Presentation
[…] of these 2 diseases presents a further therapeutic challenge. [mdedge.com]
[…] until after puberty begins, [44] Hidradenitis suppurativa is not present in eunuchs or eunuchoids, and hidradenitis suppurativa may occur as the presenting feature of premature adrenarche. [45] Also, antiandrogen therapy is of some benefit in patients [emedicine.medscape.com]
Endocrine basis for the clinical presentation of hidradenitis suppurativa. Br J Surg. 1988; 75 (10): 972-5. [ Links ] 19 Canoui-Poitrine F, Revuz JE, Wolkenstein P, Viallette C, Gabison G, Pouget F, et al. [scielo.cl]
[…] tracts, scars); 2) characteristic distribution or typography of lesions (intertriginous areas, axillae, inframammary folds, groins, buttocks, perianal and perineal areas); and 3) a relapsing, chronic disease course.29 The prototypic patient with HS presents [ncbi.nlm.nih.gov]
Entire Body System
- Sepsis
Erysipelas and sepsis following soft tissue infection have been reported in rare cases. Impaired joint mobility due to extensive fibrosis and scarring can occur, especially in the axillary region. [ncbi.nlm.nih.gov]
- Anemia
Additional complications resulting from prolonged systemic inflammation include anemia, hypoalbuminemia, and AA amyloidosis leading to kidney failure.10,34 The intense pain, malodorous discharge, and disfiguring lesions in intimate places make HS a burdensome [ncbi.nlm.nih.gov]
- Amyloidosis
Additional complications resulting from prolonged systemic inflammation include anemia, hypoalbuminemia, and AA amyloidosis leading to kidney failure.10,34 The intense pain, malodorous discharge, and disfiguring lesions in intimate places make HS a burdensome [ncbi.nlm.nih.gov]
- Fatigue
[…] ulcerative lesions and formation of endoanal fistulas possibly involving the anal sphincter are characteristic for CD and not HS.10,40 Malignancies (primary or metastatic) are usually accompanied by systemic signs of cancer (e.g., unexplained weight loss, fatigue [ncbi.nlm.nih.gov]
Respiratoric
- Pneumonia
Cultures from the sinus tracts showed abundant growth of Enterobacter aerogenes, Klebsiella pneumoniae, Enterobacter cloacae, and Proteus mirabilis. [mdedge.com]
Skin
- Papule
HS is characterised clinically by: Open double-headed comedones Painful firm papules and nodules Pustules, fluctuant pseudocysts, and abscesses Draining sinuses linking inflammatory lesions Hypertrophic and atrophic scars. [dermnetnz.org]
[…] smaller than 1 cm in diameter Painful and/or tender erythematous nodules larger than 1 cm in diameter Painful or tender abscesses and inflamed discharging papules or nodules Dermal contractures and ropelike elevation of the skin Double-ended comedones [emedicine.medscape.com]
Workup
See Workup for more detail. [emedicine.medscape.com]
Treatment
The patient reported no adverse effects during or after each treatment. [mdedge.com]
Early diagnosis and treatment are required to minimise lasting damage. [dermnetnz.org]
Update on Hidradenitis Suppurative (Part II): Treatment. Actas Dermosifiliogr. 2015; 106 (9): 716-24. [ Links ] 99 Harrison BJ, Mudge M, Hughes LE. Recurrence after surgical treatment of hidradenitis suppurativa. [scielo.cl]
Consensus on the treatment of hidradenitis suppurativa – Brazilian society of dermatology. [revistamedicasinergia.com]
Prognosis
Risk factors, clinical course and long-term prognosis in hidradenitis suppurativa: a cross-sectional study. Br J Dermatol 2014;171:819–24. Shlyankevich J, Chen AJ, Kim GE et al. [hs-online.be]
No single treatment has shown overwhelmingly positive outcomes. [60] Spontaneous resolution is rare. [7] Specific factors appear to influence the prognosis. Larger excisions may offer a better outcome. [emedicine.medscape.com]
Risk factors, clinical course and long-term prognosis in hidradenitis suppurativa: a cross-sectional study. Br J Dermatol. 2014;171(4):819–824. [PubMed] [Google Scholar] 29. Revuz JE, Jemec GBE. Diagnosing hidradenitis suppurativa. [ncbi.nlm.nih.gov]
Etiology
References Pyoderma gangrenosum (PG) and hidradenitis suppurativa (HS) are rare chronic inflammatory dermatoses of unknown etiologies that often are refractory to conventional treatments. [mdedge.com]
However, the unknown etiology and recurrent nature of HS complicates efficient disease management. [ncbi.nlm.nih.gov]
Etiology of Hidradenitis Suppurativa The exact etiology of hidradenitis suppurativa remains obscure. [emedicine.medscape.com]
Epidemiology
Jemec Medicine Journal of cutaneous medicine and surgery 2003 The epidemiology, risk factors, pathogenesis, and treatment of this disease are summarized to help clinicians with practical patient management and remain a clinical challenge to patients and [semanticscholar.org]
Hidradenitis suppurativa: Epidemiology and scope of the problem. J Am Acad Dermatol. 2015; 73 (5 Suppl 1): S4-7. [ Links ] 7 Goldburg SR, Strober BE, Payette MJ. Hidradenitis suppurativa: Epidemiology, clinical presentation, and pathogenesis. [scielo.cl]
Hidradenitis suppurativa: Epidemiology and scope of the problem. J Am Acad Dermatol. 2015;73(5 Suppl 1):S4-7. [ Links ] 27. Kokolakis G, Wolk K, Schneider-Burrus S, Kalus S, Barbus S, Gomis-Kleindienst S, et al. [scielo.isciii.es]
EPIDEMIOLOGY HS has been an overlooked disease for decades, and as a result, epidemiologic data are sparse. [ncbi.nlm.nih.gov]
Moreover, epidemiological data also suggest an association of hidradenitis suppurativa with other diseases, including metabolic syndrome. [emedicine.medscape.com]
Pathophysiology
Pathophysiology Hidradenitis suppurativa (HS) has traditionally been considered a disorder of the apocrine glands. [emedicine.medscape.com]
[…] depression, sexual dysfunction, and work disability contributes to increased sick leave and a significant quality of life impairment which exceeds that of other disabling skin disorders.4–6 TREATMENT Treatment of HS is challenging due to the lack of pathophysiologic [ncbi.nlm.nih.gov]
Prevention
Case Report A 51-year-old man was transferred to our institution from an outside hospital where he had presented with fevers and a worsening rash that had prevented him from ambulating for several days secondary to severe pain. [mdedge.com]
Early diagnosis and treatment are essential to prevent morbidity (physical and psychological) related to untreated disease and to improve quality of life in patients. [ncbi.nlm.nih.gov]