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Hidradenitis suppurative

F B Pearce, K A Richardson
OBJECTIVE: Bilateral axillary hidradenitis is a chronic, suppurative, and scarring disease that is most effectively treated by complete excision of all hair-bearing tissues. We assessed our staged procedure for excision and placement of a split-thickness skin graft for bilateral axillary hidradenitis in terms of costs, outcomes, and timing of excision. METHOD: An IRB approved retrospective case analysis was performed on patients that underwent bilateral axillary hidradenitis skin excision with eventual placement of split-thickness skin grafting using the current LSUHSC/University Health hidradenitis surgical treatment protocol...
January 2, 2017: Journal of Wound Care
A Marzano, G Damiani, I Ceccherini, E Berti, M Gattorno, M Cugno
BACKGROUND: Pyoderma gangrenosum (PG) is a rare skin disease characterized clinically by ulcers with undermined borders, and histologically by neutrophil-rich infitrates. PG may occur alone, in syndromic forms or associated with systemic diseases as inflammatory bowel diseases and hematological or rheumatological disorders. OBJECTIVES: Although some autoinflammatory diseases present with PG, to date, a specific genetic background related to autoinflammation has not been proven for PG...
December 10, 2016: British Journal of Dermatology
Peter Theut Riis, Jurr Boer, Errol P Prens, Ditte M L Saunte, Inge E Deckers, Lennart Emtestam, Karin Sartorius, Gregor B E Jemec
BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the hair follicle. Standard practice of managing acute flares with corticosteroid injection lacks scientific evidence. OBJECTIVE: We sought to assess the outcomes of routine treatment using intralesional triamcinolone (triamcinolone acetonide 10 mg/mL) in the management of acute flares in HS. METHODS: This was a prospective case series evaluating the effect of intralesional corticosteroids for alleviation of acute flares in HS...
December 2016: Journal of the American Academy of Dermatology
M Ndiaye, M Taleb, B A Diatta, A Diop, M Diallo, S Diadie, N B Seck, S Diallo, M T Ndiaye, S O Niang, F Ly, A Kane, M T Dieng
INTRODUCTION: The etiologies of intertrigo in adults are numerous and different. The objective of our work was to study the epidemiological, clinical and the risk factors of intertrigo in adults. METHODS: We conducted a prospective study for a period of seven months in two Dermatology Units in Dakar (Senegal). All adults patient with intertrigo seen during this period who gave consent were included. RESULTS: One hundred and three patients with intertrigo were diagnosed with a hospital prevalence of 2...
August 20, 2016: Journal de Mycologie Médicale
Mohammad A Ursani, Joan Appleyard, Onome Whiteru
BACKGROUND Pyogenic arthritis, pyoderma gangrenosum (PG), acne, and suppurative hidradenitis (PA-PASH) syndrome has been linked to an auto-inflammatory pathway. We report a case that is an atypical presentation of a rare syndrome, which supports literature suggesting that different phenotypes of PG-related syndromes may be a variation of the same pathogenic spectrum. Interestingly, our patient displayed a positive proteinase-3 antibody (PR-3). The clinical relevance of this is unclear. In recent literature, antineutrophil cytoplasmic autoantibodies (ANCA) positivity has been reported in various inflammatory conditions other than ANCA-associated vasculitis (AAV)...
August 17, 2016: American Journal of Case Reports
S Faleri, K Feichtner, T Ruzicka
BACKGROUND: In recent years, acne has been described as a symptom of autoinflammatory diseases, such as PASH (pyoderma gangrenosum - PG, acne and suppurative hidradenitis - SH) and PAPASH (PG, acne, pyogenic arthritis, and SH). The pathogenesis of autoinflammatory diseases is not fully understood; however, based on the possible involvement of IL-1β, the recombinant human interleukin-1 receptor antagonist anakinra has been used in the treatment of certain autoinflammatory diseases. METHODS: We describe two patients with severe acne and associated symptoms which led to the diagnosis PAPASH and PASH syndrome and who were treated with anakinra...
November 2016: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
Suchismita Paul, Daniel Bach, Nicole R LeBoeuf, Phillip M Devlin, Adam D Lipworth
Hidradenitis suppurativa is a member of the follicular occlusion tetrad, along with acne conglobata, dissecting cellulitis of the scalp and pilodinal sinus. These conditions share common pathophysiologic features, including follicle occlusion, bacterial overgrowth, severe suppurative inflammation, scarring, and sinus tract formation. Treatment of severe cases is challenging, and a novel treatment modality would be of significant value. We describe a 46-year-old man who presented with a 15-year history of suppurative and scarring nodules involving his groin, scalp, neck, face, and chest...
