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1.
Medicine (Baltimore) ; 99(5): e18991, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32000436

RESUMO

INTRODUCTION: Hidradenitis suppurativa is a complex, chronic, difficult to treat condition belonging to the spectrum of cutaneous immune-mediated inflammatory diseases. Systemic treatment options for moderate-severe disease are limited to TNF-alpha antagonists and other biologic agents, with limited clinical evidence. PATIENT CONCERNS: We report two adult patients with severe hidradenitis suppurativa presenting concomitant psoriatic arthritis and multiple medical comorbidities. Both were ineligible or resistant to adalimumab, the only biologic drug approved for the treatment of hidradenitis. DIAGNOSIS: Both patients were diagnosed with severe Hurley III-stage disease and psoriatic arthritis, showing resistance to first-line systemic treatments and a complex comorbidity profile. INTERVENTIONS: Patients underwent treatment with apremilast, an oral phosphodiesterase-4 inhibitor, approved for the treatment of psoriatic arthritis. OUTCOMES: After 16 weeks of treatment, a clinically relevant improvement of inflammatory lesions, skin- and arthritis-related pain, and patient-reported outcomes was achieved in both patients. Apremilast was well tolerated and continued up to 48 weeks of treatment. CONCLUSION: We report the "real-life" use of apremilast in the treatment of multimorbid patients with hidradenitis suppurativa and review its potential role in the management of this severe condition.


Assuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Artrite Psoriásica/tratamento farmacológico , Hidradenite Supurativa/tratamento farmacológico , Talidomida/análogos & derivados , Idoso , Artrite Psoriásica/complicações , Hidradenite Supurativa/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Talidomida/uso terapêutico
2.
Dis Colon Rectum ; 62(11): 1278-1280, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31596759

RESUMO

CASE SUMMARY: A 66-year-old obese (BMI 34) diabetic man, a former smoker who had quit 4 months ago, had a 20-year history of perianal, inguinal, and gluteal hidradenitis suppurativa. He presented to the office with persistent perianal and gluteal inflammation and drainage. He had had various surgical excisions of the affected area over the preceding 10 years. The patient was also following up with dermatology and was previously on doxycycline and infliximab with little improvement in his symptoms. On physical examination of his gluteal and perianal region, he had multiple areas of scarring and draining sinus tracts with significant induration ( and ). The patient underwent extensive unroofing of the sinus tracts and excision of active disease ().(Figure is included in full-text article.)(Figure is included in full-text article.)(Figure is included in full-text article.).


Assuntos
Antibacterianos/uso terapêutico , Tratamento Conservador/métodos , Diabetes Mellitus Tipo 2/complicações , Hidradenite Supurativa , Obesidade/complicações , Procedimentos Cirúrgicos Operatórios/métodos , Idoso , Canal Anal/patologia , Glândulas Apócrinas/patologia , Índice de Massa Corporal , Nádegas/patologia , Nádegas/cirurgia , Diagnóstico Diferencial , Hidradenite Supurativa/complicações , Hidradenite Supurativa/diagnóstico , Hidradenite Supurativa/fisiopatologia , Hidradenite Supurativa/terapia , Humanos , Masculino , Obesidade/diagnóstico , Administração dos Cuidados ao Paciente/métodos , Seleção de Pacientes
3.
J Dermatol ; 46(9): 745-751, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31282051

RESUMO

Hidradenitis suppurativa (HS) is a chronic skin disease characterized by recurrent painful inflamed nodules/abscesses and draining fistulas that negatively impact quality of life. Adalimumab, a monoclonal antibody against tumor necrosis factor-α, has been approved in the EU, USA and Japan for the treatment of moderate to severe HS. This is an interim analysis of an ongoing phase 3, multicenter, open-label, single-arm study of the safety and efficacy of adalimumab weekly dosing in Japanese patients with moderate to severe HS. Fifteen patients received adalimumab 160 mg at week 0, 80 mg at week 2 and 40 mg every week thereafter starting at week 4. The fulfillment of Hidradenitis Suppurativa Clinical Response was assessed under adalimumab treatment; clinical response was assessed by skin pain, total abscess and inflammatory nodule count and modified Sartorius score; and quality of life and safety were assessed. At week 12, 86.7% of patients achieved clinical response, with improvements at week 12 across the primary and secondary end points generally sustained through week 24. Adalimumab weekly dosing was generally safe and well tolerated with no new safety findings through week 24. These results suggest that adalimumab is effective and well tolerated in Japanese patients with moderate to severe HS.


