assessment of Pain, and Dermatology Life Quality Index total scores. Results Eighty-eight participants received at least 1 dose of study medication (61 [69%] female; median age, 36 years; range, 18-69 years). Seventy-three participants completed the study, including safety follow-up. Bimekizumab demonstrated a higher HiSCR rate vs placebo at week 12 (57.3% vs 26.1%; posterior probability of superiority equaled 0.998, calculated using bayesian analysis). Bimekizumab demonstrated greater clinical improvements compared with placebo. Improvements in the International Hidradenitis Suppurativa Severity Score (IHS4) were seen at week 12 with bimekizumab (mean [SD] IHS4, 16.0 [18.0]) compared with placebo (mean [SD] IHS4, 40.2 [32.6]). More bimekizumab-treated participants achieved positive results on stringent outcome measures compared with placebo. At week 12, 46% of bimekizumab-treated participants achieved HiSCR75 and 32% achieved HiSCR90, whereas 10% of placebo-treated participants achieved HiSCR75 and none achieved HiSCR90; in adalimumab-treated participants, 35% achieved HiSCR75 and 15% achieved HiSCR90. One participant withdrew because of adverse events. Serious adverse events occurred in 2 of 46 bimekizumab-treated participants (4%), 2 of 21 placebo-treated participants (10%), and 1 of 21 adalimumab-treated participants (5%). Conclusions and Relevance In this phase 2 randomized clinical trial, bimekizumab demonstrated clinically meaningful improvements across all outcome measures, including stringent outcomes. Bimekizumab’s safety profile was consistent with studies of other indications, supporting further evaluation in participants with HS. Trial Registration ClinicalTrials.gov Identifier: NCT03248531
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Affiliation(s)
| | - Gregor B E Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde.,Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark
| | | | - Christopher Sayed
- Department of Dermatology, University of North Carolina School of Medicine, Chapel Hill
| | | | - Jamie Weisman
- Medical Dermatology Specialists Inc, Atlanta, Georgia
| | | | | | | | | | - Christos C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane, Dessau, Germany
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Prens LM, Porter ML, Savage KT, Salian P, Horváth B, Kimball AB. Hidradenitis suppurativa disease course during pregnancy and postpartum: a retrospective survey study. Br J Dermatol 2021; 185:1072-1074. [PMID: 33760224 DOI: 10.1111/bjd.20078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 02/02/2021] [Accepted: 03/16/2021] [Indexed: 02/07/2023]
Affiliation(s)
- L M Prens
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - M L Porter
- Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215, USA.,Harvard Medical School, Boston, MA, 02215, USA
| | - K T Savage
- Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215, USA
| | - P Salian
- Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215, USA
| | - B Horváth
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - A B Kimball
- Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215, USA.,Harvard Medical School, Boston, MA, 02215, USA
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8
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Nguyen T, Damiani G, Orenstein L, Hamzavi I, Jemec G. Hidradenitis suppurativa: an update on epidemiology, phenotypes, diagnosis, pathogenesis, comorbidities and quality of life. J Eur Acad Dermatol Venereol 2020; 35:50-61. [DOI: 10.1111/jdv.16677] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 04/03/2020] [Indexed: 12/11/2022]
Affiliation(s)
- T.V. Nguyen
- Bellevue Dermatology Clinic & Clinical Research Center Bellevue WA USA
| | - G. Damiani
- Department of Dermatology Emory University School of Medicine Atlanta GA USA
| | - L.A.V. Orenstein
- Dipartimento di Fisiopatologia Medico‐Chirurgica e dei Trapianti Università degli Studi di Milano Unità Operativa di Dermatologia IRCCS Fondazione Ca' GrandaOspedale Maggiore Policlinico Milano Italy
| | - I. Hamzavi
- Department of Dermatology Henry Ford Hospital Detroit MI USA
| | - G.B. Jemec
- Department of Dermatology Zealand University Hospital Roskilde Denmark
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Fletcher JM, Moran B, Petrasca A, Smith CM. IL-17 in inflammatory skin diseases psoriasis and hidradenitis suppurativa. Clin Exp Immunol 2020; 201:121-134. [PMID: 32379344 DOI: 10.1111/cei.13449] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 04/29/2020] [Accepted: 04/29/2020] [Indexed: 12/14/2022] Open
Abstract
The skin is one of the most important organs in the body, providing integrity and acting as a barrier to exclude microbes, allergens and chemicals. However, chronic skin inflammation can result when barrier function is defective and immune responses are dysregulated or misdirected against harmless or self-antigens. During the last 15 years interleukin (IL)-17 cytokines have emerged as key players in multiple inflammatory disorders, and they appear to be especially prominent in skin inflammation. IL-17 cytokines produced by T cells and other cell types potently activate keratinocytes to promote inflammation in a feed-forward loop. Given this key pathogenic role of the IL-17 pathway in autoimmune and inflammatory disease, it has been the focus of intense efforts to target therapeutically. The inflammatory effects of IL-17 can be targeted directly by blocking the cytokine or its receptor, or indirectly by blocking cytokines upstream of IL-17-producing cells. Psoriasis has been the major success story for anti-IL-17 drugs, where they have proven more effective than in other indications. Hidradenitis suppurativa (HS) is another inflammatory skin disease which, despite carrying a higher burden than psoriasis, is poorly recognized and under-diagnosed, and current treatment options are inadequate. Recently, a key role for the IL-17 pathway in the pathogenesis of HS has emerged, prompting clinical trials with a variety of IL-17 inhibitors. In this review, we discuss the roles of IL-17A, IL-17F and IL-17C in psoriasis and HS and the strategies taken to target the IL-17 pathway therapeutically.