November 2016: Dermatologic Therapy
S Tugnoli, V Bettoli, C Agnoli, S Caracciolo
Hidradenitis Suppurative-Acne Inversa is one of the most debilitating chronic skin diseases. It seriously affects the emotional and relational life of the patient, it has a significant psychiatric comorbidity and it impairs the quality of life. We present the report of a clinical situation with onset of the illness in a young woman during pregnancy, a case characterized by particular evolution, severe systemic involvement, strong psycho-emotional impact on the patient and impairment of subjective well-being of the caregiver...
May 2016: La Clinica Terapeutica
Natalia Mukai, Lílian Vital Pinheiro, Maria de Lourdes Setsuko Ayrizono, Guilherme Cardinali Barreiro, Paulo Kharmandayan, Mariana Hanayo Akinaga, Adriano Mesquita Bento, Carlos Augusto Real Martinez, Rita Barbosa de Carvalho, Marc Ward, Cláudio Saddy Rodrigues Coy, Raquel Franco Leal
INTRODUCTION: Chronic suppurative hidradenitis (CSH) is a benign condition that can affect the perineal region and often leads to the formation of abscesses and fistulas. It is rare for CSH to undergo malignant degeneration into mucinous adenocarcinoma. PRESENTATION OF CASE: We report a case of a 55-year-old male patient with perineal CSH who suffered worsening long-term pain despite multiple surgical procedures to alleviate his symptoms. Pelvic magnetic resonance imaging (MRI) showed multiloculated cystic lesion on the left side wall of the distal rectum with gluteal extension...
2016: International Journal of Surgery Case Reports
Eugènia Agut-Busquet, Jorge Romaní, Yolanda Gilaberte, Ana García-Malinis, Miquel Ribera-Pibernat, Jesús Luelmo
Hidradenitis suppurativa is a chronic inflammatory skin disease which has an estimated prevalence of 1%. It is characterized by the formation of recurrent painful suppurative nodules and abscesses in the flexural areas of the body. It is believed that its pathogenesis involves an aberrant, genetically-determined activation of innate immunity against the bacterial commensal flora of intertriginous areas. It has been found that the formation of antibiotic-resistant bacterial biofilms is a common finding in hidradenitis lesions...
August 4, 2016: Photochemical & Photobiological Sciences
Yoko Mizutani, Tomomi Okano, Tomoko Takahashi, Hidenori Ohnishi, Osamu Ohara, Akiyo Sano, Mariko Seishima
is missing (Short communication).
February 8, 2017: Acta Dermato-venereologica
A V Marzano, A Borghi, P L Meroni, M Cugno
Pyoderma gangrenosum is a rare inflammatory neutrophilic dermatosis manifesting as painful ulcers with violaceous, undermined borders on the lower extremities. It may occur in the context of classic syndromes like PAPA (pyogenic arthritis, pyoderma gangrenosum and acne) and SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis), as well as in a recently described entity named PASH (pyoderma gangrenosum, acne and suppurative hidradenitis). Pyoderma gangrenosum has recently been included within the spectrum of autoinflammatory diseases, which are characterized by recurrent episodes of sterile inflammation, without circulating autoantibodies and autoreactive T cells...
November 2016: British Journal of Dermatology
Dubravka Zivanovic, Iva Masirevic, Thomas Ruzicka, Markus Braun-Falco, Milos Nikolic
The clinical triad of pyoderma gangrenosum, acne conglobata and hidradenitis suppurativa has been named PASH syndrome. Polycystic ovary syndrome (PCOS) is associated with hyperandrogenism and inflammation. Hidradenitis suppurativa, like acne vulgaris, may be a feature of hyperandrogenism. Obesity may be associated with both hidradenitis suppurativa and PCOS. We describe a possible association between PASH syndrome and PCOS.
February 2, 2016: Australasian Journal of Dermatology
Vincenzo Bettoli, Olivier Join-Lambert, Aude Nassif
Although hidradenitis suppurativa (HS) is not primarily an infectious disease, antibiotics are widely used to treat HS. Recent microbiological data show that HS suppurating lesions are associated with a polymorphous anaerobic flora, including actinomycetes and milleri group streptococci, and can therefore be considered as polymicrobial soft tissue and skin infections. Analysis of the literature provides little information on the efficacy of antibiotics in HS but suggests a beneficial effect of certain antimicrobial treatments, depending on the clinical severity of the disease...
