1
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McGrath C, Steyn M, Rashidghamat E. Hidradenitis suppurativa in children and young adults: a retrospective cross-sectional observational study in the United Kingdom. Int J Dermatol 2024; 63:904-906. [PMID: 38273707 DOI: 10.1111/ijd.17049] [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: 09/21/2023] [Revised: 01/03/2024] [Accepted: 01/11/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) in children and young adults (CYA) (<18 years) is uncommon. No previous observational studies have been carried out in a UK CYA HS population. METHODS This study was based on retrospective case note reviews of CYA HS patients attending tertiary-level care in the CYA HS service in a UK hospital. Patients <18 years old with a known diagnosis of HS were screened for inclusion. Exclusion criteria were those with less than one follow-up appointment. RESULTS Twenty-eight CYA HS patients were identified, with an M:F ratio of 1:8.3. Mean BMI was 25.2 (SD: 7.6). 17 (61%) of cases had a relevant family history. Long-term antibiotic monotherapy was the most common treatment initiated. Lymecycline was the most commonly prescribed antibiotic, accounting for 23 (56%) of the 41 courses prescribed. Additional treatments initiated included dual therapy with rifampicin and clindamycin, isotretinoin, and adalimumab, which were more commonly prescribed in patients with Hurley Stage II or III. CONCLUSIONS This group had a female predominance with an apparent strong genetic predisposition which is seen in other HS CYA cross-sectional research. Treatment was varied in this cohort, however long courses of antibiotics, including combined therapy with rifampicin and clindamycin, were the mainstay of treatment, similar to management in the adult population. This study therefore adds to the limited information on the demographics and management of the HS CYA population.
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Affiliation(s)
- Conn McGrath
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Mia Steyn
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Ellie Rashidghamat
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
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2
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Vural S, Baskurt D, Yıldırıcı Ş, Rasulova G, Danacı S, Botsalı A. Evaluating dietary considerations in hidradenitis suppurativa: a critical examination of existing knowledge. Int J Dermatol 2024. [PMID: 38406977 DOI: 10.1111/ijd.17101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/15/2024] [Accepted: 02/07/2024] [Indexed: 02/27/2024]
Abstract
Hidradenitis suppurativa (HS) is a chronic condition that can overwhelm patients, and the effectiveness of supplementary dietary treatments remains uncertain. The primary aim of this review is to explore the connection between diet and HS progression. However, it is imperative to note that the evidence supporting a substantial role of the diet in HS remains weak. Dietary alterations alone should not be considered independent solutions for managing HS. Medical therapy continues to be indispensable for adequate treatment. Research indicates that the Mediterranean lifestyle and diet may provide cost-effective and beneficial adjustments when combined with traditional therapies. Conversely, foods with a high glycemic index and dairy could worsen HS symptoms, conceivably through mechanisms linked to insulin resistance and inflammation. Zinc, known for its antioxidant properties, shows promise as an adjunct therapy. Moreover, evidence suggests a connection between vitamin D deficiency and HS severity, although the findings are inconclusive. Brewer's yeast-free diet, B12 supplementation, intermittent fasting, and reducing the intake of refined sugar and dairy merit further investigation. In conclusion, this review highlights the need for additional research because of the lack of standardized reporting of clinical effects in the studies under scrutiny. A deeper exploration of the pathophysiology focusing on dietary modifications and their potential associations with HS severity is essential. Furthermore, it is crucial to recognize that patients' willingness to experiment with new diets makes them vulnerable to fraudulent interventions, highlighting the importance of evidence-based dietary guidance.
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Affiliation(s)
- Seçil Vural
- Department of Dermatology and Venereology, Koç University School of Medicine, Istanbul, Turkey
| | - Defne Baskurt
- School of Medicine, Koç University, Istanbul, Turkey
| | | | - Gunel Rasulova
- Department of Dermatology and Venereology, Koç University School of Medicine, Istanbul, Turkey
| | - Senem Danacı
- Department of Medical Pharmacology, Istanbul Cerrahpasa University, Istanbul, Turkey
| | - Aysenur Botsalı
- Department of Dermatology and Venereology, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Turkey
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3
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Chiang N, Sibbald C, Levy R, Lara-Corrales I. Hidradenitis Suppurativa in Children and Adolescents: An Update on Pharmacologic Treatment Options. Paediatr Drugs 2023; 25:659-676. [PMID: 37782437 DOI: 10.1007/s40272-023-00595-6] [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] [Accepted: 09/11/2023] [Indexed: 10/03/2023]
Abstract
Hidradenitis suppurativa (HS) is a chronic, recurrent, inflammatory skin condition that manifests as painful, deep-seated, inflamed nodules and abscesses in the axillary, groin, perianal, perineal, and inframammary regions. The associated pain, malodour, and disfigurement contribute to its profound negative impact on psychosocial spheres and overall quality of life in affected individuals. Although the symptoms of HS classically begin in the second or third decade of life, HS affects children and adolescents as well. Despite this, there are limited pediatric data on treatment, which are largely based on expert opinion, extrapolation of efficacy data in adults with HS, and safety information from medication use in other pediatric diseases. On this basis, there exist several pharmacological modalities in the treatment of children and adolescents with HS including topical therapies, systemic therapies, and biologics. The goals of this review article are to: (1) review the efficacy of different pharmacological treatment modalities in children and adolescents with HS, and (2) review the safety and monitoring considerations of the different treatment options in children and adolescents with HS.
