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Garbayo-Salmons P, Expósito-Serrano V, Ribera Pibernat M, Romaní J. Hidradenitis Suppurativa Treated With Apremilast: A Case Series. ACTAS DERMO-SIFILIOGRAFICAS 2021. [DOI: 10.1016/j.adengl.2021.09.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Peña-Rosado A, Riera-Martí N, Expósito-Serrano V, Romaní J. Autoinflammatory Keratinization Diseases. ACTAS DERMO-SIFILIOGRAFICAS 2021. [DOI: 10.1016/j.adengl.2021.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Peña-Rosado A, Riera-Martí N, Expósito-Serrano V, Romaní J. Autoinflammatory keratinitzation diseases (AIKDs. ACTAS DERMO-SIFILIOGRAFICAS 2021; 112:S0001-7310(21)00208-8. [PMID: 34118208 DOI: 10.1016/j.ad.2021.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/29/2021] [Accepted: 05/09/2021] [Indexed: 10/21/2022] Open
Abstract
Autoinflammatory keratinization disease (AiKD) is a novel clinical concept encompassing diseases with a genetic background and mixed pathogenic mechanisms of autoinflammation and autoimmunity, leading to an aberrant keratinization of the skin. Recent advances in medical genetics have revealed genetic causes and/or predisposing factors for a number of AiKD's, such as mutations in IL36RN related with pustular psoriasis, acrodermatitis continua and hidradenitis suppurativa, in CARD14 in pityriasis rubra pilaris type V and some forms of pustular psoriasis, and in NLRP1 related with familial keratosis lichenoides chronica (KLC). It is suspected that AiKD pathophysiology would also be involved in non-monogenic disorders. The bidirectional relationship between inflammation and keratinization should be understood in order to outline optimal management, and new drug development should take both targets into account. We assume that new inflammatory keratinization diseases may be recognized as AiKDs in the coming years.
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Affiliation(s)
- A Peña-Rosado
- Servicio de Medicina, Consorci Corporació Sanitària Parc Taulí, Universidad Autónoma de Barcelona, Spain.
| | - N Riera-Martí
- Servicio de Dermatología, Consorci Corporació Sanitària Parc Taulí, Universidad Autónoma de Barcelona, Spain
| | - V Expósito-Serrano
- Servicio de Dermatología, Consorci Corporació Sanitària Parc Taulí, Universidad Autónoma de Barcelona, Spain
| | - J Romaní
- Servicio de Dermatología, Consorci Corporació Sanitària Parc Taulí, Universidad Autónoma de Barcelona, Spain
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Garbayo-Salmons P, Expósito Serrano V, Ribera Pibernat M, Romaní J. Hidradenitis Suppurativa Treated With Apremilast: A Case Series. ACTAS DERMO-SIFILIOGRAFICAS 2021; 112:S0001-7310(21)00173-3. [PMID: 33984314 DOI: 10.1016/j.ad.2020.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/16/2020] [Accepted: 06/29/2020] [Indexed: 10/21/2022] Open
Affiliation(s)
- P Garbayo-Salmons
- Servicio de Dermatología. Hospital Universitario Parc Taulí de Sabadell, Spain.
| | - V Expósito Serrano
- Servicio de Dermatología. Hospital Universitario Parc Taulí de Sabadell, Spain
| | - M Ribera Pibernat
- Servicio de Dermatología. Hospital Universitario Parc Taulí de Sabadell, Spain
| | - J Romaní
- Servicio de Dermatología. Hospital Universitario Parc Taulí de Sabadell, Spain
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Baseline Characteristics from UNITE: An Observational, International, Multicentre Registry to Evaluate Hidradenitis Suppurativa (Acne Inversa) in Clinical Practice. Am J Clin Dermatol 2020; 21:579-590. [PMID: 32077014 PMCID: PMC7371670 DOI: 10.1007/s40257-020-00504-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background Hidradenitis suppurativa (HS), also known as acne inversa, is a recurring, painful, chronic, and sometimes disfiguring inflammatory skin disease. Objectives Our objective was to report the baseline clinical characteristics, natural history, and associated outcomes of patients with HS from the ongoing, prospective, non-interventional UNITE registry that is collecting data regarding the natural history and associated outcomes of HS. Methods Patients with inflammatory HS lesions were enrolled, including adolescents (aged 12 to < 18 years) and adults (aged ≥ 18 years). None had participated in previous or current originator-adalimumab studies/registries. Patients received treatment consistent with site-specific, routine clinical practice. HS disease status was assessed by HS lesions and disease flare; treatment and outcomes data were collected at enrolment and every 6 months for ≤ 4 years. Results Enrolment (N = 594; 89.1% adults; 10.9% adolescents) occurred from 29 October 2013 to 29 December 2015 at 73 sites in 12 countries. At baseline, the majority were female (69.7%) and White (81.2%), had moderate-to-severe disease (Hurley stage II or III; 93.3%), and had undergone prior procedures/surgery for HS (68.7%). In total, 61.6% of adults and 49.2% of adolescents were obese; 40.2% of patients reported current tobacco use. Scarring due to lesions occurred in 91.2% of patients. The prevalence of comorbidities of interest was as follows: depression (13.3%), other psychiatric disorders (9.6%), inflammatory bowel disease (2.7%), diabetes (9.1%), and polycystic ovary syndrome (5.2%). Conclusions In this population from the UNITE HS registry, obesity and smoking were common, and disease burden was high, manifesting as multiple lesions, scarring, surgical history, and considerable comorbidities. Electronic supplementary material The online version of this article (10.1007/s40257-020-00504-4) contains supplementary material, which is available to authorized users.
