Hidradenitis suppurativa and follicular occlusion syndrome: Where is the pathogenetic link?

The follicular occlusion tetrad complex encompasses several entities (hidradenitis suppurativa, acne conglobata, dissecting cellulitis of the scalp, and pilonidal cyst) that share common clinical features, risk factors, and pathophysiology. Follicular occlusion is a crucial triggering mechanism in the etiology in each of these disorders, leading to development of distinctive skin lesions such as deep-seated nodules, abscesses, comedones, and draining sinuses, often with accompanying scarring. Despite the fact that the follicular occlusion tetrad components manifest multiple similarities, they also exhibit many differences among themselves and require individual approaches and treatment.

The Composition of Subgingival Microbiome in Hidradenitis Suppurativa and Periodontitis Patients.

Hidradenitis suppurativa (HS) is a chronic inflammatory disorder of the pilosebaceous unit of the intertriginous body areas. Recent findings have suggested the association between periodontitis and HS. This investigation aimed to characterize and compare the composition of subgingival microbiome between HS, periodontitis, and control patients. The nine crucial perio-pathogenic species and total bacteria were analyzed using RT-PCR based tests in samples collected from 30 patients with periodontitis, 30 patients with HS and 30 controls. Patients with HS were excluded if they had periodontitis and patients with periodontitis were excluded if they had HS. The mean total bacteria count was significantly higher in HS and periodontitis samples than in control samples (p < 0.05). The majority of perio-pathogens tested were more frequently detected in HS and periodontitis groups than among controls. Treponema denticola was the most common pathogen in individuals with HS (70%) and periodontitis (86.7%), while among controls Capnocytophyga gingivalis was the most frequently detected isolate (33.2%). The results of the present investigation demonstrated that HS and periodontitis patients share some similarities in their subgingival microbiome composition.

The Prevalence of Periodontitis and Assessment of Oral Micro-Biota in Patients with Hidradenitis Suppurativa: A Descriptive Cross-Sectional Study.

Periodontitis has been causally connected with the development of other immune-mediated inflammatory disorders previously. Nevertheless, the current literature does not provide knowledge on oral health in hidradenitis suppurativa (HS) individuals. The aim of this study was to assess the prevalence of periodontitis and characterize an oral microbiome in HS patients. Fifty-five patients with HS and fifty-five healthy controls were enlisted in the study. The incidence of periodontitis was assessed in all patients during the periodontal evaluation. RT-PCR tests were used to quantification of bacterial content and assess the number and composition of nine crucial periodontal pathogens. HS patients had a significantly higher prevalence of periodontitis than healthy controls (45.5% versus 14.5%). Significantly higher values of average copy-count numbers of total bacteria were found in HS patients. The majority of periodontal pathogens were more frequently isolated in patients with HS than among controls. The most frequently detected pathogen in the HS group was Treponema denticola (70.9%), whereas among controls Capnocytophaga gingivalis (34.5%) was the most common isolate. There was no correlation between HS severity and the number of DNA copies of periodontal bacteria. The findings of this research suggest that periodontitis may contribute to the development of HS.

Basal cell carcinoma secondary to trauma: A 3-year experience of the single center.

BACKGROUND: Basal cell carcinoma (BCC) is the most frequent cancer worldwide in humans. The risk factors reported in the literature encompass excessive sun exposure, genetic predisposition, irradiation, exposure to arsenic, and trauma. The exact role of trauma in the etiology of BCC remains unexplained. OBJECTIVES: To analyze patients with BCC treated surgically in the Dermatosurgery Unit, looking for possible cases of BCC secondary to trauma. MATERIAL AND METHODS: We performed a retrospective review all of treated BCCs in the Dermatosurgery Unit between January 2017 and June 2020. RESULTS: Among 1,832 patients with BCC, 5 (0.27%) tumors had a positive history of previous trauma. Many different types of injuries have been associated with oncogenesis in the area of the scar. The clinical presentations of lesions varied between the patients. CONCLUSIONS: It is worth to underline that BCC may be located in the area of post-traumatic scar; however, the incidence seems to be lower comparing to reported previously (7.3-13%). This article illustrates the importance of exclusion malignancy in every non-healing lesion. A neoplasm may be difficult to differentiate from infection or local ischemia in the area of the scar. Prudent management of all clinically unclear lesions should include a biopsy.