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Affiliation(s)
- J M Fletcher
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland.,School of Medicine, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - B Moran
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - A Petrasca
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - C M Smith
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
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Systematic Review of Light-Based Treatments for Hidradenitis Suppurativa. ACTAS DERMO-SIFILIOGRAFICAS 2020. [DOI: 10.1016/j.adengl.2019.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Gracia Cazaña T, Berdel Díaz L, Martín Sánchez J, Querol Nasarre I, Gilaberte Y. Revisión sistemática de las terapias con luz en el tratamiento de la hidradenitis supurativa. ACTAS DERMO-SIFILIOGRAFICAS 2020; 111:89-106. [DOI: 10.1016/j.ad.2019.04.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 04/19/2019] [Accepted: 04/22/2019] [Indexed: 02/06/2023] Open
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Hayran Y, Allı N, Yücel Ç, Akdoğan N, Turhan T. Serum IL-36α, IL-36β, and IL-36γ levels in patients with hidradenitis suppurativa: association with disease characteristics, smoking, obesity, and metabolic syndrome. Arch Dermatol Res 2019; 312:187-196. [DOI: 10.1007/s00403-019-02012-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 10/21/2019] [Accepted: 11/05/2019] [Indexed: 12/14/2022]
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Lacarrubba F, Dini V, Napolitano M, Venturini M, Caposiena Caro D, Molinelli E, Passoni E, Monfrecola G, Argenziano G, Berti E, Bianchi L, Calzavara Pinton P, Cannavò SP, Costanzo A, Donini M, Fabbrocini G, Fierro MT, Micali G, Offidani A, Parodi A, Patrizi A, Pellacani G, Peris K, Pimpinelli N, Potenza C, Romanelli M, Rongioletti F, Solivetti F. Ultrasonography in the pathway to an optimal standard of care of hidradenitis suppurativa: the Italian Ultrasound Working Group experience. J Eur Acad Dermatol Venereol 2019; 33 Suppl 6:10-14. [DOI: 10.1111/jdv.15847] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 07/24/2019] [Indexed: 02/07/2023]
Affiliation(s)
- F. Lacarrubba
- Dermatology Clinic University of Catania Catania Italy
| | - V. Dini
- Department of Dermatology University of Pisa Pisa Italy
| | - M. Napolitano
- Department of Medicine and Health Sciences Vincenzo Tiberio University of Molise Campobasso Italy
| | - M. Venturini
- Department of Dermatology University of Brescia Brescia Italy
| | | | - E. Molinelli
- Dermatology Unit Polytechnic Marche University Ancona Italy
| | - E. Passoni
- Dermatology Unit Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milan Italy
| | - G. Monfrecola
- Section of Dermatology University of Naples Federico II Naples Italy
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Marrón S, Gómez-Barrera M, Tomás-Aragonés L, Díaz Díaz R, Vilarrasa Rull E, Madrid Álvarez M, Puig L. Development and Preliminary Validation of the HSQoL-24 Tool to Assess Quality of Life in Patients With Hidradenitis Suppurativa. ACTAS DERMO-SIFILIOGRAFICAS 2019. [DOI: 10.1016/j.adengl.2019.07.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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15
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Marrón SE, Gómez-Barrera M, Tomás-Aragonés L, Díaz Díaz RM, Vilarrasa Rull E, Madrid Álvarez MB, Puig L. Development and Preliminary Validation of the HSQoL-24 Tool to Assess Quality of Life in Patients With Hidradenitis Suppurativa. ACTAS DERMO-SIFILIOGRAFICAS 2019; 110:554-560. [PMID: 31023484 DOI: 10.1016/j.ad.2019.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 02/03/2019] [Accepted: 02/07/2019] [Indexed: 10/27/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the skin with a negative impact on quality of life. Up to now, there are no disease specific instruments in Spanish to assess quality of life in HS. The objective of this study was to develop and validate a questionnaire to evaluate the quality of life in patients with HS. MATERIAL AND METHODS A multicentre study was carried out in Spain between 2016 and 2017 to develop the questionnaire. Both the conceptual framework and understanding of the patient's situation were considered through a review of the literature, consensus of professionals from different related health areas, and in-depth interviews with patients. The resulting questionnaire was passed to a group of 30 patients with 30±10 days of interval between both assessments. RESULTS The reliability analysis shows a good internal consistency and reproducibility with Cronbach's alpha score of 0.920 (test) and 0.917 (retest) and intraclass correlation coefficient with DLQI and Skindex-29 of 0.698 IC 95% (0.456-0.844) and 0.900 IC 95% (0.801-0.951) respectively. Cut-off points were established for its use and the instrument was found to be sensitive to change. CONCLUSIONS The HSQoL-24 is the first disease-specific self-administered instrument to assess quality of life in patients with HS in Spanish. It is user friendly, and easy to score. This study shows that the instrument is reliable, valid and sensitive to change, pending confirmatory study with a larger sample of 100 patients with HS.