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Hidradenitis Suppurativa: Our Experience with a Surgical Case Management Team. ACTAS DERMO-SIFILIOGRAFICAS 2020. [DOI: 10.1016/j.adengl.2019.12.009] [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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Hidradenitis Suppurative: Our Experience with a Surgical Case Management Team. ACTAS DERMO-SIFILIOGRAFICAS 2020; 111:408-412. [PMID: 32408974 DOI: 10.1016/j.ad.2019.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 11/23/2019] [Accepted: 12/02/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The complexity of hidradenitis suppurativa (HS) treatment calls for a multidisciplinary approach. We therefore created a multidisciplinary team to manage surgical care. This study aimed to describe the clinical characteristics of the patients we evaluated and the outcomes of the surgical techniques used. MATERIAL AND METHODS Descriptive cross-sectional study of 104 patients evaluated by our surgical case management team between September 2015 and July 2018. RESULTS Surgery was used to treat 46% of the patients with HS who were evaluated. Most were men (73%) with no family history of HS (63%) and smokers or former smokers (76%). Gluteal HS comprised the largest phenotype group (41%) and the majority of cases were serious (Hurley stage II, 36%; stage III, 46%). The anatomical regions with the largest number of lesions were the axillae (51.9%) and the groin (41.3%). Surgery was most often performed in the axilla (38.3%), followed by the gluteus (23.4%). The most common drug treatment was a combination of rifampicin and clindamycin, Deroofing was the technique used most often (in 48% of the patients who underwent surgery). Postoperative outcomes were assessed as satisfactory overall in 63.4% of the cases. The HS lesion recurred in 20% and 12% developed wound dehiscence. CONCLUSIONS Our experience leads us to recommend forming multidisciplinary teams to improve communication between specialists, provide tailored treatment for the patient with HS, and improve follow-up.
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Martorell A, Jfri A, Koster S, Gomez‐Palencia P, Solera M, Alfaro‐Rubio A, Hueso L, Sanz‐Motilva V. Defining hidradenitis suppurativa phenotypes based on the elementary lesion pattern: results of a prospective study. J Eur Acad Dermatol Venereol 2020; 34:1309-1318. [DOI: 10.1111/jdv.16183] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 11/12/2019] [Indexed: 01/01/2023]
Affiliation(s)
- A. Martorell
- Department of Dermatology Hospital de Manises Valencia Spain
| | - A. Jfri
- Department of Dermatology McGill University Montreal Canada
| | - S.B.L. Koster
- Medical student Erasmus MC Rotterdam The Netherlands
| | | | - M. Solera
- Department of Dermatology Hospital de Manises Valencia Spain
| | - A. Alfaro‐Rubio
- Department of Dermatology Hospital de Manises Valencia Spain
| | - L. Hueso
- Department of Dermatology Hospital de Manises Valencia Spain
| | - V. Sanz‐Motilva
- Department of Dermatology Hospital de Manises Valencia Spain
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Nazzaro G, Passoni E, Calzari P, Marzano AV. Ultrasonographic assessment of fibrosis in hidradenitis suppurativa fistulae helps in addressing treatment. Skin Res Technol 2019; 26:445-446. [DOI: 10.1111/srt.12805] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 11/09/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Gianluca Nazzaro
- UOC Dermatologia Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milan Italy
| | - Emanuela Passoni
- UOC Dermatologia Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milan Italy
| | - Paolo Calzari
- Dipartimento di Fisiopatologia Medico‐Chirurgica e dei Trapianti Università degli Studi di Milano Milan Italy
| | - Angelo V. Marzano
- UOC Dermatologia Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milan Italy
- Dipartimento di Fisiopatologia Medico‐Chirurgica e dei Trapianti Università degli Studi di Milano Milan Italy
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Defining Fistular Patterns in Hidradenitis Suppurativa: Impact on the Management. Dermatol Surg 2019; 45:1237-1244. [DOI: 10.1097/dss.0000000000001916] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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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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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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Scholl L, Hessam S, Reitenbach S, Bechara FG. [Surgical treatment options for hidradenitis suppurativa/acne inversa]. Hautarzt 2019; 69:149-161. [PMID: 29322225 DOI: 10.1007/s00105-017-4114-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Hidradenitis suppurativa/acne inversa (HS/AI) is a chronic inflammatory skin disease. Therapy consists of conservative and surgical treatment options. In Hurley stages II and III, surgical intervention is regarded as the method of choice for areas with irreversible tissue destruction. Resection techniques with different grades of invasiveness are described in the literature. Nevertheless, there is no generally accepted concept regarding resection and reconstruction techniques or specific postoperative care. Due to lack of definitions of recurrence after surgery and poor study quality, recurrence rates are difficult to determine.