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Affiliation(s)
- Nicholas Chiang
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Cathryn Sibbald
- Division of Dermatology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Rebecca Levy
- Division of Dermatology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Irene Lara-Corrales
- Division of Dermatology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
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4
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Masson R, Ma E, Parvathala N, Shih T, Atluri S, Hogeling M, Hughes M, Sayed CJ, Shi VY, Hsiao JL. Efficacy of medical treatments for pediatric hidradenitis suppurativa: A systematic review. Pediatr Dermatol 2023; 40:775-788. [PMID: 37525978 DOI: 10.1111/pde.15404] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/11/2023] [Indexed: 08/02/2023]
Abstract
Hidradenitis suppurativa (HS) is a chronic, inflammatory skin condition that has been insufficiently studied in the pediatric population. Timely and effective medical treatments may improve quality of life, mitigate disease burden, and prevent the need for invasive procedural interventions such as surgical excisions. However, there is a paucity of research on the efficacy of medical management strategies for HS in children and adolescents. The aim of this study was to perform a systematic review of the literature on the efficacy and safety of medical treatments for HS in patients <18 years of age. In April 2022, MEDLINE and EMBASE databases were searched for articles on the efficacy of medical treatments for HS in the pediatric population. Between 1984 and 2022, 35 articles (101 patients) met the inclusion criteria. Most patients had Hurley Stage II disease (46.7%, 35/75) followed by Stage I (36%, 27/75), and Stage III (17.3%, 13/75). 100% (23/23) of patients responded to antibiotics, 100% (8/8) to finasteride, 93.9% (31/33) to biologics, 80% (4/5) to oral retinoids, and 50% (6/12) to metformin. Overall, this study demonstrates that medical treatment regimens can improve HS symptoms in pediatric patients, but the extent of improvement is unclear, and the results were largely based on case reports or case series. Prospective studies are warranted to better understand the efficacy and safety of medical treatments for pediatric HS. Clinical trials of HS therapies need to be inclusive of pediatric patients to help define the optimal timing of treatment initiation and guide patient selection.
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Affiliation(s)
- Rahul Masson
- Keck School of Medicine of USC, University of Southern California, Los Angeles, California, USA
| | - Elaine Ma
- Keck School of Medicine of USC, University of Southern California, Los Angeles, California, USA
| | - Neha Parvathala
- Keck School of Medicine of USC, University of Southern California, Los Angeles, California, USA
| | - Terri Shih
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Swetha Atluri
- College of Medicine, University of Arizona, Tucson, Arizona, USA
| | - Marcia Hogeling
- Division of Dermatology, University of California, Los Angeles, California, USA
| | - Meagan Hughes
- Department of Dermatology, University of Southern California, Los Angeles, California, USA
- Division of Dermatology, Children's Hospital of Los Angeles, Los Angeles, California, USA
| | - Christopher J Sayed
- Department of Dermatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Vivian Y Shi
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Jennifer L Hsiao
- Department of Dermatology, University of Southern California, Los Angeles, California, USA
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5
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Bukvić Mokos Z, Markota Čagalj A, Marinović B. Epidemiology of hidradenitis suppurativa. Clin Dermatol 2023; 41:564-575. [PMID: 37696341 DOI: 10.1016/j.clindermatol.2023.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
Hidradenitis suppurativa (HS) is a chronic, inflammatory, recurrent skin disease affecting hair follicles in predominantly intertriginous areas, characterized by deep, painful nodules and abscesses, fistulas, sinus tracts, and scarring. The estimated global prevalence of HS is highly variable, as revealed in a growing body of published literature, and ranges from 0.053% to 4.1%. In North American and European patients, HS is three times more common in women than men, whereas in South Korea and Japan, male predominance is found. The disease most frequently manifests itself between the ages of 18 and 29. Numerous published studies have reported the association between smoking, obesity, and HS, although there are limitations in confirming the causal relationship due to the retrospective design of the available studies. Case-control studies have frequently evaluated the association between HS, metabolic syndrome, and other systemic comorbidities. Due to increased mental health problems, a higher risk of suicide in patients with HS has been reported. We provide up-to-date evidence about the epidemiology, genetic and environmental risk factors, comorbidities, and quality of life of patients with HS. The divergence in HS frequency, possibly due to differences in populations and methodologies, remains to be explained in future worldwide studies.