Assuntos
Adalimumab/administração & dosagem , Hidradenite Supurativa/tratamento farmacológico , Dor/tratamento farmacológico , Adalimumab/efeitos adversos , Adulto , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Hidradenite Supurativa/complicações , Hidradenite Supurativa/diagnóstico , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Dor/diagnóstico , Dor/etiologia , Medição da Dor , Satisfação Pessoal , Qualidade de Vida , Índice de Gravidade de Doença , Inquéritos e Questionários/estatística & dados numéricos , Resultado do Tratamento
4.
BMC Dermatol ; 19(1): 11, 2019 07 23.
Artigo em Inglês | MEDLINE | ID: mdl-31337387

RESUMO

BACKGROUND: Hidradenitis suppurativa is one member of the follicular occlusion triad: acne conglobata, hidradenitis suppurativa, and dissecting cellulitis of the scalp. The presence of acantholysis and desmoglein autoantibodies in hidradenitis suppurativa is rare. CASE PRESENTATION: We report a case of 68-year-old male with a diagnosis of gluteal hidradenitis suppurativa co-presenting pemphigus-like findings including acantholysis and positive desmoglein autoantibodies. CONCLUSION: To our knowledge, comorbidity of gluteal hidradenitis suppurativa and pemphigus-like findings has not been reported before. This case implies a relationship between two different conditions; the follicular occlusion triad and pemphigus, highlighting a potential induction of pemphigus-like lesion by chronic inflammatory process.


Assuntos
Acantólise/imunologia , Autoanticorpos/sangue , Hidradenite Supurativa/diagnóstico , Pênfigo/diagnóstico , Acantólise/diagnóstico , Acne Conglobata/diagnóstico , Idoso , Autoanticorpos/imunologia , Nádegas , Desmogleína 1/imunologia , Desmogleína 3/imunologia , Diagnóstico Diferencial , Hidradenite Supurativa/complicações , Hidradenite Supurativa/imunologia , Humanos , Masculino , Pele/imunologia , Pele/patologia
5.
Dermatology ; 235(4): 308-314, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31121589

RESUMO

BACKGROUND/AIM: Hidradenitis suppurativa (HS) is a chronic skin disease with a heavy impact on patients' quality of life (QoL). The aim of this study was to evaluate in detail the QoL impact of HS comparing it with other skin conditions, and in particular with psoriasis. METHODS: Patients with a diagnosis of HS were recruited. QoL was measured using the Skindex-17 questionnaire. RESULTS: Data were available for 69 HS patients. HS had the worst QoL among several skin conditions. Compared to psoriasis the mean symptom score was 69.4 versus 53.7, and the mean psychosocial score was 56.1 versus 32.7. Overall, the scores of patients with HS were higher than those of psoriasis patients on 16 of the 17 items of the Skindex-17. CONCLUSIONS: When compared to many different skin conditions, and in particular to psoriasis, HS was the most impairing condition, even at low levels of clinical severity.


