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hidradenitis guidelines

Caroline Vinkel, Simon F Thomsen
Autoinflammatory syndromes associated with hidradenitis suppurativa (HS) and/or acne are rare but potentially debilitating disorders if not diagnosed and treated correctly. They share a common pathogenesis involving a dysregulated innate immune system with abnormal interleukin (IL)-1 signaling leading to sterile neutrophilic inflammation. The clinical features are recurrent episodes of fever, painful arthritis, and skin lesions consistent with HS, acne, and pyoderma gangrenosum (PG) accompanied by elevated systemic inflammatory markers in blood...
March 27, 2017: International Journal of Dermatology
J W Frew, D A Vekic, J Woods, G D Cains
INTRODUCTION: Hidradenitis Suppurativa (HS) is a severe chronic inflammatory disorder characterised by recurrent painful deep seated nodules with a predilection to the apocrine bearing areas of skin. A minority of cases of HS are due to mutations in the gamma secretase complex. Contention exists surrounding the pathogenicity of sequence variants and their effects upon notch signalling. METHODS: This systematic review was registered with PROSPERO (CRD42016041425) and was conducted in line with the PRISMA statement...
March 9, 2017: British Journal of Dermatology
R Kjærsgaard Andersen, Gregor B E Jemec
Hidradenitis suppurativa (HS) is not easily treated. Although not uncommon, HS is often misdiagnosed outside specialized clinics and inappropriately treated as a simple boil or abscess. In recent years, guidelines have been developed on the basis of expert opinion and the available literature. A multifaceted approach is necessary as HS lesions include both inflammation (amenable to medical treatment) as well as fibrosis (amenable to surgery only). The recommended antiinflammatory therapies encompass both antimicrobials and regular anti-inflammatory drugs...
March 2017: Clinics in Dermatology
Bader Hamza Shirah, Hamza Asaad Shirah
BACKGROUND: Hidradenitis suppurativa is a chronic inflammatory cutaneous disorder that involves the infundibular terminal follicles in areas rich in apocrine glands and associated with the formation of abscesses and fistulating sinus. The clinical course is variable, and definitive evidence-based guidelines for the management are not well-established. Conservative treatment is controversial, and surgical excision is the recommended method. Herein, we aim to analyze the results of a modified conservative tissue preserving management protocol for stage I axillary hidradenitis suppurativa...
December 16, 2016: Journal of Dermatological Treatment
Christina Fotiadou, Efstratios Vakirlis, Dimitrios Ioannides
Hidradenitis suppurativa (HS) is a chronic, recurrent, inflammatory skin disease that affects the hair follicles of the aprocrine gland-bearing anatomical areas of the body. It is characterized by deep painful nodules and abscesses that rupture and contribute to the formation of sinus tracks and scarring. The management of HS is based on the assessment of disease severity and a combination of medical and surgical treatment according to the European Guidelines. Adalimumab, a recombinant, fully humanized, anti-tumor necrosis factor alpha (anti-TNF-α) monoclonal antibody, is the only officially approved treatment for the management of moderate-to-severe HS...
2016: Clinical, Cosmetic and Investigational Dermatology
Georgios-Marios Makris, Nikiforita Poulakaki, Aristea-Maria Papanota, Evgenia Kotsifa, Theodoros N Sergentanis, Theodora Psaltopoulou
BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory disease that frequently involves the perineal and perianal regions. The association between HS and malignant transformation is a rare but under recognized phenomenon. OBJECTIVE: This systematic review aims to summarize all available cases of vulvar and perianal/perineal cancer emerging in patients with HS, describing clinical and therapeutic particularities of these coexisting conditions in female patients...
January 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
R Andersen, G B E Jemec
Hidradenitis suppurativa (HS) is difficult to treat. Official guidelines have only recently been developed, and suggest that patients should be provided with both adjuvant, medical and surgical therapy. The guidelines are the result of resurgent interest in this disease, in which etiology and pathogenesis are only partially understood at present. Recent research has, however, identified possible targets for specific intervention using biologicals. In addition, classical clinically driven developments of new treatments continue to evolve, leading to several interesting new therapies for HS patients...