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Affiliation(s)
- Zrinka Bukvić Mokos
- School of Medicine University of Zagreb, University Hospital Centre Zagreb, Department of Dermatology and Venereology, European Reference Network (ERN) - Skin, Zagreb, Croatia
| | - Adela Markota Čagalj
- University Hospital Centre Split, Department of Dermatology and Venereology, School of Medicine, University of Split, Split, Croatia
| | - Branka Marinović
- School of Medicine University of Zagreb, University Hospital Centre Zagreb, Department of Dermatology and Venereology, European Reference Network (ERN) - Skin, Zagreb, Croatia.
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6
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Di Cesare A, Rosi E, Amerio P, Prignano F. Clinical and Ultrasonographic Characterization of Hidradenitis Suppurativa in Female Patients: Impact of Early Recognition of the Disease. Life (Basel) 2023; 13:1630. [PMID: 37629487 PMCID: PMC10455481 DOI: 10.3390/life13081630] [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: 07/03/2023] [Revised: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 08/27/2023] Open
Abstract
Hidradenitis suppurativa (HS) is considered a post-pubertal disease; however, earlier onset is not infrequent. The burden of HS on the female population is very relevant, and early identification might reduce the quality of life impairment and improve the therapeutic approach. In this study, we investigated clinical biomarkers of HS that could impact the management of patients affected by HS. Female patients affected by stable HS were prospectively included in this study. Anamnestic data, clinical and ultrasonographic features were collected and analyzed. Overall, 53 patients were included in this study. The median age of onset was 19 (IQR: 14-25). Early onset was reported by 22/53 patients (median age of onset: 14; IQR: 11-16). Four patients had pre-menstruation occurrence. Early-onset patients had an earlier first-menstrual-cycle age and more frequent genital localization of HS, and were more often treated with biologics. Patients with early-onset-HS and genital localization had more severe disease with a higher number of areas affected, Hurley, and IHS4 scores. Genital involvement might be prevalent in patients with early-onset HS, leading to a worse impact on the global severity of the disease and tailored treatment protocols, including multidisciplinary approaches, in order to improve the early recognition of hidden lesions.
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Affiliation(s)
- Antonella Di Cesare
- Section of Dermatology, Department of Health Sciences, University of Florence, 50122 Florence, Italy; (A.D.C.); (E.R.)
| | - Elia Rosi
- Section of Dermatology, Department of Health Sciences, University of Florence, 50122 Florence, Italy; (A.D.C.); (E.R.)
| | - Paolo Amerio
- Dermatologic Clinic, Department of Medicine and Ageing Science, “G. D’Annunzio” University, 66100 Chieti, Italy;
| | - Francesca Prignano
- Section of Dermatology, Department of Health Sciences, University of Florence, 50122 Florence, Italy; (A.D.C.); (E.R.)
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7
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Molinelli E, De Simoni E, Candelora M, Sapigni C, Brisigotti V, Rizzetto G, Offidani A, Simonetti O. Systemic Antibiotic Therapy in Hidradenitis Suppurativa: A Review on Treatment Landscape and Current Issues. Antibiotics (Basel) 2023; 12:978. [PMID: 37370297 DOI: 10.3390/antibiotics12060978] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/19/2023] [Accepted: 05/24/2023] [Indexed: 06/29/2023] Open
Abstract
Hidradenitis suppurativa (HS) is a chronic, recurrent, and inflammatory skin disease characterized by painful, deep-seated, nodules, abscesses, and sinus tracts in sensitive areas of the body, including axillary, inguinal, and anogenital regions. Antibiotics represent the first-line pharmacological treatment of HS because of their anti-inflammatory properties and antimicrobial effects. This narrative review summarizes the most significant current issues on the role of systemic antibiotics in the management of HS, critically analyzing the main limits of their use (antibiotic resistance and toxicity). Although, in the last decades, several cytokines have been implicated in the pathomechanism of HS and the research on the use of novel biologic agents in HS has been intensified, antibiotics remain a valid therapeutic approach. Future challenges regarding antibiotic therapy in HS comprise their use in association with biologics in the management of acute flare or as a bridge therapy to surgery.
