RESUMEN
A 6-month-old girl with an isolated bald spot was seen at the general practice. We diagnosed aplasia cutis congenita, a rare disorder with a wide variation in clinical symptoms. Most lesions can be managed conservatively. Larger defects, however, require surgery.
Asunto(s)
Displasia Ectodérmica , Enfermedades Raras , Cuero Cabelludo , Alopecia/diagnóstico , Alopecia/etiología , Displasia Ectodérmica/diagnóstico , Displasia Ectodérmica/patología , Displasia Ectodérmica/cirugía , Familia , Femenino , Humanos , Lactante , Cuero Cabelludo/patologíaAsunto(s)
Eficiencia , Hidradenitis Supurativa/complicaciones , Presentismo/estadística & datos numéricos , Adulto , Ansiedad/epidemiología , Ansiedad/etiología , Ansiedad/psicología , Estudios Transversales , Depresión/epidemiología , Depresión/etiología , Depresión/psicología , Femenino , Hidradenitis Supurativa/diagnóstico , Hidradenitis Supurativa/psicología , Humanos , Masculino , Persona de Mediana Edad , Dolor/diagnóstico , Dolor/epidemiología , Dolor/etiología , Dolor/psicología , Dimensión del Dolor , Calidad de Vida , Factores de Riesgo , Índice de Severidad de la EnfermedadAsunto(s)
Hidradenitis Supurativa/clasificación , Hidradenitis Supurativa/patología , Autoevaluación (Psicología) , Encuestas y Cuestionarios , Centros Médicos Académicos , Adulto , Factores de Edad , Progresión de la Enfermedad , Femenino , Hidradenitis Supurativa/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Países Bajos , Variaciones Dependientes del Observador , Pacientes Ambulatorios/estadística & datos numéricos , Reproducibilidad de los Resultados , Índice de Severidad de la Enfermedad , Factores SexualesRESUMEN
BACKGROUND: Hidradenitis suppurativa (HS) is a chronic debilitating disease, whereby school attendance and employment can be disturbed. OBJECTIVE: We sought to determine the socioeconomic status (SES) in patients with HS relative to other dermatologic patients, and whether specific clinical HS characteristics correlate with SES. METHODS: For this multicenter cross-sectional reference study, data were collected from patients with HS and sex- and age-matched dermatologic patients in a 1:2 ratio. SES was derived from the mean household income and real estate value on a neighborhood level. RESULTS: The SES distribution among 1018 patients with HS was significantly lower than among 2039 age- and sex-matched dermatologic control patients (P < .001). In patients with HS a low SES was associated with axillary involvement (odds ratio 1.42, P = .04), high body mass index (odds ratio 1.03, P = .003), and lower age at inclusion (odds ratio 0.98, P = .001), but not with disease severity or age of disease onset. LIMITATIONS: SES was based on postal code level and causality cannot be determined. CONCLUSION: In the general population, low SES is associated with an unhealthy lifestyle such as smoking and obesity. Therefore, low SES might be a risk factor for developing HS.
Asunto(s)
Hidradenitis Supurativa/diagnóstico , Hidradenitis Supurativa/epidemiología , Renta/estadística & datos numéricos , Factores Socioeconómicos , Adulto , Distribución por Edad , Análisis de Varianza , Estudios Transversales , Femenino , Humanos , Incidencia , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Países Bajos/epidemiología , Obesidad/complicaciones , Obesidad/epidemiología , Pronóstico , Estudios Retrospectivos , Medición de Riesgo , Índice de Severidad de la Enfermedad , Distribución por Sexo , Fumar/efectos adversos , Fumar/epidemiologíaRESUMEN
BACKGROUND: Hidradenitis suppurativa (HS) has recently been associated with inflammatory bowel disease (IBD). The objective of this study is to investigate the prevalence of HS in IBD and to identify clinical and genetic parameters associated with HS in IBD. METHODS: A questionnaire, validated for HS, was sent to 1969 patients suffering from IBD. RESULTS: The prevalence of HS in our IBD cohort (1260 participating patients) was significantly higher than in the general population (6.8%-10.6% versus 1%-2%). IBD patients with HS were affected by IBD significantly earlier and more often treated with anti-TNF-α therapy and surgical resection compared to IBD without HS. Female gender, smoking, a higher body mass index, and younger age were independent associated parameters for HS. Within cases allelic association analysis was performed for 59 cases (IBD with HS) and 293 controls (IBD without HS). We observed 2 promising new associations in genomic regions harboring ELOVL7 (rsnumber 10057395 P = 7.15 × 10, odds ratio = 0.4), and in the intergenic region between SULT1B1 and SULT1E1 (rsnumber 2014777 P = 7.48 × 10, odds ratio = 2.3). CONCLUSIONS: HS is present in 6.8% to 10.6% of IBD patients. Co-morbid HS is associated with an early onset of IBD in which anti-tumor necrosis factor-α therapy and surgical resections are often needed. We identified a suggestive protective association with ELOVL7 and suggestive risk association with the genes SULT1B1 and SULT1E1 for HS, in the context of IBD. These genetic associations need further exploration and replication in additional independent cohorts.
Asunto(s)
Estudios de Asociación Genética , Hidradenitis Supurativa/epidemiología , Hidradenitis Supurativa/patología , Enfermedades Inflamatorias del Intestino/fisiopatología , Comorbilidad , Femenino , Estudios de Seguimiento , Hidradenitis Supurativa/genética , Humanos , Masculino , Persona de Mediana Edad , Países Bajos/epidemiología , Pronóstico , Encuestas y CuestionariosRESUMEN
Hidradenitis suppurativa is difficult to treat owing to its complex pathomechanism; beside the extensive inflammation with abscesses and inflammatory nodules, there is also an architectural loss with sinus tract formation and in severe cases with extensive scarring. Therefore, surgery is mandatory in moderate and severe HS.
Asunto(s)
Hidradenitis Supurativa/cirugía , Cicatriz , Contractura , Disección , Drenaje , Humanos , Complicaciones Posoperatorias , Índice de Severidad de la Enfermedad , Técnicas de Cierre de HeridasAsunto(s)
Procedimientos Quirúrgicos Dermatologicos , Electrocirugia/métodos , Hidradenitis Supurativa/cirugía , Antiinflamatorios/uso terapéutico , Procedimientos Quirúrgicos Dermatologicos/efectos adversos , Electrocirugia/efectos adversos , Hidradenitis Supurativa/diagnóstico , Humanos , Satisfacción del Paciente , Estudios Prospectivos , Recurrencia , Factores de Tiempo , Resultado del Tratamiento , Cicatrización de HeridasRESUMEN
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. Documentation of pain requires an assessment of the severity and timing of the pain. Although anti-inflammatory drugs and surgery for HS can alleviate pain, adjunctive pain medications are typically necessary. Topical analgesics, oral acetaminophen, and oral nonsteroidal anti-inflammatory drugs are considered first-line agents for the treatment of pain in patients with HS. If pain management is ineffective with those agents, oral opiates can be considered. In addition, anticonvulsants and selective serotonin reuptake inhibitors/serotonin-norepinephrine reuptake inhibitors possess neuropathic pain-relieving properties that offer not only control of HS-associated pain but beneficial effects on itch and depression. There is clearly a need for additional studies on pain management in patients with HS.