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Krajewski A, Alsayed A, Capek A, Casey K, Chandawarkar R. Surgical Management of Hidradenitis Suppurativa. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5860. [PMID: 38872991 PMCID: PMC11175856 DOI: 10.1097/gox.0000000000005860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 03/18/2024] [Indexed: 06/15/2024]
Abstract
Hidradenitis suppurativa (HS) is a chronic, relapsing inflammatory disease of the skin, characterized by recurrent draining sinuses and abscesses, predominantly in skin folds carrying terminal hairs and apocrine glands. Treatment for this debilitating disease has been medical management with antibiotics and immune modulators. With the advent of better reconstructive surgical techniques, the role of surgery in the treatment of HS has expanded, from being a last resort to a modality that is deployed earlier. Larger defects can be more easily reconstructed, allowing for a more radical excision of diseased areas. Locoregional flaps, perforator flaps, and propeller flaps that use the fasciocutaneous tissue allow reconstruction of defects with similar tissue, and provide better cosmetic and functional outcomes. They are easy to execute and can be performed even in resource-poor settings with concurrent use of immune modulators and postoperative antibiotics. Hidradenitis can be successfully treated with surgery in early stages as well as severe disease, due to the advances in understanding disease behavior, multidisciplinary care, and advanced reconstructive techniques. Coupled with a multidisciplinary care team, surgery offers a durable, lasting cure for HS, significantly reducing disease morbidity.
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Affiliation(s)
| | - Ahmed Alsayed
- Department of Plastic Surgery, Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Allison Capek
- Department of Plastic Surgery, Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Kathleen Casey
- Department of Plastic Surgery, Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Rajiv Chandawarkar
- Department of Plastic Surgery, Ohio State University Wexner Medical Center, Columbus, Ohio
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Fortoul MC, Macias Martinez B, Ventura Rodriguez D, Dallara M, Stelnicki EJ, Kamel G. A Retrospective Review of Laser Therapy for Treatment of Hidradenitis Suppurativa. Ann Plast Surg 2023; 91:758-762. [PMID: 37856194 DOI: 10.1097/sap.0000000000003690] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
PURPOSE Hidradenitis suppurativa (HS) is a chronic inflammatory disease characterized by painful and foul-smelling cystic nodules and sinus tracts in the apocrine gland-bearing regions. The treatment options include topical, intralesional, systemic, and surgical modalities. Currently, the most novel therapy is laser therapy to provide localized treatment without systemic adverse effects. However, data regarding patient outcomes after laser treatment are limited because of the low prevalence of this disease. This study aimed to evaluate the efficacy of laser therapy as a treatment modality for patients with HS. METHODS A retrospective review cohort analysis of patients with HS undergoing laser treatment between 2016 and 2021 was conducted. Patient demographics, lesion location(s), Hurley stage, age of onset and diagnosis, treatment length, type, outcomes, and complications were analyzed. RESULTS Ninety-four patients met the inclusion criteria; on average, patients were treated with 5.8 laser sessions for 14.8 months with no complications and minor blood loss. Hidradenitis suppurativa progression commonly starts during puberty, with a median onset of 13.8 years and diagnosis of HS at 16.2 years. All patients (n = 94) showed an improvement in HS disease severity: 59.6% completed treatment, 12.0% are currently undergoing treatment, and 26.0% were lost to follow-up. CONCLUSIONS Laser therapy is an effective and safe therapy for HS leading to improved quality of life and should be considered in the treatment and management of HS.