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Affiliation(s)
- Elisa Molinelli
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60126 Ancona, Italy
| | - Edoardo De Simoni
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60126 Ancona, Italy
| | - Matteo Candelora
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60126 Ancona, Italy
| | - Claudia Sapigni
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60126 Ancona, Italy
| | - Valerio Brisigotti
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60126 Ancona, Italy
| | - Giulio Rizzetto
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60126 Ancona, Italy
| | - Annamaria Offidani
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60126 Ancona, Italy
| | - Oriana Simonetti
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60126 Ancona, Italy
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8
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Molinelli E, Gioacchini H, Sapigni C, Diotallevi F, Brisigotti V, Rizzetto G, Offidani A, Simonetti O. New Insight into the Molecular Pathomechanism and Immunomodulatory Treatments of Hidradenitis Suppurativa. Int J Mol Sci 2023; 24:ijms24098428. [PMID: 37176138 PMCID: PMC10179439 DOI: 10.3390/ijms24098428] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/19/2023] [Accepted: 04/19/2023] [Indexed: 05/15/2023] Open
Abstract
Hidradenitis suppurativa (HS) is an immune-mediated inflammatory disorder characterized by deep-seated nodules, abscesses, sinus tracts and scars localized in the intertriginous areas. It is accompanied by pain, malodourous secretion and a dramatically decreased quality of life. Although the pathogenesis has not been entirely elucidated, the primary event is follicular hyperkeratosis of the pilosebaceous apocrine unit. Since the registration of the tumor necrosis factor-alpha inhibitor Adalimumab in 2015, several cytokines have been implicated in the pathomechanism of HS and the research of novel therapeutic targets has been intensified. We provide an update on the inflammatory cytokines with a central role in HS pathogenesis and the most promising target molecules of future HS management.
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Affiliation(s)
- Elisa Molinelli
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60126 Ancona, Italy
| | - Helena Gioacchini
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60126 Ancona, Italy
| | - Claudia Sapigni
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60126 Ancona, Italy
| | - Federico Diotallevi
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60126 Ancona, Italy
| | - Valerio Brisigotti
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60126 Ancona, Italy
| | - Giulio Rizzetto
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60126 Ancona, Italy
| | - Annamaria Offidani
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60126 Ancona, Italy
| | - Oriana Simonetti
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60126 Ancona, Italy
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9
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Molinelli E, Sapigni C, Simonetti O, D'Agostino GM, Brisigotti V, Rizzetto G, Offidani A. Acitretin plus macrolides and acitretin monotherapy in the management of hidradenitis suppurativa. J Eur Acad Dermatol Venereol 2023; 37:e392-e394. [PMID: 36306173 DOI: 10.1111/jdv.18706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 10/25/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Elisa Molinelli
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Claudia Sapigni
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Oriana Simonetti
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Giovanni Marco D'Agostino
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Valerio Brisigotti
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Giulio Rizzetto
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Annamaria Offidani
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
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10
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Molinelli E, D'Agostino GM, Sapigni C, Gioacchini H, Brisigotti V, Rizzetto G, Offidani A, Simonetti O. Oral oxybutynin chloride therapy in the management of hidradenitis suppurativa: A prospective study. J Eur Acad Dermatol Venereol 2023; 37:e744-e746. [PMID: 36682048 DOI: 10.1111/jdv.18901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/16/2023] [Indexed: 01/23/2023]
Affiliation(s)
- Elisa Molinelli
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Giovanni Marco D'Agostino
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Claudia Sapigni
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Helena Gioacchini
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Valerio Brisigotti
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Giulio Rizzetto
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Annamaria Offidani
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Oriana Simonetti
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
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11
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Zou P, Du Y, Yang C, Cao Y. Trace element zinc and skin disorders. Front Med (Lausanne) 2023; 9:1093868. [PMID: 36733937 PMCID: PMC9887131 DOI: 10.3389/fmed.2022.1093868] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 12/28/2022] [Indexed: 01/18/2023] Open
Abstract
Zinc is a necessary trace element and an important constituent of proteins and other biological molecules. It has many biological functions, including antioxidant, skin and mucous membrane integrity maintenance, and the promotion of various enzymatic and transcriptional responses. The skin contains the third most zinc in the organism. Zinc deficiency can lead to a range of skin diseases. Except for acrodermatitis enteropathic, a rare genetic zinc deficiency, it has also been reported in other diseases. In recent years, zinc supplementation has been widely used for various skin conditions, including infectious diseases (viral warts, genital herpes, cutaneous leishmaniasis, leprosy), inflammatory diseases (hidradenitis suppurativa, acne vulgaris, rosacea, eczematous dermatitis, seborrheic dermatitis, psoriasis, Behcet's disease, oral lichen planus), pigmentary diseases (vitiligo, melasma), tumor-associated diseases (basal cell carcinoma), endocrine and metabolic diseases (necrolytic migratory erythema, necrolytic acral erythema), hair diseases (alopecia), and so on. We reviewed the literature on zinc application in dermatology to provide references for better use.
