RESUMO
Hidradenitis suppurativa (HS) is a chronic, recurrent, inflammatory disease associated with a high physical and psychological burden. It is a disorder of the infundibular segment of the pilosebaceous unit, characterized by subcutaneous nodules, abscesses, sinus tracts and scar formation on the intertriginous and apocrine-bearing areas. HS is quite rare in young and prepubertal children. It usually begins after puberty, but several reports of prepubertal HS onset have been described. These cases are strongly linked to hormonal disorders and genetic susceptibility. Specific guidelines for prepubertal patients are still lacking, so further studies are warranted to better delineate a tailored approach. This paper aims to summarize the most significant aspects, as well as the most recent information about the epidemiology, pathogenesis, clinical features, diagnosis, comorbidities and treatment of paediatric HS. In addition, we report our clinical experience in managing HS in a group of eight prepubertal patients based on systemic antibiotics (azithromycin) and zinc oral supplementation.
Assuntos
Antibacterianos/uso terapêutico , Hidradenite Supurativa/tratamento farmacológico , Azitromicina/uso terapêutico , Criança , Clindamicina/uso terapêutico , Quimioterapia Combinada , Feminino , Predisposição Genética para Doença , Hidradenite Supurativa/complicações , Hidradenite Supurativa/epidemiologia , Hidradenite Supurativa/genética , Humanos , Hiperandrogenismo/complicações , Hiperinsulinismo/complicações , Guias de Prática Clínica como Assunto , Puberdade Precoce/complicaçõesAssuntos
Doença das Coronárias/tratamento farmacológico , Antagonistas Adrenérgicos beta/uso terapêutico , Idoso , Angina Pectoris/tratamento farmacológico , Anticoagulantes/uso terapêutico , Aspirina/uso terapêutico , Bloqueadores dos Canais de Cálcio/uso terapêutico , Doença das Coronárias/mortalidade , Digitalis , Diuréticos/uso terapêutico , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/tratamento farmacológico , Plantas Medicinais , Plantas Tóxicas , Agregação Plaquetária/efeitos dos fármacos , Fatores de Tempo , Vasodilatadores/uso terapêuticoAssuntos
Lipídeos , Membranas , Mitocôndrias Musculares , Miocárdio , Fosfolipídeos , Animais , Bovinos , Fenômenos Químicos , Físico-Química , Íons , Mitocôndrias Musculares/enzimologia , Proteínas Musculares , Miocárdio/citologia , Fósforo , Cloreto de Sódio , Solubilidade , Glycine max , Succinato Desidrogenase , Temperatura , Fatores de TempoRESUMO
Rats were fed a low protein diet deficient in and supplemented with lysine and threonine. Liver lipids contained more lecithin, sphingomyelin, and free fatty acids, and less amino phospholipids in the deficient rats. No variations in fatty acid composition of choline- and ethanolamine-containing phospholipids were found; only palmitic acid was increased in the serine-containing phospholipids of the deficient animals. The incorporation of acetate-(14)C into phospholipids, but not into other liver lipids, was lower in deficient rats. In the plasma of deficient rats the concentration of esterified fatty acids and phospholipids was lower, of free fatty acids higher, than in the controls. The fatty acid composition of depot fat differed from that of liver neutral fat both in deficient and supplemented animals. The results presented establish that multiple metabolic defects resulting from lysine and threonine deficiency accompany the fatty liver. The design of the experiments does not permit conclusions to be drawn regarding the causal relationship between the various alterations in lipid metabolism and the fatty liver.