Assuntos
Hidradenite Supurativa/diagnóstico , Psoríase/diagnóstico , Qualidade de Vida , Adulto , Efeitos Psicossociais da Doença , Feminino , Indicadores Básicos de Saúde , Hidradenite Supurativa/complicações , Hidradenite Supurativa/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Psoríase/complicações , Psoríase/psicologia , Adulto Jovem
6.
Actas dermo-sifiliogr. (Ed. impr.) ; 110(4): 279-288, mayo 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-180900

RESUMO

En recientes estudios se ha demostrado la existencia de una relación entre la hidradenitis supurativa (HS) y el síndrome metabólico (SM), sin embargo, hasta el momento no se ha realizado ningún metaanálisis que incluya estudios ajustados según variables de confusión. Objetivos: Determinar la asociación entre la HS y el SM. Metodología: Se realizó una revisión sistemática y un metaanálisis, donde se incluyeron estudios observacionales acerca de la HS y el SM en pacientes adultos, localizados en MEDLINE, SCOPUS, SCIELO, GOOGLE SCHOLAR, SCIENCE DIRECT y LILACS, y que fueron publicados en un periodo comprendido entre el inicio de la base de datos hasta enero del 2016. De esta manera, se realizó un metaanálisis, para el cual se siguió el modelo de efectos aleatorios basándose en aquellos estudios con odds ratios (OR) ajustadas y crudas y que además presentaban un intervalo de confianza (IC) del 95%. El subgrupo analizado se correlacionó posteriormente con el tipo de población con HS (población general con HS vs. población hospitalaria con HS) y con el grupo de edad (adultos vs. niños y adultos). Resultados: Cinco estudios, incluyendo 3.950 pacientes con HS fueron analizados. Se encontró que el SM estaba presente en el 9,64% de los pacientes con HS (OR 1,82, IC del 95%, 1,39-2,25). Estudios realizados en centros dermatológicos hospitalarios de tercer nivel (OR 2,82, IC del 95%, 0,58-5,06) mostraron una mayor asociación al SM comparados con estudios realizados en la población general (OR 1,78, IC del 95%, 1,34-2,22). Los estudios que incluyeron una población pediátrica registraron así mismo una asociación significativa al SM (OR 2,10, IC del 95%, 1,58-2,62). Limitación: Se contó con escasos estudios ajustados a las variables de confusión. Conclusión: Los pacientes con HS tendrán un riesgo incrementado de presentar SM. Se debería considerar la realización de un cribado de factores de riesgo metabólicos en todos los pacientes con HS


Background: Recent studies have shown a relationship between hidradenitis suppurativa (HS) and metabolic syndrome (MS), but the literature offers no meta-analysis restricted to studies that have been adjusted for confounders. Objective: To determine the association between HS and MS. Methods: A systematic review and meta-analysis of observational studies on HS and MS in adults. We searched MEDLINE, SCOPUS, SCIELO, Google Scholar, Science Direct, and LILACS from the inception of the databases to January 2016. We performed a random effects model meta-analysis for studies reporting adjusted and crude odds ratios (ORs) with 95% CIs. A subgroup analysis was related to the type of HS patient (general patients vs hospital patients) and age group (adults vs children and adults). Results: Five studies including 3950 HS patients were analyzed. We found that MS was present in 9.64% of HS patients (OR, 1.82; 95%, CI 1.39-2.25). Studies from tertiary care hospital dermatology clinics (OR, 2.82; 95% CI, 0.58-5.06) reported a greater risk for MS than studies carried out in patients treated outside hospitals (OR, 1.78; 95% CI, 1.34-2.22). Studies that included pediatric populations reported a significant association (OR, 2.10; 95% CI, 1.58-2.62). Limitation: Few of the included studies reported adjusted ORs. Conclusions: HS patients have an increased risk for MS. Clinicians should consider screening HS patients for metabolic risk factors


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Hidradenite Supurativa/complicações , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/etiologia , Fatores de Confusão (Epidemiologia) , Estudos Prospectivos , Estudos Retrospectivos , Estudos Observacionais como Assunto , Criança , Fumantes
7.
Cir Cir ; 86(1): 77-80, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30951036