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Affiliation(s)
- S E Marrón
- Servicio de Dermatología, Hospital Royo Villanova, Zaragoza, España; Grupo Aragonés de Investigación en Psicodermatología (GAI+PD), Zaragoza, España; Grupo Español de Investigación en Dermatología y Psiquiatría (GEDEPSI) de la Academia Española de Dermatología y Venereología (AEDV), Madrid, España.
| | - M Gómez-Barrera
- Universidad San Jorge, Villanueva de Gallego, Zaragoza, España; Pharmacoeconomics & Outcomes Research Iberia, Pozuelo de Alarcón, Madrid, España
| | - L Tomás-Aragonés
- Departamento de Psicología, Universidad de Zaragoza, Zaragoza, España; Grupo Aragonés de Investigación en Psicodermatología (GAI+PD), Zaragoza, España; Grupo Español de Investigación en Dermatología y Psiquiatría (GEDEPSI) de la Academia Española de Dermatología y Venereología (AEDV), Madrid, España
| | - R M Díaz Díaz
- Servicio de Dermatología, Hospital Infanta Sofía, San Sebastián de los Reyes, Madrid, España; Grupo Español de Investigación en Dermatología y Psiquiatría (GEDEPSI) de la Academia Española de Dermatología y Venereología (AEDV), Madrid, España
| | - E Vilarrasa Rull
- Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - M B Madrid Álvarez
- Servicio de Dermatología, Hospital Dr. Negrín, Las Palmas de Gran Canaria, España; Grupo Español de Investigación en Dermatología y Psiquiatría (GEDEPSI) de la Academia Española de Dermatología y Venereología (AEDV), Madrid, España
| | - L Puig
- Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
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16
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García-Martínez FJ, Vilarrasa Rull E, Salgado-Boquete L, Martorell A, Pascual JC, Hernández-Martín Á, Silvente C, Ciudad-Blanco C, Andrés Esteban E, Alfageme-Roldán F. Intralesional corticosteroid injection for the treatment of hidradenitis suppurativa: a multicenter retrospective clinical study. J DERMATOL TREAT 2019; 32:286-290. [DOI: 10.1080/09546634.2019.1655524] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Francisco Javier García-Martínez
- Dermatology Department, Clínica Universidad de Navarra, Madrid, Spain
- Hidradenitis Suppurativa and Cutaneous Ultrasound Unit, Hospital Universitario del Sureste, Madrid, Spain
| | - Eva Vilarrasa Rull
- Dermatology Department, Hospital Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain
| | | | | | | | | | | | | | - Eva Andrés Esteban
- Preventive Medicine Department, Universidad Jaume I de Castellón, Castellón, Spain
| | - F. Alfageme-Roldán
- Dermatology Department, Hospital Universitario Puerta de Hierro, Madrid, Spain
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17
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Association Between Hidradenitis Suppurativa and Metabolic Syndrome: A Systematic Review and Meta-analysis. ACTAS DERMO-SIFILIOGRAFICAS 2019. [DOI: 10.1016/j.adengl.2019.03.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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18
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Zimman S, Comparatore M, Vulcano A, Absi M, Mazzuoccolo L. Hidradenitis Suppurativa: Estimated Prevalence, Clinical Features, Concomitant Conditions, and Diagnostic Delay in a University Teaching Hospital in Buenos Aires, Argentina. ACTAS DERMO-SIFILIOGRAFICAS 2019. [DOI: 10.1016/j.adengl.2019.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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19
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Magalhães RF, Rivitti-Machado MC, Duarte GV, Souto R, Nunes DH, Chaves M, Hirata SH, Ramos AMC. Consensus on the treatment of hidradenitis suppurativa - Brazilian Society of Dermatology. An Bras Dermatol 2019; 94:7-19. [PMID: 31166401 PMCID: PMC6544037 DOI: 10.1590/abd1806-4841.20198607] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Accepted: 09/13/2018] [Indexed: 12/27/2022] Open
Abstract
Hidradenitis suppurativa is a chronic immune mediated disease of universal distribution that causes great damage to the quality of life of the affected individual, whose prevalence is estimated at 0.41% in the Brazilian population. The objective of this work was update on physiopathogenesis, diagnosis and classification of hidradenitis suppurativa and to establish therapeutic recommendations in the Brazilian reality. It was organized as a work group composed of eight dermatologists from several institutions of the country with experience in the treatment of hidradenitis suppurativa and carried out review on the topic. Recommendations were elaborated and voted by modified Delphi system and statistical analysis of the results was performed. The Brazilian consensus on the clinical approach of hidradenitis suppurativa had the support of the Brazilian Society of Dermatology.