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Affiliation(s)
- Pan Zou
- Department of Dermatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuxin Du
- Department of Dermatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chunguang Yang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,*Correspondence: Chunguang Yang ✉
| | - Yuchun Cao
- Department of Dermatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,Yuchun Cao ✉
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12
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Molinelli E, Sapigni C, D’Agostino GM, Brisigotti V, Rizzetto G, Bobyr I, Cirioni O, Giacometti A, Brescini L, Mazzanti S, Offidani A, Simonetti O. The Effect of Dalbavancin in Moderate to Severe Hidradenitis Suppurativa. Antibiotics (Basel) 2022; 11:1573. [PMID: 36358228 PMCID: PMC9686733 DOI: 10.3390/antibiotics11111573] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/23/2022] [Accepted: 10/31/2022] [Indexed: 09/06/2023] Open
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by painful nodules, abscesses, and fistulas, localized to the areas of the folds where apocrine glands are present: the armpits, groin, inframammary region, and genital or perineal region. The management is still challenging, and it includes mainly systemic antibiotics, immunosuppressors, and biologic agents. Antibiotics are frequently used in the management of HS for their anti-inflammatory, immunomodulatory, and antimicrobial properties, but no data have been reported regarding the use of dalbavancin in HS. The aim of our practice was to evaluate efficacy, flare, and disease-free survival after dalbavancin therapy in a selected population with HS. We report the experience of the Ancona Dermatology Clinic in treating HS flare-ups with dalbavancin and its rationale for use. Our observation shows that the use of dalbavancin is an effective and well-tolerated treatment for the management of Hurley stage II-III HS; currently, dalbavancin should be considered as a supportive therapy for selected patients.
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Affiliation(s)
- Elisa Molinelli
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60121 Ancona, Italy
| | - Claudia Sapigni
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60121 Ancona, Italy
| | - Giovanni Marco D’Agostino
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60121 Ancona, Italy
| | - Valerio Brisigotti
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60121 Ancona, Italy
| | - Giulio Rizzetto
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60121 Ancona, Italy
| | - Ivan Bobyr
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60121 Ancona, Italy
| | - Oscar Cirioni
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60121 Ancona, Italy
| | - Andrea Giacometti
- Clinic of Infectious Diseases, Department of Biochemical Sciences and Public Health, Polytechnic University of the Marche Region, 60121 Ancona, Italy
| | - Lucia Brescini
- Clinic of Infectious Diseases, Department of Biochemical Sciences and Public Health, Polytechnic University of the Marche Region, 60121 Ancona, Italy
| | - Sara Mazzanti
- Clinic of Infectious Diseases, Department of Biochemical Sciences and Public Health, Polytechnic University of the Marche Region, 60121 Ancona, Italy
| | - Annamaria Offidani
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60121 Ancona, Italy
| | - Oriana Simonetti
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60121 Ancona, Italy
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Molinelli E, Sapigni C, Simonetti O, Radi G, Gambini D, Maurizi A, Rizzetto G, D'Agostino GM, Offidani A. Successfully and safety use of dupilumab in the management of severe atopic dermatitis and concomitant moderate-to-severe hidradenitis suppurativa. Dermatol Ther 2022; 35:e15645. [PMID: 35716015 PMCID: PMC9539466 DOI: 10.1111/dth.15645] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 06/13/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Elisa Molinelli
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Claudia Sapigni
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Oriana Simonetti
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Giulia Radi
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Daisy Gambini
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Andrea Maurizi
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Giulio Rizzetto
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Giovanni Marco D'Agostino
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Annamaria Offidani
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