RESUMO

Lymphedema is the result of an alteration of the lymphatic drainage, and its most common worldwide cause is filariasis. In our practice usually is associated to neoplasic, inflammatory and granulomatous processes, radiotherapy, hydroelectrolytic disbalances, and idiopathic. It can affect any part of the body, including the penis and scrotum. The genital lymphedema is a rare presentation, it corresponds to 0.6% of lymphedema. However, causes serious functional, social and emotional limitations for the patient. Too often have pain, recurrent infections, sexual dysfunction, cosmetic deformity, sometimes it limits mobility and ambulation. Although there are several treatment options, both medical and surgical, it has not been found ideal for this disease. We present a 43 years old patient with penoscrotal lymphedema due to hidradenitis suppurativa, it limits his normal activity. The patient was referred to our center after unsuccessful medical treatment (doxycycline and clindamycin cycles). Surgical treatment consisted of total excision of the skin and subcutaneous tissue to Buck's fascia. Split thickness skin grafts were used to cover the defect. The result was satisfactory both functionally and aesthetically.


Assuntos
Hidradenite Supurativa/complicações , Linfedema/etiologia , Doenças do Pênis/etiologia , Escroto , Adulto , Doenças dos Genitais Masculinos/etiologia , Doenças dos Genitais Masculinos/cirurgia , Humanos , Linfedema/cirurgia , Masculino , Doenças do Pênis/cirurgia
9.
Medicine (Baltimore) ; 98(16): e15263, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31008968

RESUMO

RATIONALE: Follicular occlusion triad (FOT) is an autosomal recessive inherited disease and no more than 3 variants of the triad have been reported. We give a report in which scrotal elephantiasis is a variant of FOT and further perform a literature review. PATIENT CONCERNS: A 41-year-old man came to us because of a large scrotal cyst and generalized skin lesions that had occurred over the past 10 years. The generalized skin lesions consisted of hidradenitis suppurativa on the perineum and back, acne conglobata in the armpit, and dissecting cellulitis of the scalp. He took antibiotics for a long time but achieved poor effect. Furthermore, he told his father and elder brother also manifested such skin lesions. DIAGNOSES: Magnetic resonance showed a mass in the left scrotum with clear boundaries. A routine blood test showed a high leukocyte level of 12 × 10/L and a hemoglobin content of 78 g/L. C-reactive-protein increased. Series of autoimmune antibody tests were negative. The postoperative pathologic findings showed that the mass was an epidermoid cyst, and hematoxylin and eosin staining showed hyperkeratosis of the skin as well as inflammatory and edematous changes. A diagnosis of a variant of FOT was made. INTERVENTIONS: We removed skin abscesses and lesioned the inner part with hydrogen peroxide. Then we performed an excision of the scrotal lesion. OUTCOME: The patient recovered well and had no evidence of recurrence at a 16-month follow-up. LESSONS: We reported a case in which scrotal elephantiasis was a variant of FOT and surgical intervention played an important role in secondary urologic diseases.


Assuntos
Acne Conglobata/complicações , Celulite (Flegmão)/complicações , Elefantíase/etiologia , Hidradenite Supurativa/complicações , Dermatoses do Couro Cabeludo/complicações , Escroto , Dermatopatias Genéticas/complicações , Acne Conglobata/genética , Adulto , Celulite (Flegmão)/genética , Elefantíase/genética , Elefantíase/patologia , Elefantíase/cirurgia , Hidradenite Supurativa/genética , Humanos , Imagem por Ressonância Magnética , Masculino , Dermatoses do Couro Cabeludo/genética , Escroto/diagnóstico por imagem , Escroto/patologia , Escroto/cirurgia , Dermatopatias Genéticas/genética
10.
Dermatol Surg ; 45(10): 1237-1244, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-30893168