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Affiliation(s)
- Renata Ferreira Magalhães
- Discipline of Dermatology, Department of Internal Medicine,
Universidade Estadual de Campinas, Campinas (SP), Brazil
| | | | | | - Roberto Souto
- Dermatology Service, Hospital Universitário Pedro Ernesto,
Universidade do Estado do Rio de Janeiro, Rio de Janeiro (RJ), Brazil
| | - Daniel Holthausen Nunes
- Dermatology Service, Hospital Universitário, Universidade
Federal de Santa Catarina, Florianópolis (SC), Brazil
| | - Mario Chaves
- Dermatology Service, Hospital Universitário Pedro Ernesto,
Universidade do Estado do Rio de Janeiro, Rio de Janeiro (RJ), Brazil
| | | | - Andrea Machado Coelho Ramos
- Dermatology Service, Hospital de Clínicas, Universidade
Federal de Minas Gerais, Belo Horizonte (MG), Brazil
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20
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Zimman S, Comparatore MV, Vulcano AF, Absi ML, Mazzuoccolo LD. Hidradenitis Suppurativa: Estimated Prevalence, Clinical Features, Concomitant Conditions, and Diagnostic Delay in a University Teaching Hospital in Buenos Aires, Argentina. ACTAS DERMO-SIFILIOGRAFICAS 2019; 110:297-302. [PMID: 30885385 DOI: 10.1016/j.ad.2019.01.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 01/11/2019] [Accepted: 01/22/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Hidradenitis suppurativa is a chronic recurrent systemic inflammatory disease that mainly involves large skin folds. It develops when pilosebaceous units become blocked, leading to the formation of painful nodules, abscesses, fistulas, and scarring. The impact of this disease on quality of life is great. OBJECTIVES To describe the prevalence and clinical features of hidradenitis suppurativa in patients treated at Hospital Italiano de Buenos Aires and determine the frequency of comorbidities and time to diagnosis in this population. MATERIAL AND METHODS Retrospective descriptive cross-sectional study. Information was extracted from the computerized clinical records of all patients with a diagnosis of hidradenitis suppurativa managed in Hospital Italiano de Buenos Aires between July 2012 and October 2017. RESULTS Our initial search of the records yielded 180 cases; the diagnosis was confirmed in 66 cases. Sixty-five percent of the patients were women, and the mean age was 37 years. The prevalence of this diagnosis was 0.02%. The armpits, vulva, and groin were the locations most frequently affected. Smoking, overweight, and obesity were the most commonly recorded concomitant conditions. Male sex and perianal and gluteal locations were associated with severity. Time until diagnosis varied widely, ranging from diagnosis at the first visit in some cases to as long as 142 months and 21 visits. CONCLUSIONS Our findings are consistent with the literature on hidradenitis suppurativa. This is the first Argentinian study to describe the prevalence of this disease as well as the concomitant conditions found and the rate of diagnostic error.
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Affiliation(s)
- S Zimman
- Servicio de Dermatología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
| | - M V Comparatore
- Servicio de Dermatología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - A F Vulcano
- Servicio de Dermatología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - M L Absi
- Servicio de Ginecología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - L D Mazzuoccolo
- Servicio de Dermatología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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21
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Association Between Hidradenitis Suppurativa and Metabolic Syndrome: A Systematic Review and Meta-analysis. ACTAS DERMO-SIFILIOGRAFICAS 2019; 110:279-288. [PMID: 30846164 DOI: 10.1016/j.ad.2018.10.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 09/05/2018] [Accepted: 10/21/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Recent studies have shown a relationship between hidradenitis suppurativa (HS) and metabolic syndrome (MS), but the literature offers no meta-analysis restricted to studies that have been adjusted for confounders. OBJECTIVE To determine the association between HS and MS. METHODS A systematic review and meta-analysis of observational studies on HS and MS in adults. We searched MEDLINE, SCOPUS, SCIELO, Google Scholar, Science Direct, and LILACS from the inception of the databases to January 2016. We performed a random effects model meta-analysis for studies reporting adjusted and crude odds ratios (ORs) with 95% CIs. A subgroup analysis was related to the type of HS patient (general patients vs hospital patients) and age group (adults vs children and adults). RESULTS Five studies including 3950 HS patients were analyzed. We found that MS was pres-ent in 9.64% of HS patients (OR, 1.82; 95%, CI 1.39-2.25). Studies from tertiary care hospital dermatology clinics (OR, 2.82; 95% CI, 0.58-5.06) reported a greater risk for MS than studies carried out in patients treated outside hospitals (OR, 1.78; 95% CI, 1.34-2.22). Studies that included pediatric populations reported a significant association (OR, 2.10; 95% CI, 1.58-2.62). LIMITATION Few of the included studies reported adjusted ORs. CONCLUSIONS HS patients have an increased risk for MS. Clinicians should consider screening HS patients for metabolic risk factors.