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Affiliation(s)
- Marla C Fortoul
- From the Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University
| | - Brian Macias Martinez
- From the Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University
| | | | - Marissa Dallara
- From the Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University
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Grotenhermen F, Oláh A. Case in Context: Acne Inversa (Hidradenitis Suppurativa). Cannabis Cannabinoid Res 2023; 8:608-611. [PMID: 37074343 DOI: 10.1089/can.2023.0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Affiliation(s)
| | - Attila Oláh
- Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Kridin K, Valido K, Cohen JM, Cohen AD. Hidradenitis suppurativa and the risk of myocardial infarction, cerebrovascular accident, and peripheral vascular disease: a population-based study. Arch Dermatol Res 2023; 315:429-435. [PMID: 35871185 DOI: 10.1007/s00403-022-02369-5] [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: 01/03/2022] [Revised: 06/06/2022] [Accepted: 07/02/2022] [Indexed: 11/02/2022]
Abstract
Previous studies have identified an association between myocardial infarction (MI), cerebrovascular accident (CVA), and peripheral vascular disease (PVD) in patients with hidradenitis suppurativa (HS). To evaluate the risk and prognostic outcomes of MI, CVA, and PVD in patients with HS. A population-based retrospective cohort study using the computerized database of Clalit Health Services (CHS), the largest managed care organization in Israel, was conducted to compare the incidence of MI, CVA, and PVD among patients with HS (N = 6779) with age-, sex- and ethnicity-matched control subjects (N = 33,260). Adjusted hazard ratios (HRs) were estimated by multivariate Cox regression analysis. The overall incidence rates of MI, CVA, and PVD were estimated at 2.9 (2.3-3.4), 1.3 (0.9-1.7), and 0.8 (0.6-1.1) per 1000 person-year, respectively. Patients with HS were at an increased risk of developing MI (fully-adjusted HR 1.33; 95% CI 1.04-1.68; P = 0.021), but the risk of CVA (fully-adjusted HR 0.82; 95% CI 0.59-1.14; P = 0.245) and PVD (fully-adjusted HR 1.22; 95% CI 0.80-1.87; P = 0.355) was comparable relative to controls. Compared to other patients with HS, increased risk of all-cause mortality was observed among patients with HS and comorbid MI (HR 12.56; 95% CI 7.59-20.80; P < 0.001), CVA (HR 13.33; 95% CI 7.29-24.37; P < 0.001), and PVD (HR 7.11; 95% CI 2.61-19.32; P < 0.001). Patients with HS are at an increased risk of MI, but not CVA and PVD. Awareness of these epidemiological findings is of importance for clinicians managing patients with HS.
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Affiliation(s)
- Khalaf Kridin
- Unit of Dermatology and Skin Research Laboratory, Baruch Padeh Poria Medical Center, Poriya, Israel
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | | | - Jeffrey M Cohen
- Department of Dermatology, Yale School of Medicine, 15 York St, New Haven, CT, 06510, USA.
| | - Arnon D Cohen
- Department of Quality Measures and Research, Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel
- Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Faverio K, Peitsch WK, Görig T, Schneider‐Burrus S, Benzel F, Goebeler M, Schummer P, Badran A, Schaarschmidt M, Harth W, Mössner R, Kromer C. Patient Preferences in Hidradenitis Suppurativa (APProach‐HS): a discrete choice experiment. J Dtsch Dermatol Ges 2022; 20:1441-1452. [DOI: 10.1111/ddg.14886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 08/02/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Kristin Faverio
- Department of Dermatology and Phlebology Vivantes Klinikum im Friedrichshain Berlin Germany
- Faculty of Medicine Charité – University Medicine Berlin Berlin Germany
| | - Wiebke K. Peitsch
- Department of Dermatology and Phlebology Vivantes Klinikum im Friedrichshain Berlin Germany
| | - Tatiana Görig
- Department of Medical Informatics Biometry and Epidemiology Friedrich‐Alexander‐University of Erlangen‐Nuremberg Erlangen Germany
| | | | - Friderike Benzel
- Department of Dermatology and Phlebology Vivantes Klinikum im Friedrichshain Berlin Germany
| | - Matthias Goebeler
- Department of Dermatology Venereology and Allergology University Hospital Würzburg Würzburg Germany
| | - Patrick Schummer
- Department of Dermatology Venereology and Allergology University Hospital Würzburg Würzburg Germany
| | - Alaa Badran
- Department of Dermatology Venereology and Allergology University Hospital Würzburg Würzburg Germany
| | - Marthe‐Lisa Schaarschmidt
- Department of Dermatology Venereology and Allergology University Medical Center Mannheim Heidelberg University Mannheim Germany