RESUMO

BACKGROUND: Recent studies suggest that there are different fistular subtypes in hidradenitis suppurativa (HS) patients who are associated with variable therapeutic outcomes. OBJECTIVE: To describe clinical and ultrasound features that characterize the different fistular patterns in HS and to evaluate the response to medical therapies. METHODS: A retrospective study developed by a well-recognized center specialized in HS analyzing both clinical and ultrasound (US) aspects of fistular structures in HS patients was performed. Medical therapy response was evaluated through follow-up visits at Week 24. RESULTS: A total of 117 fistulas detected in the skin of 40 patients were evaluated. Four different types of fistulas were described: dermal fistula (Type A), dermoepidermal fistula (Type B), complex fistula (Type C), and subcutaneous fistula (Type D). Fistulas Type A and B showed a complete resolution after 6 months of different medical therapies in up to 95% and 65% of cases, respectively. Contrary to this, fistulas Type C and D showed no significant response after a medical intervention. CONCLUSION: The US evaluation seems to play an important role to define these important structures that will help the clinician in elaborating a personalized combined medical and surgical management of the HS patient.


Assuntos
Anti-Infecciosos/uso terapêutico , Produtos Biológicos/uso terapêutico , Fístula Cutânea/diagnóstico por imagem , Procedimentos Cirúrgicos Dermatológicos , Hidradenite Supurativa/complicações , Adulto , Fístula Cutânea/etiologia , Fístula Cutânea/terapia , Feminino , Hidradenite Supurativa/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Pele/diagnóstico por imagem , Pele/patologia , Resultado do Tratamento , Ultrassonografia
11.
Orv Hetil ; 160(8): 291-299, 2019 Feb.
Artigo em Húngaro | MEDLINE | ID: mdl-30773037

RESUMO

Hidradenitis suppurativa is a chronic inflammatory disease of the hair follicles, usually presenting after puberty on the apocrine gland-bearing areas of the body. It usually flares up periodically and can lead to a severe condition affecting the 20-40-year-old childbearing age group. HS occurs more commonly in women. The main clinical features consist of painful, cicatrizing nodules and abscesses which develop mostly in the axillary, inguinal, genital and perianal regions and also on the breasts. HS is often accompanied by severe pain and malodorous discharge, both of which cause significant psychological stress and social stigma. Our main aim with this review paper is to highlight the gynecological aspects of this disease, as many times - due to the typical localization of the disease - patients seek gynecological care first when they experience the first symptoms of this disease. The most important classification of HS is the Hurley scale, which is based on the severity of the clinical symptoms. In recent years, numerous clinical trials have been conducted to seek optimized care of HS patients. Several drugs are used for the treatment of HS, but in most cases, the treatment has to be switched many times. It is of great importance to carefully follow comorbidities and possible pregnancies as in these cases, careful selection of treatment is required. Thus, HS is not only a dermatological, but also a gynecological disease. With an appropriate treatment and follow-up, the disease can be effectively handled. Orv Hetil. 2019; 160(8): 291-299.


Assuntos
Hidradenite Supurativa/diagnóstico , Hidradenite Supurativa/psicologia , Qualidade de Vida , Abscesso/etiologia , Adulto , Feminino , Ginecologia , Hidradenite Supurativa/complicações , Humanos , Dor/etiologia , Gravidez , Maturidade Sexual , Estigma Social , Adulto Jovem
12.
J Eur Acad Dermatol Venereol ; 33(4): 766-773, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30633405