August 2016: Drugs of Today
Hannah John, Nikolaos Manoloudakis, J Stephen Sinclair
AIM: To conduct a systematic review of the effectiveness of various types of lasers (and light based therapies) for the treatment of hidradenitis suppurativa (HS) and to establish recommendations based on our findings. DATA SOURCES: MEDLINE, Cochrane and PubMed databases. STUDY SELECTION: English language studies describing the use of laser for the treatment of HS. DATA EXTRACTION: Multiple reviewers performed independent extraction and identified 22 studies that met the inclusion and exclusion criteria...
October 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Wayne Gulliver, Christos C Zouboulis, Errol Prens, Gregor B E Jemec, Thrasivoulos Tzellos
Hidradenitis suppurativa/acne inversa (HS) is a chronic inflammatory skin disease characterized by painful, recurrent nodules and abscesses that rupture and lead to sinus tracts and scarring. To date, an evidence-based therapeutic approach has not been the standard of care and this is likely due to the lack of evidence based treatment guidelines. The purpose of this study was to promote a holistic evidence-based approach which implemented Level of Evidence and Strength of Recommendation for the treatment of HS...
September 2016: Reviews in Endocrine & Metabolic Disorders
M Megna, V Bettoli, S Chimenti, A Chiricozzi, L Naldi, A Virgili, G Girolomoni, G Monfrecola
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by nodules, abscesses and sinus tracts, primarily affecting the intertriginous areas. The occlusion of the upper part of the folliculopilosebaceous unit, leading to rupture of the sebofollicular canal with the consequent development of perifollicular lympho-histiocytic inflammation, is believed to be the initial pathogenic event in HS. Giving the chronic nature of HS, its destructive impact on social, working and daily life of patients, its management is often frustrating both for patients and physicians...
December 2015: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
Barbara Horváth, Ineke C Janse, Gary R Sibbald
Hidradenitis suppurativa (HS) is a chronic, relapsing, and painful inflammatory disease. HS patients' quality of life is severely impaired, and this impairment correlates strongly with their pain. Pain in HS can be acute or chronic and has both inflammatory and noninflammatory origins. The purpose of this review is to provide a summary of the existing literature regarding pain management in patients with HS. While there are no formal studies investigating pain management in HS, existing recommendations are based on general pain guidelines and expert opinion...
November 2015: Journal of the American Academy of Dermatology
Giulia Ganzetti, Anna Campanati, E Molinelli, A Offidani
Biologic treatments have modified the therapeutic armamentarium in the treatment of many dermatological and non- dermatological diseases and data on literature have widely focused on the efficacy and safety of TNF-alpha inhibitors in psoriasis. Although the etiopathogenesis has not completely elucidated, inflammation appears the lait motif unifying the immune-pathogenesis of diverse skin disease, as atopic dermatitis, alopecia areata and hidradenitis suppurativa. Actually, data on the off-label use of biologics in cutaneous immune-mediated inflammatory diseases are scarce and restricted to anecdotal cases and case series...
2016: Current Drug Safety
Elena Godoy-Gijón, Carmen Meseguer-Yebra, Lucía Palacio-Aller, Diego Vicente Godoy-Rocati, Carlos Lahoz-Rallo
The increased cardiovascular risk in some dermatological diseases has been demonstrated in recent decades. Diseases such as psoriasis and systemic lupus erythematosus are currently included in the guidelines for prevention of cardiovascular disease. Other diseases such as androgenic alopecia, polycystic ovary syndrome, hidradenitis suppurativa or lichen planus have numerous studies that point to an increased risk, however, they have not been included in these guidelines. In this article we review the evidence supporting this association, in order to alert the clinician to the need for greater control in cardiovascular risk factors in these patients...
May 2016: Clínica e Investigación en Arteriosclerosis
Monica Enamandram, James P Rathmell, Alexandra B Kimball
A number of chronic dermatologic conditions may necessitate long-term adjunctive pain management in addition to treatment of the primary skin disease, such as hidradenitis suppurativa, lichen planus, and other systemic diseases associated with significant pain. Adequate management of chronic pain can represent a unique challenge, but remains an integral component of clinical treatment in relevant contexts. For nociceptive pain of moderate to severe intensity, opioid analgesics can be beneficial when other pain management strategies have failed to produce adequate relief...