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Affiliation(s)
- L Scholl
- Klinik für Dermatologie, Venerologie und Allergologie, St. Josef-Hospital, Klinik der Ruhr-Universität Bochum, Gudrunstr. 56, 44791, Bochum, Deutschland
| | - S Hessam
- Klinik für Dermatologie, Venerologie und Allergologie, St. Josef-Hospital, Klinik der Ruhr-Universität Bochum, Gudrunstr. 56, 44791, Bochum, Deutschland
| | - S Reitenbach
- Klinik für Dermatologie, Venerologie und Allergologie, St. Josef-Hospital, Klinik der Ruhr-Universität Bochum, Gudrunstr. 56, 44791, Bochum, Deutschland
| | - F G Bechara
- Klinik für Dermatologie, Venerologie und Allergologie, St. Josef-Hospital, Klinik der Ruhr-Universität Bochum, Gudrunstr. 56, 44791, Bochum, Deutschland.
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Mendes-Bastos P, Martorell A, Magina S. Ertapenem for the treatment of Hidradenitis suppurativa: how much do we need it? ACTAS DERMO-SIFILIOGRAFICAS 2018. [DOI: 10.1016/j.adengl.2018.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Mendes-Bastos P, Martorell A, Magina S. Ertapenem for the treatment of Hidradenitis suppurativa: how much do we need it? ACTAS DERMO-SIFILIOGRAFICAS 2018; 109:582-583. [PMID: 29803362 DOI: 10.1016/j.ad.2018.03.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 03/25/2018] [Indexed: 11/17/2022] Open
Affiliation(s)
- P Mendes-Bastos
- Centro de Dermatología, Hospital CUF Descobertas, Lisboa, Portugal.
| | - A Martorell
- Departamento de Dermatología, Hospital de Manises, Valencia, España
| | - S Magina
- Departamento de Dermatología y Venereología, Centro Hospitalario de São João, Oporto, Portugal; Departamento de Farmacología y Terapéutica, Facultad de Medicina, Universidad de Oporto, Oporto, Portugal
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Ultrasound Evaluation as a Complementary Test in Hidradenitis Suppurativa: Proposal of a Standarized Report. Dermatol Surg 2017; 43:1065-1073. [PMID: 28538033 DOI: 10.1097/dss.0000000000001147] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Staging and monitoring of patients with hidradenitis suppurativa (HS) have been traditionally based on clinical findings. However, the physical examination may show important limitations because of its poor sensitivity for differentiating between different lesion subtypes, and its low sensitivity to define the disease's activity. OBJECTIVE To develop a consensus ultrasound (US) report that could summarize the relevant anatomical characteristics and staging of patients considering the experience of radiologists and dermatologists working on imaging of HS. METHODS A questionnaire on different aspects related to US examination in HS was performed. A working group, called DERMUS, composed of doctors from 9 countries who have been working in dermatologic US applied in patients with HS on a regular basis were included to evaluate the different items provided. RESULTS A consensus US report to evaluate HS patients was established. CONCLUSION The authors present the first attempt to define a HS standardized sonographic report. This model would be the first effort to include this imaging technique as the first elective medical test for staging and monitoring patients, which can support therapeutic decisions by providing earlier, objective, deeper, anatomical, and comparative evaluations in this difficult to treat disease.
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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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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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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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Improvement of overlapping hidradenitis suppurativa and ankylosing spondylitis after the introduction of adalimumab. Reumatologia 2016; 54:321-325. [PMID: 28115784 PMCID: PMC5241370 DOI: 10.5114/reum.2016.64910] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Accepted: 12/13/2016] [Indexed: 11/17/2022] Open
Abstract
Hidradenitis suppurativa is a chronic inflammatory disorder characterized by occlusion of the follicular pilosebaceous units of the skin. The treatment options are sometimes very limited and unpleasant odor and abundant drainage complicate the disease. Ankylosing spondylitis is a form of seronegative spondyloarthritis with predominantly axial but also peripheral joint involvement. Both of the conditions lower the patient's quality of life and affect everyday activities. We describe a 39-year-old male patient with both diseases treated with different medications with only a modest result. After the initiation of a tumor necrosis factor α (TNF-α) inhibitor (adalimumab) the patient experienced first the musculoskeletal and later on the skin improvement. The introduction of TNF-α inhibitors should be considered early in the treatment of overlapping hidradenitis suppurativa and the spondyloarthritis spectrum of conditions. Available medical data confirm the positive results and beneficial effect on disease course, activity and, most importantly, quality of life.
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