| | - Wolfgang Harth
- Department of Dermatology and Allergology Vivantes Klinikum Spandau Berlin Germany
| | - Rotraut Mössner
- Department of Dermatology Venereology and Allergology University Medical Center Göttingen Göttingen Germany
| | - Christian Kromer
- Department of Dermatology Venereology and Allergology University Medical Center Göttingen Göttingen Germany
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Faverio K, Peitsch WK, Görig T, Schneider‐Burrus S, Benzel F, Goebeler M, Schummer P, Badran A, Schaarschmidt M, Harth W, Mössner R, Kromer C. Patientenpräferenzen bei Hidradenitis suppurativa (APProach‐HS): ein “Discrete‐Choice”‐Experiment. J Dtsch Dermatol Ges 2022; 20:1441-1454. [DOI: 10.1111/ddg.14886_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 08/02/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Kristin Faverio
- Klinik für Dermatologie und Phlebologie Vivantes Klinikum im Friedrichshain Berlin Deutschland
- Medizinische Fakultät Charité –Universitätsmedizin Berlin Deutschland
| | - Wiebke K. Peitsch
- Klinik für Dermatologie und Phlebologie Vivantes Klinikum im Friedrichshain Berlin Deutschland
| | - Tatiana Görig
- Institut für Medizininformatik Biometrie und Epidemiologie (IMBE) Friedrich‐Alexander‐Universität Erlangen‐Nürnberg Erlangen Deutschland
| | | | - Friderike Benzel
- Klinik für Dermatologie und Phlebologie Vivantes Klinikum im Friedrichshain Berlin Deutschland
| | - Matthias Goebeler
- Klinik und Poliklinik für Dermatologie Venerologie und Allergologie Universitätsklinikum Würzburg Würzburg Deutschland
| | - Patrick Schummer
- Klinik und Poliklinik für Dermatologie Venerologie und Allergologie Universitätsklinikum Würzburg Würzburg Deutschland
| | - Alaa Badran
- Klinik und Poliklinik für Dermatologie Venerologie und Allergologie Universitätsklinikum Würzburg Würzburg Deutschland
| | - Marthe‐Lisa Schaarschmidt
- Klinik für Dermatologie Venerologie und Allergologie Universitätsmedizin Mannheim Universität Heidelberg Mannheim Deutschland
| | - Wolfgang Harth
- Klinik für Dermatologie und Allergologie Vivantes Klinikum Spandau Berlin Deutschland
| | - Rotraut Mössner
- Klinik für Dermatologie Venerologie und Allergologie Universitätsmedizin Göttingen Göttingen Deutschland
| | - Christian Kromer
- Klinik für Dermatologie Venerologie und Allergologie Universitätsmedizin Göttingen Göttingen Deutschland
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Kashyap MP, Khan J, Sinha R, Jin L, Atigadda V, Deshane JS, Ahmed AR, Kilic A, Raman C, Mukhtar MS, Elmets CA, Athar M. Advances in molecular pathogenesis of hidradenitis suppurativa: Dysregulated keratins and ECM signaling. Semin Cell Dev Biol 2022; 128:120-129. [PMID: 35131152 PMCID: PMC9232849 DOI: 10.1016/j.semcdb.2022.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 01/12/2022] [Accepted: 01/14/2022] [Indexed: 12/12/2022]
Abstract
Hidradenitis suppurativa (HS) is characterized by deep-seated, highly inflamed, and painful lumps/abscesses, fistulae, and sinus tracts that grow extensively deep in the dermis and are highly immunogenic in nature. In about one-third of the HS patients there is strong evidence for the role of γ-secretase mutations along with dysregulated Notch signaling. However, the contribution of dysregulated Notch signaling in HS pathogenesis in relation to hair follicle alterations and hyper-activation of the immune system remains undefined. A genome-wide association study (GWAS), proteomic data and functional investigations of identified sequence variants in HS pathology are not fully revealing. The disease initiation or progression may involve bacterial infection besides intrinsic functional defects in keratinocytes, which may be key to further exacerbate immune cell infiltration and cytokine production in and around the lesional tissue. The absence of a suitable animal model that could fully recapitulate the pathogenesis of HS is a major impediment for proper understanding the underlying mechanisms and development of effective treatments. The presence of extracellular matrix (ECM) degradation products along with dysregulation in keratinocytes and, dermal fibroblasts ultimately affect immune regulation and are various components of HS pathogenesis. Bacterial infection further exacerbates the complexity of the disease progression. While anti-TNFα therapy shows partial efficacy, treatment to cure HS is absent. Multiple clinical trials targeting various cytokines, complement C5a and ECM products are in progress. This review provides state-of-the-art information on these aspects with a focus on dysregulated keratinocyte and immune cells; and role of ECM, and Keratin functions in this regard.