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22
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Repercusión diagnóstica y terapéutica del estudio ecográfico en los trayectos fistulosos perianales en pacientes con sospecha de hidradenitis supurativa. ACTAS DERMO-SIFILIOGRAFICAS 2018; 109:845-847. [DOI: 10.1016/j.ad.2017.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 09/18/2017] [Accepted: 10/02/2017] [Indexed: 11/20/2022] Open
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23
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Gómez-Zubiaur A, Alfageme F, Martínez-Lorenzo E, Roustán G. Diagnostic and Therapeutic Implications of Ultrasound Imaging of Perianal Fistulous Tracts in Patients with Suspected Hidradenitis Suppurativa. ACTAS DERMO-SIFILIOGRAFICAS 2018. [DOI: 10.1016/j.adengl.2018.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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24
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Maarouf M, Platto JF, Shi VY. The role of nutrition in inflammatory pilosebaceous disorders: Implication of the skin-gut axis. Australas J Dermatol 2018; 60:e90-e98. [PMID: 30175843 DOI: 10.1111/ajd.12909] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 07/24/2018] [Indexed: 12/11/2022]
Abstract
Nutrition plays a critical role in the manifestation and management of inflammatory pilosebaceous disorders. There is rich potential for insight into the impact of dietary effects on the pathophysiology of inflammatory pilosebaceous disorders including acne vulgaris, hidradenitis suppurativa, rosacea, and the closely related seborrhoeic dermatitis. Acne vulgaris and hidradenitis suppurativa are thought to have similar diet-modulating pathogenic pathways. Western diet influences Acne vulgaris and hidradenitis suppurativa by increasing insulin and modulating FOX01/mTOR, resulting in over-expression of cytokeratins, hyperproliferation of keratinocytes, and hypercornification of the follicular wall. Key receptors in rosacea are alternatively activated by UV radiation, hot beverages, spicy foods, vanilla, cinnamon, caffeine, alcohol, cold temperatures, and niacin- and formalin-containing foods, to increase oedema and flushing, resulting in erythema, telangiectasia, and warmth, characteristic features of the condition. Seborrhoeic dermatitis, while not a follicular disorder, is closely related, and can be modulated by dietary influences, such as biotin and probiotics. This overview summarizes the role that nutrition plays on these disorders, and identifies dietary modifications as potential adjunctive therapies.
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Affiliation(s)
- Melody Maarouf
- College of Medicine, University of Arizona, Tucson, Arizona, USA
| | - Jody F Platto
- College of Medicine, University of Arizona, Tucson, Arizona, USA
| | - Vivian Y Shi
- Dermatology Division, Department of Medicine, University of Arizona, Tucson, Arizona, USA
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25
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Chiricozzi A, Bettoli V, De Pità O, Dini V, Fabbrocini G, Monfrecola G, Musumeci ML, Parodi A, Sampogna F, Pennella A, Buzzulini F, Gualberti G, di Luzio Paparatti U, Atzori L. HIDRAdisk: an innovative visual tool to assess the burden of hidradenitis suppurativa. J Eur Acad Dermatol Venereol 2018; 33:e24-e26. [PMID: 29894009 PMCID: PMC7027443 DOI: 10.1111/jdv.15122] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- A Chiricozzi
- Dipartimento di Dermatologia, Università di Pisa, Pisa, Italy
| | - V Bettoli
- Dipartimento di Medicina Clinica e Sperimentale, U.O. di Dermatologia, Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy
| | - O De Pità
- Struttura Complessa di Patologia Clinica, Ospedale Cristo Re, Rome, Italy
| | - V Dini
- U.O. di Dermatologia Universitaria, Ospedale Santa Chiara, Pisa, Italy
| | - G Fabbrocini
- Dipartimento di Medicina Clinica e Chirurgia, Università di Napoli "Federico II", Naples, Italy
| | - G Monfrecola
- Dipartimento di Medicina Clinica e Chirurgia, Università di Napoli "Federico II", Naples, Italy
| | - M L Musumeci
- Clinica Dermatologica, P.O. "G. Rodolico", A.O.U. Policlinico-Vittorio Emanuele, Università di Catania, Catania, Italy
| | - A Parodi
- DiSSal, Sezione Dermatologia, Ospedale-Policlinico San Martino, Università di Genova, Genoa, Italy
| | - F Sampogna
- Unità di Epidemiologia, IRCCS FLMM, Istituto Dermopatico dell'Immacolata (IDI), Rome, Italy
| | - A Pennella
- Scuola di Specializzazione in Psicologia della Salute, Università degli Studi di Roma"Sapienza", Rome, Italy
| | | | | | | | - L Atzori
- Clinica Dermatologica, Dipartmento di Scienze Mediche e Sanità Pubblica, Università di Cagliari, Cagliari, Italy
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26
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Segura Palacios J, García Montero P, Fúnez Liébana R, Repiso Jiménez J. Human Papilloma Virus and the Risk of Squamous Cell Carcinoma Arising in Hidradenitis Suppurativa. ACTAS DERMO-SIFILIOGRAFICAS 2018. [DOI: 10.1016/j.adengl.2018.04.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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27
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Abstract
Individuals with cutaneous diseases of the external genitalia often initially present to their primary care provider. When present, these conditions may be associated with considerable physical symptoms and psychological distress. Dermatoses affecting the genitals may be of infectious, inflammatory, or neoplastic cause, and can be processes confined to the genitalia or a manifestation of a more widespread dermatologic condition. This article provides a guide to recognizing and managing common genital dermatoses and when to refer for specialist opinion.