October 2015: Journal of the American Academy of Dermatology
C C Zouboulis, N Desai, L Emtestam, R E Hunger, D Ioannides, I Juhász, J Lapins, L Matusiak, E P Prens, J Revuz, S Schneider-Burrus, J C Szepietowski, H H van der Zee, G B E Jemec
Hidradenitis suppurativa/acne inversa (HS) is a chronic, inflammatory, recurrent, debilitating skin disease of the hair follicle that usually presents after puberty with painful, deep-seated, inflamed lesions in the apocrine gland-bearing areas of the body, most commonly the axillae, inguinal and anogenital regions. A mean disease incidence of 6.0 per 100,000 person-years and an average prevalence of 1% has been reported in Europe. HS has the highest impact on patients' quality of life among all assessed dermatological diseases...
April 2015: Journal of the European Academy of Dermatology and Venereology: JEADV
J L Blok, M Boersma, J B Terra, J R Spoo, F W J Leeman, E R van den Heuvel, J Huizinga, M F Jonkman, B Horváth
BACKGROUND: Treatment of hidradenitis suppurativa (HS) is a difficult undertaking, especially as there is no consensus on what surgical technique is preferred. At our centre severe HS (Hurley II/III) is operated under general anaesthesia, mostly with the STEEP procedure. OBJECTIVES: To investigate characteristics, surgical outcomes and patient satisfaction of HS patients who underwent deroofing or STEEP under general anaesthesia. METHODS: A clinical records-based retrospective analysis was conducted of all patients who had surgery under general anaesthesia between 1999 and 2013...
August 2015: Journal of the European Academy of Dermatology and Venereology: JEADV
A Barbaud
Dermatoses have been better characterized as hypochromic vitiligo in subjects with dark skin or the acquired racquet nails associated with hyperparathyroidism. The innate immunity has a central role in the new classification of auto inflammatory diseases, neutrophilic dermatoses, neutrophilic urticaria or pseudo-neutrophilic urticaria. Comorbidities have been studied e.g. cardiovascular co morbidities for psoriasis, IBD associated with hidradenitis suppurativa or neurological disorders associated with pemphigoid...
December 2014: Annales de Dermatologie et de Vénéréologie
R J Borgonjen, J J E van Everdingen, P C M van de Kerkhof, Ph I Spuls
BACKGROUND: Clinical practice guideline (CPG) development starts with selecting appropriate topics, as resources to develop a guideline are limited. However, a standardized method for topic selection is commonly missing and the way different criteria are used to prioritize is not clear. OBJECTIVES: To select and prioritize dermatological topics for CPG development and elucidate criteria dermatologists find important in selecting guideline topics. METHODS: All 410 dermatologists in the Netherlands were asked to create a top 20 of dermatological topics for which a guideline would be desirable, regardless of existing guidelines...
August 2015: Journal of the European Academy of Dermatology and Venereology: JEADV
Jessica B Chang, Theodore A Kung, Paul S Cederna
Marjolin's ulcers are rare cutaneous malignancies that most commonly present as squamous cell carcinomas in previously injured, chronically inflamed, or scarred skin. Acute and chronic types have been distinguished by the length of latency; by definition, the acute type occurs within 12 months of injury whereas the chronic type appears over 12 months after injury. In this report, 3 cases of acute Marjolin's ulcers are described and questions are raised about the diagnosis of acute Marjolin's ulcer. Other than a discrepancy in lag time, it is unclear if there is any difference in clinical or histological characteristics or even prognosis between acute and chronic Marjolin's ulcers...
May 2014: Annals of Plastic Surgery
Daniel A Gold, Virginia J Reeder, Meredith G Mahan, Iltefat H Hamzavi
BACKGROUND: Metabolic syndrome is a multifaceted disorder strongly associated with increased risk for development of cardiovascular disease. Chronic inflammatory diseases have been associated with metabolic syndrome. Hidradenitis suppurativa is a chronic inflammatory skin disease with significant physical and emotional sequelae. OBJECTIVE: We sought to investigate a possible association between hidradenitis suppurativa and metabolic syndrome. METHODS: A retrospective chart review of all dermatology clinic encounters over an 18-month period identified 366 patients with an appropriate diagnosis of hidradenitis suppurativa...
April 2014: Journal of the American Academy of Dermatology
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