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Molinelli E, Brisigotti V, Simonetti O, Sapigni C, D'Agostino GM, Rizzetto G, Giacchetti A, Offidani A. Efficacy and safety of topical resorcinol 15% versus topical clindamycin 1% in the management of mild‐to‐moderate hidradenitis suppurativa: a retrospective study. Dermatol Ther 2022; 35:e15439. [PMID: 35278025 PMCID: PMC9286535 DOI: 10.1111/dth.15439] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 12/11/2021] [Accepted: 03/07/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Elisa Molinelli
- Dermatological Unit, Department of Clinical and Molecular Sciences Polytechnic Marche University Ancona Italy
| | - Valerio Brisigotti
- Dermatological Unit, Department of Clinical and Molecular Sciences Polytechnic Marche University Ancona Italy
| | - Oriana Simonetti
- Dermatological Unit, Department of Clinical and Molecular Sciences Polytechnic Marche University Ancona Italy
| | - Claudia Sapigni
- Dermatological Unit, Department of Clinical and Molecular Sciences Polytechnic Marche University Ancona Italy
| | - Giovanni Marco D'Agostino
- Dermatological Unit, Department of Clinical and Molecular Sciences Polytechnic Marche University Ancona Italy
| | - Giulio Rizzetto
- Dermatological Unit, Department of Clinical and Molecular Sciences Polytechnic Marche University Ancona Italy
| | - Alfredo Giacchetti
- Dermatological Unit Institute for Treatment and Research (INRCA IRCCS) Ancona Italy
| | - Annamaria Offidani
- Dermatological Unit, Department of Clinical and Molecular Sciences Polytechnic Marche University Ancona Italy
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15
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Molinelli E, Sapigni C, Simonetti O, Brisigotti V, Giuliodori K, Offidani A. Alexandrite laser as an adjuvant therapy in the management of mild-moderate hidradenitis suppurativa: a controlled prospective clinical study. J Am Acad Dermatol 2021; 87:674-675. [PMID: 34774922 DOI: 10.1016/j.jaad.2021.10.060] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 08/06/2021] [Accepted: 10/13/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Elisa Molinelli
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Claudia Sapigni
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Oriana Simonetti
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy.
| | - Valerio Brisigotti
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Katia Giuliodori
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Annamaria Offidani
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
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16
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Molinelli E, Sapigni C, Campanati A, Brisigotti V, Offidani A. Metabolic, pharmacokinetic, and toxicological issues of biologic therapies currently used in the treatment of hidradenitis suppurativa. Expert Opin Drug Metab Toxicol 2020; 16:1019-1037. [PMID: 32896186 DOI: 10.1080/17425255.2020.1810233] [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] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Hidradenitis suppurativa is a chronic, relapsing, debilitating inflammatory dermatologic disease of the terminal hair follicles at intertriginous sites clinically characterized by painful inflammatory nodules, abscesses, draining sinus tracts, and dermal fibrosis. The management of hidradenitis suppurativa is a challenge and usually consists of both medical and surgical approaches, which must often be combined for best outcome. The introduction of biological therapies, specifically TNFα-inhibitors such as adalimumab, has profoundly changed the therapeutic armamentarium of the disease. AREAS COVERED The PubMed database was searched using combinations of the following keywords: hidradentis suppurativa, biologic therapy, TNF-α inhibitors, adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, adverse effects, pharmacodynamics, pharmacology, adverse events, pharmacokinetics, drug interaction. This article reviews and updates the chemistry, pharmacokinetics, mechanism of action, adverse effects, drug interactions of on-label and off-label use of TNF-α inhibitors in HS. EXPERT OPINION Biologic agents, particularly adalimumab, exhibit clinical efficacy in patients with hidradenitis suppurativa. Careful patient selection and close monitoring during treatment are mandatory to provide safe and effective use of the TNF-α inhibitor. Familiarity with biologic agents is crucial because these agents could become a consolidated treatment option in the clinician's therapeutic approaches.