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Affiliation(s)
- Emily Yura
- Department of Urology, Northwestern University, Tarry Building Room 16-703, 300 East Superior Street, Chicago, IL 60611, USA
| | - Sarah Flury
- Department of Urology, Northwestern University, Tarry Building Room 16-703, 300 East Superior Street, Chicago, IL 60611, USA.
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28
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Lu L, Lai H, Pan Z, Hu T, Hou X, Cao K, Ju Q. Clinical and histopathological characteristics in patients with scarring folliculitis type of acne inversa. DERMATO-ENDOCRINOLOGY 2018; 9:e1361575. [PMID: 29484097 PMCID: PMC5821155 DOI: 10.1080/19381980.2017.1361575] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 07/26/2017] [Indexed: 11/05/2022]
Abstract
Objective: This study was designed to study the clinical and histopathological characteristics of patients with the scarring folliculitis type acne inversa in Chinese population. Methods: A total of 21 patients with acne inversa and 6 controls without known dermatological disease were recruited from outpatient department of dermatology and orthopedic surgery. Two-millimeter punch biopsies were taken from 8 patients with acne inversa and 6 controls, fixed in formalin, embedded in paraffin and stained with haematoxylin and eosin prior to histopathological analysis. Results: There were 12 patients (57.14%) belonging to the scarring folliculitis type presented with double comedones, papules, nodules, depressed scars, and were mainly Hurley stage I (66.67%). Many of the scarring folliculitis type were smokers (58.33%), some had a history of occupational exposure (41.67%) and some were overweight (50%), the mean BMI of which is 25.18±3.16 kg/m2. Histopathological changes such as perifollicular inflammation can be observed in scarring folliculitis type of acne inversa and controls as well. However, epidermal hyperplasia, follicular hyperplasia, sebaceous gland disappearance, destruction of hair follicle and sebaceous gland, collagen hyperplasia, perivascular inflammation, granulomatous inflammation, Micro thrombus were only seen in scarring folliculitis type. The mean surface area in patients (8073.36±15798.43 μm2) was smaller than that in controls (302059.08±502813.78 μm2), with statistically significant difference. (P = 0.024). Conclusion: The scarring folliculitis type in acne inversa in Chinese population could be characterized by depressed scars, double-ended comedones, epidermal cysts and had high proportion of smokers, or occupational exposure with lower Hurley stage, as well as diminished sebaceous gland. Further studies are needed to clarify the relations between the clinical subtypes of acne inversa and their corresponding genetypes.
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Affiliation(s)
- Lingyi Lu
- Department of Dermatology, Ningbo First Hospital, Ningbo, Zhejiang, PR China.,Department of Dermatology, RenJi Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China
| | - Huiying Lai
- Department of Dermatology, RenJi Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China
| | - Zhanyan Pan
- Department of Dermatology, RenJi Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China
| | - Tingting Hu
- Department of Dermatology, RenJi Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China
| | - Xiaoxiao Hou
- Department of Dermatology, RenJi Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China
| | - Ke Cao
- Department of Dermatology, RenJi Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China
| | - Qiang Ju
- Department of Dermatology, RenJi Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China
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29
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Segura Palacios JM, García Montero P, Fúnez Liébana R, Repiso Jiménez JB. Human Papilloma Virus and the Risk of Squamous Cell Carcinoma Arising in Hidradenitis Suppurativa. ACTAS DERMO-SIFILIOGRAFICAS 2017; 109:457-459. [PMID: 29169556 DOI: 10.1016/j.ad.2017.06.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 06/20/2017] [Accepted: 06/25/2017] [Indexed: 10/18/2022] Open
Affiliation(s)
| | - P García Montero
- Servicio de Dermatología, Hospital Costa del Sol, Marbella, Málaga, España
| | - R Fúnez Liébana
- Servicio de Anatomía Patológica, Hospital Costa del Sol, Marbella, Málaga, España
| | - J B Repiso Jiménez
- Servicio de Dermatología, Hospital Costa del Sol, Marbella, Málaga, España
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30
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García-Martínez F, López-Martín I, Pascual J. Respuesta de los autores. Semergen 2017; 43:596-597. [DOI: 10.1016/j.semerg.2017.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 03/20/2017] [Indexed: 11/28/2022]