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Affiliation(s)
- Mahendra Pratap Kashyap
- UAB Research Center of Excellence in Arsenicals, Department of Dermatology, University of Alabama at Birmingham, Birmingham AL35294, USA
| | - Jasim Khan
- UAB Research Center of Excellence in Arsenicals, Department of Dermatology, University of Alabama at Birmingham, Birmingham AL35294, USA
| | - Rajesh Sinha
- UAB Research Center of Excellence in Arsenicals, Department of Dermatology, University of Alabama at Birmingham, Birmingham AL35294, USA
| | - Lin Jin
- UAB Research Center of Excellence in Arsenicals, Department of Dermatology, University of Alabama at Birmingham, Birmingham AL35294, USA
| | - Venkatram Atigadda
- UAB Research Center of Excellence in Arsenicals, Department of Dermatology, University of Alabama at Birmingham, Birmingham AL35294, USA
| | - Jessy S Deshane
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham AL35294, USA
| | - Ayesha R Ahmed
- Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, WA 99202, USA
| | - Ali Kilic
- Division of Plastic Surgery, University of Alabama at Birmingham, Birmingham AL35294, USA
| | - Chander Raman
- UAB Research Center of Excellence in Arsenicals, Department of Dermatology, University of Alabama at Birmingham, Birmingham AL35294, USA
| | - M Shahid Mukhtar
- Department of Biology, University of Alabama at Birmingham, Birmingham AL35294, USA
| | - Craig A Elmets
- UAB Research Center of Excellence in Arsenicals, Department of Dermatology, University of Alabama at Birmingham, Birmingham AL35294, USA
| | - Mohammad Athar
- UAB Research Center of Excellence in Arsenicals, Department of Dermatology, University of Alabama at Birmingham, Birmingham AL35294, USA.
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Bu W, Zhao S, Zhang Q, Fang F, Yang L. Effects of the modified excision combined with bidirectional photodynamic therapy on refractory hidradenitis suppurativa: a retrospective study. Lasers Med Sci 2022; 37:2865-2872. [PMID: 35389111 DOI: 10.1007/s10103-022-03555-7] [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: 09/09/2021] [Accepted: 03/29/2022] [Indexed: 10/18/2022]
Abstract
To describe the clinical features of refractory hidradenitis suppurativa (HS) patients (Hurley stageII and stage III) and evaluate the efficacy of combined treatment of the modified excision with bidirectional photodynamic therapy (PDT). A retrospective, multicenter study was conducted in 35 refractory HS patients. They were treated with the modified excision combined with bidirectional PDT. The outcomes, patients' satisfaction, adverse effects, and the Dermatology Life Quality Index (DLQI) were observed. There were more males than females (6:1). The axilla was the most frequently affected region (37.5%). All patients had experienced treatment failures before and had good response to our combined therapy (clearance rate > 75%). The average time required for complete wound healing was 11 days. After 1 year of follow-up, no significant recurrence was observed. The DLQI decreased significantly after the combined treatment. The comprehensive evaluation of scar and the deformation showed good cosmetic results after treatment. Reversible adverse events such as small patchy blackness, necrosis, or ulcer in the tip of the flap occurred in six patients (17.1%). Of the 35 patients, 30 were very satisfied with the treatment. This case series finds that the modified excision combined with bidirectional PDT may hold promise for radical treatment of Hurley stage II and stage III.