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Affiliation(s)
- Elisa Molinelli
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University , Ancona, Italy
| | - Claudia Sapigni
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University , Ancona, Italy
| | - Anna Campanati
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University , Ancona, Italy
| | - Valerio Brisigotti
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University , Ancona, Italy
| | - Annamaria Offidani
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University , Ancona, Italy
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17
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Caposiena Caro RD, Molinelli E, Brisigotti V, Offidani A, Bianchi L. Lymecycline vs. clindamycin plus rifampicin in hidradenitis suppurativa treatment: clinical and ultrasonography evaluation. Clin Exp Dermatol 2020; 46:96-102. [PMID: 32683727 DOI: 10.1111/ced.14388] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 07/07/2020] [Accepted: 07/15/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Antibiotic therapy remains the first-line treatment for hidradenitis suppurativa (HS). However, literature data on its comparative clinical efficacy and safety are limited. AIM To investigate the efficacy of tetracycline (lymecycline 300 mg daily) vs. the combination therapy clindamycin and rifampicin (600 mg plus 600 mg daily) by evaluating and comparing the clinical response at the end of antibiotic treatment (10 weeks). METHODS The study retrospectively analysed 52 patients divided in two groups of 26 patients: Group A received lymecycline and Group B received clindamycin plus rifampicin for 10 weeks. Subjects had mild, moderate and severe HS. The clinical and ultrasonography extent of disease was measured by the Hurley Score, Sonographic Score of Hidradenitis Suppurativa, International Hidradenitis Suppurativa Severity Score System (IHS4), pain visual analogue scale (pain VAS) and Dermatology Life Quality Index (DLQI). The primary outcome was the clinical response at the end of the antibiotic treatment period, according to the Hidradenitis Suppurativa Clinical Response measure. RESULTS Both groups showed a significant improvement in IHS4, pain VAS and DLQI from baseline, but this was more marked in Group A. Reductions in nodule counts were similar between the two groups, whereas the number of abscesses and draining tunnels decreased more in Group B. Disease-free survival was similar between the two groups. CONCLUSION Lymecycline monotherapy and clindamycin plus rifampicin combination are both effective treatments for patients with moderate-severe HS. Nodular-type HS seems to respond better to lymecycline, whereas the abscess/tunnel type seems to respond better to clindamycin plus rifampicin.
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Affiliation(s)
- R D Caposiena Caro
- Dermatology Department, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - E Molinelli
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - V Brisigotti
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - A Offidani
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - L Bianchi
- Dermatology Department, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
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18
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Molinelli E, Diotallevi F, Simonetti O, Brisigotti V, Sapigni C, Radi G, Campanati A, Offidani A. Management of patients with hidradenitis suppurativa during the COVID-19 pandemic: Risk and benefit of immunomodulatory therapy. Dermatol Ther 2020; 33:e14256. [PMID: 32860474 DOI: 10.1111/dth.14256] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 08/04/2020] [Accepted: 08/16/2020] [Indexed: 01/20/2023]
Abstract
Coronavirus disease 2019 (COVID-19) is a clinical syndrome caused by a new coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Italy has been the first nation affected by the coronavirus pandemic and is the second in the number of reported deaths in the European Union. In the United Hospital of Ancona, a specialist outpatient clinic dealing with diagnosis and treatment of immunomediated skin diseases has been operating since 1985, and 291 patients with hidradenitis suppurativa (HS) are currently being treated. Several cutaneous immunomediated diseases, including HS, are treated with biologic and nonbiologic immunosuppressive and immunomodulatory drugs. Since the end of February 2020, when the SARS-CoV-2 pandemic had already spread in most of Italy, a task force comprised of seven specialists has been set up with the aim of addressing problems relating to the specific risk for this class of patients in relation to SARS-CoV-2 infection and immunosuppressive ongoing therapy. In this article, the management of HS disease during the COVID-19 pandemic is discussed. The main goal was to evaluate the risk/benefit in modulating treatment taking into consideration patients' risk of exposure to SARS-CoV-2 virus.
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Affiliation(s)
- Elisa Molinelli
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Federico Diotallevi
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Oriana Simonetti
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Valerio Brisigotti
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Claudia Sapigni
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Giulia Radi
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Anna Campanati
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Annamaria Offidani
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
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20
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Ingram JR. The epidemiology of hidradenitis suppurativa. Br J Dermatol 2020; 183:990-998. [PMID: 32880911 DOI: 10.1111/bjd.19435] [Citation(s) in RCA: 90] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2020] [Indexed: 12/19/2022]
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease defined clinically by multiple, painful inflammatory lesions occurring predominantly in flexural sites. Onset is typically soon after puberty; however, it remains unknown whether the menopause induces remission. In North American and European patients with HS the female-to-male ratio is approximately 3 : 1 but the ratio is 1 : 2 in South Korean patients. It may be that some elements of HS epidemiology cannot be generalized across all populations. Elements of HS epidemiology in the USA and Europe are well established, including strong associations with obesity and smoking, which may increase disease severity. There are associations between HS and other cardiovascular disease (CVD) risk factors, including type 2 diabetes and metabolic syndrome. People with HS have double the risk of death from CVD compared with those without HS and 1·5 times the risk compared with patients with psoriasis. Depression and anxiety are associated with HS and completed suicide rates in those with HS are more than double the rates in controls. Associations exist between HS and other chronic inflammatory conditions, particularly inflammatory bowel disease and inflammatory arthritis. Case-control studies demonstrate associations with pilonidal sinus, polycystic ovary syndrome, Down syndrome, obstructive sleep apnoea and pyoderma gangrenosum. Population-based studies using routinely collected healthcare data from the USA estimate a prevalence of 0·1%, suggesting HS is relatively uncommon. European studies include undiagnosed patients and typically estimate prevalence of 1% or more, suggesting a common condition. Resolving the controversy surrounding a greater than 10-fold difference in HS prevalence estimates remains a high priority.