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31
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The Clinical Significance of Increased Serum Proinflammatory Cytokines, C-Reactive Protein, and Erythrocyte Sedimentation Rate in Patients with Hidradenitis Suppurativa. Mediators Inflamm 2017; 2017:2450401. [PMID: 28769536 PMCID: PMC5523401 DOI: 10.1155/2017/2450401] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 05/22/2017] [Accepted: 06/13/2017] [Indexed: 01/20/2023] Open
Abstract
Objectives To assess inflammatory serum markers including serum proinflammatory cytokines, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) according to the clinical inflammatory activity of patients with hidradenitis suppurativa (HS). Patients and Methods Seventy-four patients with HS were studied based on the Hidradenitis Suppurativa-Physician Global Assessment (HS-PGA) score and Hurley staging system. Proinflammatory cytokines were measured using a multiplex cytokine assay. Twenty-two healthy volunteers were recruited. Results Serum interleukin- (IL-) 6, IL-23, soluble tumour necrosis factor alpha (TNF-α) receptor I (sTNF-RI), CRP, and ESR were different in the patients with HS compared with those in the healthy controls (P < 0.05). The levels of IL-1β, IL-6, IL-8, IL-10, IL-12p70, IL-17A, sTNF-RII, CRP, and ESR were significantly elevated according to inflammatory activity based on HS-PGA scores (r > 0.25, P < 0.05). The levels of IL-6 (r = 0.53, P < 0.001), CRP (r = 0.54, P < 0.001), and ESR (r = 0.60, P < 0.001) were especially well correlated with clinical inflammatory activity based on HS-PGA scores. The levels of IL-6, IL-8, sTNF-RI, sTNF-RII, CRP, and ESR were significantly elevated according to Hurley staging system. Conclusions Serum proinflammatory cytokines, CRP, and ESR are increased in relation to the clinical inflammatory activity of patients with HS compared with healthy controls. Serum IL-6, CRP, and ESR are effective biomarkers for evaluating the severity of HS.
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32
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Moran B, Sweeney CM, Hughes R, Malara A, Kirthi S, Tobin AM, Kirby B, Fletcher JM. Hidradenitis Suppurativa Is Characterized by Dysregulation of the Th17:Treg Cell Axis, Which Is Corrected by Anti-TNF Therapy. J Invest Dermatol 2017; 137:2389-2395. [PMID: 28652108 DOI: 10.1016/j.jid.2017.05.033] [Citation(s) in RCA: 132] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 05/30/2017] [Accepted: 05/31/2017] [Indexed: 01/05/2023]
Abstract
Hidradenitis suppurativa (HS) is a chronic, inflammatory, and debilitating disease of hair follicles with 1-4% prevalence and high morbidity. There is a dearth of information on the pathogenesis and immune dysregulation underlying HS; therefore, we carried out a detailed analysis of skin-infiltrating T cells. Cells isolated from skin biopsy samples and blood from HS patients and healthy control subjects were analyzed by 16-parameter flow cytometry to provide detailed profiles of CD4 T-cell subsets. We observed substantial infiltration of inflammatory T cells with a striking T helper (Th) type 17-skewed cytokine profile in HS skin; these cells expressed the Th17 lineage marker CD161 and IL-17, as well as proinflammatory cytokines GM-CSF, IL-22, IFN-γ, and tumor necrosis factor. Regulatory T cells were also enriched in HS lesional skin; however, the ratio of Th17 to regulatory T cells was nonetheless highly dysregulated in favor of Th17 cells. In contrast, lesional skin from anti-tumor necrosis factor-treated HS patients who showed substantial clinical improvement exhibited a significant reduction in the frequency of Th17 cells and normalization of the Th17 to regulatory T cell ratio. These data suggest that inhibition of pathogenic IL-17 via tumor necrosis factor blockade is associated with improvement in immune dysregulation in HS and may provide a rationale for targeting IL-17 in the disease.
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Affiliation(s)
- Barry Moran
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Ireland
| | - Cheryl M Sweeney
- Dermatology Research, Education and Research Centre, St. Vincent's University Hospital, Dublin 4, Ireland
| | - Rosalind Hughes
- Department of Dermatology, St. Vincent's University Hospital, Dublin 4, Ireland
| | - Anna Malara
- Department of Dermatology, St. Vincent's University Hospital, Dublin 4, Ireland
| | | | - Anne-Marie Tobin
- Department of Dermatology, Tallaght Hospital, Dublin 24, Ireland
| | - Brian Kirby
- Department of Dermatology, St. Vincent's University Hospital, Dublin 4, Ireland
| | - Jean M Fletcher
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Ireland; School of Medicine, Trinity Biomedical Sciences Institute, Trinity College Dublin, Ireland.