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Affiliation(s)
- Wenbo Bu
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Institute of Dermatology, Chinese Academy of Medical Science & Peking Union Medical College, Nanjing, 210042, China
| | - Shuang Zhao
- Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Qian Zhang
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Institute of Dermatology, Chinese Academy of Medical Science & Peking Union Medical College, Nanjing, 210042, China
| | - Fang Fang
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Institute of Dermatology, Chinese Academy of Medical Science & Peking Union Medical College, Nanjing, 210042, China.
| | - Liu Yang
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
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Ross Y, Ballou S. Association of Hidradenitis Suppurativa (HS) with Autoimmune Disease and Autoantibodies. Rheumatol Adv Pract 2021; 6:rkab108. [PMID: 35531048 PMCID: PMC9073366 DOI: 10.1093/rap/rkab108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 12/20/2021] [Indexed: 11/14/2022] Open
Abstract
Objective There is thought to be an association between hidradenitis suppurativa (HS) and autoimmune diseases. This retrospective longitudinal cohort study looked to identify whether certain autoimmune diseases or autoantibody specificities are more closely associated with HS than others and whether such associations are related to the severity of HS. Methods Patients were identified using the SlicerDicer search tool in Epic from 1 January 2010 to 15 August 2020. Search criteria included HS diagnosis by ICD-10 code (L73.2) and at least one visit to the dermatology department. Charts were reviewed to determine HS disease severity, treatment modalities, presence of autoimmune disease and autoantibody positivity. Results Six hundred and twenty-seven patients were identified. Most patients were female (75.3%) and had obese BMIs (71.1%), but there were no significant demographic differences between HS patients with and without autoimmune diseases. One hundred and one (16.1%) patients in the total cohort had at least one autoimmune disease, most commonly thyroid disease, lupus, psoriasis and IBD. Two hundred and twelve patients were also tested for the presence of autoantibodies. The most common positive autoantibody, found in 54 patients (28.4%), was ANA. Fifty-four patients with more severe HS disease manifestations required biologic medications to treat their HS. Neither HS severity nor biologic treatment was associated with presence of autoimmune disease or positive autoantibodies. Conclusion In a large cohort of patients with HS followed longitudinally, autoimmune disorders (especially lupus, psoriasis and IBD) and presence of autoantibodies were more commonly observed than expected in the normal population.
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Affiliation(s)
- Yael Ross
- Department of Rheumatology, Case Western Reserve University at MetroHealth Medical Center, Cleveland, OH, USA
| | - Stanley Ballou
- Department of Rheumatology, Case Western Reserve University at MetroHealth Medical Center, Cleveland, OH, USA
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Okeke CAV, Khanna R, Okoye GA, Byrd AS. Assessment of the Generalizability of Hidradenitis Suppurativa Microbiome studies: The Minimal Inclusion of Racial and Ethnic Populations. J Am Acad Dermatol 2021; 86:e159-e161. [PMID: 34757150 DOI: 10.1016/j.jaad.2021.10.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 10/13/2021] [Indexed: 10/20/2022]
Affiliation(s)
| | - Raveena Khanna
- Department of Psychiatry, Creighton University School of Medicine, Phoenix, AZ
| | - Ginette A Okoye
- Department of Dermatology, Howard University College of Medicine, Washington, DC
| | - Angel S Byrd
- Department of Dermatology, Howard University College of Medicine, Washington, DC.