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Affiliation(s)
- John R Ingram
- Department of Dermatology & Academic Wound Healing, Division of Infection and Immunity, Cardiff University, Cardiff, CF14 4XN, UK
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21
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Molinelli E, Brisigotti V, Simonetti O, Campanati A, Sapigni C, D'Agostino GM, Giacchetti A, Cota C, Offidani A. Efficacy and safety of topical resorcinol 15% as long-term treatment of mild-to-moderate hidradenitis suppurativa: a valid alternative to clindamycin in the panorama of antibiotic resistance. Br J Dermatol 2020; 183:1117-1119. [PMID: 32579711 DOI: 10.1111/bjd.19337] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/16/2020] [Accepted: 06/16/2020] [Indexed: 12/15/2022]
Affiliation(s)
- E Molinelli
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - V Brisigotti
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - O Simonetti
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - A Campanati
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - C Sapigni
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - G M D'Agostino
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - A Giacchetti
- Dermatological Unit, Institute for Treatment and Research INRCA IRCCS, Ancona, Italy
| | - C Cota
- Dermatological Unit, Institute for Treatment and Research INRCA IRCCS, Ancona, Italy
| | - A Offidani
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
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22
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Efficacy of oral zinc and nicotinamide as maintenance therapy for mild/moderate hidradenitis suppurativa: A controlled retrospective clinical study. J Am Acad Dermatol 2020; 83:665-667. [DOI: 10.1016/j.jaad.2020.04.092] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 04/17/2020] [Accepted: 04/17/2020] [Indexed: 01/16/2023]
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23
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Vaiopoulos AG, Nikolakis G, Zouboulis CC. Hidradenitis suppurativa in paediatric patients: a retrospective monocentric study in Germany and review of the literature. J Eur Acad Dermatol Venereol 2020; 34:2140-2146. [PMID: 32324936 DOI: 10.1111/jdv.16520] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 04/10/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is a chronic, inflammatory, recurrent, debilitating skin disease of the hair follicle affecting apocrine glands-rich areas of the body. The disease usually occurs after puberty leading to painful nodules, abscesses, tunnels and scarring. Although uncommonly, HS can also occur in children and adolescents. OBJECTIVE Our objective was to describe the epidemiology, characteristics, predisposing factors and clinical course of HS in paediatric patients. METHODS The retrospective cohort study included patients with HS, who have been diagnosed in Dessau Medical Center and reported development of HS during childhood or adolescence, fulfilled the diagnostic criteria for HS and had a follow-up period of at least one year. A systematic review was conducted on MEDLINE, EMBASE and CENTRAL on 19 March 2020 using the terms 'hidradenitis' or 'acne inversa' together with the terms 'children', 'paediatric' and 'adolescence'. RESULTS Twenty paediatric patients [1 child (0.22%), 19 adolescents (4.25%)] were detected out of 447 patients evaluated (4.5%) with a male to female ratio of 1.86 : 1. The median age at diagnosis was 17 years [interquartile range (IQR) 16-18] and the median age at onset 15 years (IQR: 14-16.5). The majority of the patients suffered from moderate disease were overweight or obese and non-smokers. The most common comorbid disorder was acne vulgaris. The systematic review revealed reports with data heterogeneity and lack of systematic documentation of specific demographic characteristics. Most paediatric patients were female, obese and non-smokers, with considerable comorbid disorders. CONCLUSIONS Hidradenitis suppurativa in Germany may affect children and adolescents exhibiting a particular phenotype of mainly male non-smokers.
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Affiliation(s)
- A G Vaiopoulos
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane, Dessau, Germany.,European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany
| | - G Nikolakis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane, Dessau, Germany.,European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany
| | - C C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane, Dessau, Germany.,European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany
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