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33
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Reconstruction after Excision of Hidradenitis Suppurativa: Are Skin Grafts Better than Flaps? PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2017; 5:e1280. [PMID: 28507851 PMCID: PMC5426870 DOI: 10.1097/gox.0000000000001280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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34
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Niroula A, Vihinen M. Predicting Severity of Disease-Causing Variants. Hum Mutat 2017; 38:357-364. [PMID: 28070986 DOI: 10.1002/humu.23173] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 12/07/2016] [Accepted: 01/06/2017] [Indexed: 12/22/2022]
Abstract
Most diseases, including those of genetic origin, express a continuum of severity. Clinical interventions for numerous diseases are based on the severity of the phenotype. Predicting severity due to genetic variants could facilitate diagnosis and choice of therapy. Although computational predictions have been used as evidence for classifying the disease relevance of genetic variants, special tools for predicting disease severity in large scale are missing. Here, we manually curated a dataset containing variants leading to severe and less severe phenotypes and studied the abilities of variation impact predictors to distinguish between them. We found that these tools cannot separate the two groups of variants. Then, we developed a novel machine-learning-based method, PON-PS (http://structure.bmc.lu.se/PON-PS), for the classification of amino acid substitutions associated with benign, severe, and less severe phenotypes. We tested the method using an independent test dataset and variants in four additional proteins. For distinguishing severe and nonsevere variants, PON-PS showed an accuracy of 61% in the test dataset, which is higher than for existing tolerance prediction methods. PON-PS is the first generic tool developed for this task. The tool can be used together with other evidence for improving diagnosis and prognosis and for prioritization of preventive interventions, clinical monitoring, and molecular tests.
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Affiliation(s)
- Abhishek Niroula
- Department of Experimental Medical Science, Lund University, Lund, SE-22184, Sweden
| | - Mauno Vihinen
- Department of Experimental Medical Science, Lund University, Lund, SE-22184, Sweden
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García-Martínez F, Pascual J, López-Martín I, Pereyra-Rodríguez J, Martorell Calatayud A, Salgado-Boquete L, Labandeira-García J. Actualización en hidrosadenitis supurativa en Atención Primaria. Semergen 2017; 43:34-42. [DOI: 10.1016/j.semerg.2015.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 10/30/2015] [Accepted: 12/14/2015] [Indexed: 12/22/2022]
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Vihinen M. How to Define Pathogenicity, Health, and Disease? Hum Mutat 2016; 38:129-136. [PMID: 27862583 DOI: 10.1002/humu.23144] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 10/13/2016] [Accepted: 11/03/2016] [Indexed: 11/07/2022]
Abstract
Scientific and clinical communities produce ever increasing amounts of data and details about health and disease. Our ability to understand and utilize this information is limited because of imprecise language and lack of well-defined concepts. This problem involves also the principal concepts of health, disease, and pathogenicity. Here, a systematic model is presented for pathogenicity, as well as for health and disease. It has three components: extent, modulation, and severity, which jointly define the continuum of pathogenicity. The model is population based, and once implemented, it can be used for numerous purposes such as diagnosis, patient stratification, prognosis, finding phenotype-genotype correlations, or explaining adverse drug reactions. The new model has several benefits including health economy by allowing evidence-based personalized/precision medicine.
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Affiliation(s)
- Mauno Vihinen
- Department of Experimental Medical Science, Lund University, BMC B13, Lund, SE-22184, Sweden
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Fotiadou C, Vakirlis E, Ioannides D. Spotlight on adalimumab in the treatment of active moderate-to-severe hidradenitis suppurativa. Clin Cosmet Investig Dermatol 2016; 9:367-372. [PMID: 27799806 PMCID: PMC5076543 DOI: 10.2147/ccid.s93619] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Hidradenitis suppurativa (HS) is a chronic, recurrent, inflammatory skin disease that affects the hair follicles of the aprocrine gland-bearing anatomical areas of the body. It is characterized by deep painful nodules and abscesses that rupture and contribute to the formation of sinus tracks and scarring. The management of HS is based on the assessment of disease severity and a combination of medical and surgical treatment according to the European Guidelines. Adalimumab, a recombinant, fully humanized, anti-tumor necrosis factor alpha (anti-TNF-α) monoclonal antibody, is the only officially approved treatment for the management of moderate-to-severe HS. Case reports, concerning 42 patients who received adalimumab for severe HS (with the standard dose regimen for psoriasis), reported a cumulative response rate of 58% (≥50% in 23 patients) with a relapse rate of 71% (10 out of 14 patients). The most recent and most well-powered phase III, randomized placebo-controlled trials for the evaluation of the efficacy and safety of adalimumab in treatment of moderate-to-severe HS (PIONEER studies I and II) showed that the Hidradenitis Suppurativa Clinical Response (HiSCR) rate at week 12 was significantly higher for patients randomized to adalimumab compared to placebo. Adverse events were comparable to placebo. In conclusion, adalimumab, to date, holds the most robust data regarding treatment efficacy in HS. Larger, registry-based studies are needed to further establish the efficacy and safety profile of this anti-TNF-α agent in HS.
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Affiliation(s)
- Christina Fotiadou
- First Department of Dermatology-Venereology, Aristotle University Medical School, Thessaloniki, Greece
| | - Efstratios Vakirlis
- First Department of Dermatology-Venereology, Aristotle University Medical School, Thessaloniki, Greece
| | - Dimitrios Ioannides
- First Department of Dermatology-Venereology, Aristotle University Medical School, Thessaloniki, Greece
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