RESUMO

BACKGROUND: Hidradenitis suppurativa (HS) is a chronic, relapsing, inflammatory skin disease characterized by painful inflamed nodules, recurrent abscesses and fistulas located in apocrine gland-bearing body sites. The negative impact of HS on patient's quality of life (QoL) has been reported to be greater than other dermatologic conditions as psoriasis and atopic eczema, and its improvement is an important goal in disease management. Nowadays, there are no specific validated QoL instruments available for HS and generic dermatologic questionnaires are used. OBJECTIVE: The objective of this study was to demonstrate the validity, reliability and responsiveness of HIDRAdisk, a new innovative tool designed for rapid assessment of HS burden and, at the same time, an intuitive graphic visualization of the measurement outcome. METHODS: A multicentre, longitudinal, observational study was conducted to validate the HIDRAdisk compared with other validated questionnaires [Skindex-16, Dermatology Life Quality Index (DLQI), Work Productivity and Activity Impairment-General Health (WPAI:GH)] and to evaluate its correlation with disease severity in Italian patients with any degree of HS severity, as measured by Hurley stage and HS Physician Global Assessment (HS-PGA). RESULTS: A total of 140 patients (59% women; mean age 34.9 ± 11.0 years) were enrolled in 27 dermatologic centres. HIDRAdisk showed a strong correlation with Skindex-16 and DLQI, and a good one with WPAI:GH (correlation coefficient: 0.7568, 0.6651 and 0.5947, respectively) and a statistically significant correlation with both Hurley stage and HS-PGA. Very good internal consistency (Cronbach coefficient >0.80; intraclass correlation coefficient >0.6), with correlation between the 10 items, good test-retest reliability (Spearman correlation coefficient, 0.8331; P < 0.0001) and responsiveness to changes were demonstrated. CONCLUSION: Our study shows that HIDRAdisk, a short and innovative visual HS QoL instrument, has been psychometrically validated in Italian language and it may help improve the management of HS once implemented in routine clinical practice.


Assuntos
Hidradenite Supurativa , Qualidade de Vida , Índice de Gravidade de Doença , Inquéritos e Questionários , Adulto , Feminino , Hidradenite Supurativa/complicações , Humanos , Itália , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Escala Visual Analógica , Adulto Jovem
13.
Dermatology ; 235(2): 144-149, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30650424

RESUMO

BACKGROUND: A more reliable classification of skin inflammation and severity of active disease results from ultrasound sonography and the new hidradenitis suppurativa/acne inversa (HS) classification system IHS4. However, an objective assessment of skin inflammation in a continuous mode is still the ultimate goal. Long-wave medical infrared thermography (MIT) may offer a blood flow and temperature differential assessment in inflammatory conditions. OBJECTIVE: To evaluate the application of MIT in HS. METHODS: Standardized photography of the areas involved or been candidates for HS involvement was performed and MIT pictures were taken simultaneously and superimposed on the photographs of 18 patients (11 female, 7 male, median age 38.75 years [95% confidence interval 28.5 and 51 years], Hurley score I 5.6%, Hurley score II 38.9%, and Hurley score III 55.5%). A modification of the Otsu's method facilitated the automatic lesion segmentation from the background, depicting the inflammation area. Moreover, MIT was administered in real-time mode during radical HS surgery. RESULTS: A 1°C temperature difference from a corresponding symmetric body region was indicative of inflammation. MIT figures detected a gradual increase of skin temperature from 33.0°C in healthy skin on average to 35.0-36.6°C at the center of inflamma tory lesions in the axilla and to 35.4-36.9°C at the center of inflammation in the groin area. Real-time MIT assessment enabled the definition of the margins and depth of the surgical intervention during the procedure. CONCLUSION: MIT is a promising tool for the detection of inflammation severity in HS lesions and can be used as a clinical biomarker in evaluation studies of medical and surgical HS treatment.


Assuntos
Dermatite/diagnóstico por imagem , Hidradenite Supurativa/diagnóstico por imagem , Termografia/métodos , Adulto , Biomarcadores , Dermatite/complicações , Dermatite/fisiopatologia , Feminino , Hidradenite Supurativa/complicações , Hidradenite Supurativa/fisiopatologia , Hidradenite Supurativa/cirurgia , Humanos , Processamento de Imagem Assistida por Computador , Raios Infravermelhos , Masculino , Imagem Multimodal , Fotografação , Índice de Gravidade de Doença , Temperatura Cutânea
14.
Dermatol Surg ; 45(4): 519-526, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30608295