January 2016: Dermatologic Clinics
Olivier Join-Lambert, Hélène Coignard-Biehler, Jean-Philippe Jais, Maïa Delage, Hélène Guet-Revillet, Sylvain Poirée, Sabine Duchatelet, Vincent Jullien, Alain Hovnanian, Olivier Lortholary, Xavier Nassif, Aude Nassif
OBJECTIVES: Hidradenitis suppurativa (HS) is an inflammatory skin disease typically localized in the axillae and inguinal and perineal areas. In the absence of standardized medical treatment, severe HS patients present chronic suppurative lesions with polymicrobial anaerobic abscesses. Wide surgery is the cornerstone treatment of severe HS, but surgical indications are limited by the extent of lesions. Intravenous broad-spectrum antibiotics may help control HS, but their efficacy is not documented...
February 2016: Journal of Antimicrobial Chemotherapy
Olivier Join-Lambert, Sabine Duchatelet, Maïa Delage, Snaigune Miskinyte, Hélène Coignard, Nicolas Lemarchand, Murielle Alemy-Carreau, Olivier Lortholary, Xavier Nassif, Alain Hovnanian, Aude Nassif
Pyoderma gangrenosum, severe acne, and suppurative hidradenitis (PASH) syndrome can prove refractory to treatment and is characterized by relapses and recurrences. The combination of antibiotic therapy and surgery can produce success in the management of the syndrome. Acute treatment is required, but maintenance therapy is also necessary to prevent disease relapse. The response to antibiotic therapy is hypothesis generating, raising the issue of a modified host response. To date, anecdotal reports support the use of surgery and medical therapy, but controlled investigations with extended follow-up are necessary to substantiate preliminary data observed with individual cases...
November 2015: Journal of the American Academy of Dermatology
J Revuz
Treatment and long-term management of patients with chronic diseases require the use of instruments to measure severity and outcome. In the case of hidradenitis suppurativa, such instruments are currently poorly understood and utilised. Herein, we describe the main instruments, their scope of application, their qualities and their shortcomings. The Hurley classification, which was devised for surgical assessment and is limited to description of impairment at a given site, is too often used to assess overall severity in individual patients...
December 2015: Annales de Dermatologie et de Vénéréologie
Peter Theut Riis, K Søeby, D M Saunte, G B E Jemec
Hidradenitis is a chronic inflammatory skin disease with recurrent nodules, tunnels, scarring and suppuration of intertrigious areas. Hospital-treated HS patients have an increased risk of metabolic syndrome and a wide array of co-morbidities that possibly are related to systemic inflammation. Neutrophile to lymphocyte ratio has been suggested as a marker of systemic inflammation. Studies of psoriasis patients have found their neutrophile to lymphocyte ratio to be increased. In this study, routine blood samples collected during control visits from 50 HS patients are examined, and compared to routine blood samples from 250 age- and sex-matched dermatological outpatients...
December 2015: Archives of Dermatological Research
A Martorell, F J García, D Jiménez-Gallo, J C Pascual, J Pereyra-Rodríguez, L Salgado, E Villarrasa
Although hidradenitis suppurativa is a common and serious skin condition, its treatment is not well established. It is now accepted that the moderate and severe forms of the disease are associated with marked systemic inflammation. The goal of treatment in hidradenitis suppurative is therefore to achieve systemic control of inflammation. In some cases, surgery may also be necessary to reduce the severity of the manifestations of cutaneous inflammation. Recent advances in our understanding of hidradenitis suppurativa have been accompanied by the emergence of novel approaches to its treatment, including the use of certain biologic drugs...
November 2015: Actas Dermo-sifiliográficas
Ana Alberca-Páramo, Esther Pilar García-Santos, Susana Sánchez-García, Francisco Javier Ruescas-García, José Luis Bertelli-Puche, Jesús Martín-Fernández
BACKGROUND: Hidradenitis is a disorder where abscesses appear after the infection of the apocrine sweat glands. It is located normally in the axillae, groin, perineal region, and the scalp. CLINICAL CASE: A 37 year old male was referred by his GP to the General Surgery Department with axillary hidradenitis which had evolved over the years. The physical examination shows signs of hidradenitis in both axillae, with a noticeable suppurative hidradenitis in the right armpit...
May 2016: Cirugia y Cirujanos
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