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Hidradenitis Suppurativa: Where We Are and Where We Are Going. Cells 2021; 10:cells10082094. [PMID: 34440863 PMCID: PMC8392140 DOI: 10.3390/cells10082094] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/11/2021] [Accepted: 08/13/2021] [Indexed: 12/19/2022] Open
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease primarily affecting apocrine gland-rich areas of the body. It is a multifactorial disease in which genetic and environmental factors play a key role. The primary defect in HS pathophysiology involves follicular occlusion of the folliculopilosebaceous unit, followed by follicular rupture and immune responses. Innate pro-inflammatory cytokines (e.g., IL-1β, and TNF-α); mediators of activated T helper (Th)1 and Th17 cells (e.g., IFN-γ, and IL-17); and effector mechanisms of neutrophilic granulocytes, macrophages, and plasma cells are involved. On the other hand, HS lesions contain anti-inflammatory mediators (e.g., IL-10) and show limited activity of Th22 cells. The inflammatory vicious circle finally results in pain, purulence, tissue destruction, and scarring. HS pathogenesis is still enigmatic, and a valid animal model for HS is currently not available. All these aspects represent a challenge for the development of therapeutic approaches, which are urgently needed for this debilitating disease. Available treatments are limited, mostly off-label, and surgical interventions are often required to achieve remission. In this paper, we provide an overview of the current knowledge surrounding HS, including the diagnosis, pathogenesis, treatments, and existing translational studies.
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Anduquia-Garay F, Rodríguez-Gutiérrez MM, Poveda-Castillo IT, Valdes-Moreno PL, Agudelo-Rios DA, Benavides-Moreno JS, Lozada-Martínez ID, Bolaño-Romero MP, Borraez-Segura B, Rahman S. Hidradenitis suppurativa: Basic considerations for its approach: A narrative review. Ann Med Surg (Lond) 2021; 68:102679. [PMID: 34401142 PMCID: PMC8353381 DOI: 10.1016/j.amsu.2021.102679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/30/2021] [Accepted: 08/03/2021] [Indexed: 01/18/2023] Open
Abstract
Hidradenitis suppurativa is a chronic and debilitating skin disease, whose lesions can range from inflammatory nodules to abscesses and fistulas in the armpits, groin, perineum, inframammary region. Diagnosis can be confused with a large number of clinical pictures, and although studies on hidradenitis suppurativa are not so scarce in the literature, doctors are often unaware of this disease and therefore its diagnosis is often late. Pharmacological treatment ranges from retinoids to immunosuppression and radiation therapy, and surgical treatment ranges from incision and drainage to more complete excisions and laser therapies. Hidradenitis suppurativa is a disease seen and treated mainly by dermatologists and general surgeons, however, it is necessary for general practitioners to have basic knowledge about this entity, as they are the first line of care in the health system. Hidradenitis suppurativa is an entity of necessary recognition by the surgeon. It is a preventable and treatable condition with a good prognosis. This condition should be managed by a multidisciplinary team.
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Affiliation(s)
- Felipe Anduquia-Garay
- Future Surgeons Chapter, Colombian Surgery Association, Bogotá, Colombia
- School of Medicine, Universidad Tecnológica de Pereira, Pereira, Colombia
| | - María Manuela Rodríguez-Gutiérrez
- Future Surgeons Chapter, Colombian Surgery Association, Bogotá, Colombia
- Medical and Surgical Research Center, School of Medicine, Fundación Universitaria Autónoma de las Americas, Pereira, Colombia
| | | | | | | | | | - Ivan David Lozada-Martínez
- Future Surgeons Chapter, Colombian Surgery Association, Bogotá, Colombia
- Medical and Surgical Research Center, University of Cartagena, Cartagena, Colombia
| | | | | | - Sabrina Rahman
- Department of Public Health, Independent University-Bangladesh, Dhaka, Bangladesh
- Corresponding author.
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Elston DM. Hidradenitis suppurativa: New drugs, old challenges. J Am Acad Dermatol 2020; 83:733-734. [DOI: 10.1016/j.jaad.2020.05.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 05/09/2020] [Indexed: 10/24/2022]
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