RESUMO

BACKGROUND: Few reports describe squamous cell carcinoma (SCC) arising in hidradenitis suppurativa (HS). OBJECTIVE: The 2 objectives were (1) to describe the clinical characteristics, pathologic findings, and postoperative outcomes of SCC in HS and (2) to assess whether human papillomavirus (HPV) is involved in the pathogenesis. MATERIALS AND METHODS: Cases of SCC in HS were identified through institutional medical records (1976-2013) and the Rochester Epidemiology Project. Tumor specimens were assessed for HPV DNA/RNA with in situ hybridization. RESULTS: Twelve patients were identified (11 Caucasians and 9 men). All SCCs involved gluteal, perianal, or perineal skin; 1 patient had, in addition, involvement of the vagina. Surgical excision was performed on all 12 patients, 4 of whom had a colostomy. Mean duration of HS before SCC development was 28.5 years (range, 15-53 years). Mean follow-up was 4.3 years after surgical excision. Seven of 12 patients followed had postoperative SCC recurrence. Squamous cell carcinoma caused death despite wide surgical excision in these 7 patients. Of the remaining 5 patients, 4 are unknown and 1 who did not recur had an in situ SCC (Bowen disease carcinoma). Squamous cell carcinoma was not associated with high-risk or low-risk HPV. CONCLUSION: Invasive SCC arising in HS carries a high risk of death.


Assuntos
Carcinoma de Células Escamosas/patologia , Hidradenite Supurativa/patologia , Neoplasias Cutâneas/patologia , Canal Anal/patologia , Nádegas/patologia , Carcinoma de Células Escamosas/etiologia , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/virologia , Feminino , Hidradenite Supurativa/complicações , Hidradenite Supurativa/mortalidade , Hidradenite Supurativa/virologia , Humanos , Masculino , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/virologia , Períneo/patologia , Pele/patologia , Neoplasias Cutâneas/etiologia , Neoplasias Cutâneas/mortalidade , Neoplasias Cutâneas/virologia
19.
J Am Acad Dermatol ; 80(5): 1314-1321, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30502416

RESUMO

BACKGROUND: Antibiotics are recognized as first-line treatments for hidradenitis suppurativa (HS), but the data on their efficacy are limited. OBJECTIVE: Evaluate the efficacy of oral clindamycin versus that of clindamycin plus rifampicin in patients with HS. METHODS: A total of 60 patients with mild-to-moderate-severe HS who were classified according to their International Hidradenitis Suppurativa Severity Score System (IHS4) and Hurley scores, were subdivided into 2 groups of 30 patients each (group A, the members of which received clindamycin plus rifampicin, and group B, the members of which were treated with clindamycin alone) and retrospectively studied. The main objective was to evaluate and compare the clinical and ultrasound responses between the groups after 8 weeks of treatment according to the Hidradenitis Suppurativa Clinical Response measure. RESULTS: After the treatment, 17 of 30 patients in group A and 19 of 30 in group B met the primary outcome. Both groups showed a similar improvement of IHS4 score, whereas the Dermatology Life Quality Index and pain Visual Analogue Scale scores improved more in group B. In particular, the reductions in nodule and abscess counts were similar between the 2 groups, whereas the number of draining tunnels decreased more in group B. The factors significantly associated with Hidradenitis Suppurativa Clinical Response score were age, body mass index, IHS4 score, and absence of axillary involvement. Disease-free survival was similar between the 2 groups. LIMITATIONS: The study was not randomized or placebo-controlled. CONCLUSION: Clindamycin may be a useful treatment alternative to antibiotic combination regardless of HS clinical stage.


Assuntos
Antibacterianos/uso terapêutico , Clindamicina/uso terapêutico , Hidradenite Supurativa/tratamento farmacológico , Rifampina/uso terapêutico , Adolescente , Adulto , Fatores Etários , Índice de Massa Corporal , Intervalo Livre de Doença , Quimioterapia Combinada , Feminino , Hidradenite Supurativa/complicações , Hidradenite Supurativa/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Dor/etiologia , Qualidade de Vida , Estudos Retrospectivos , Índice de Gravidade de Doença , Resultado do Tratamento , Ultrassonografia , Adulto Jovem
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