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1.
J Drugs Dermatol ; 21(8): 867-874, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35946973

RESUMO

BACKGROUND: International Dermatology Outcome Measures (IDEOM) is a non-profit organization founded in 2013. It is composed of researchers and stakeholders who work to develop evidenced-based outcome measures to enhance research and treatment recommendations of dermatologic diseases. SUMMARY: The 2021 IDEOM Virtual Annual Meeting occurred from November 19-20, 2021. Contributions were made by leaders and stakeholders from the psoriasis, psoriatic arthritis, pediatric hidradenitis suppurativa, acne, vitiligo, actinic keratosis, alopecia areata, itch, and cutaneous lymphoma workgroups. The psoriasis, psoriatic arthritis, and actinic keratosis workgroups provided an overview of their respective instruments for treatment satisfaction and symptom measurement. The inaugural meetings of the itch, alopecia areata, and cutaneous lymphoma workgroups identified unmet needs of their respective diseases and future goals. The acne, vitiligo, and pediatric hidradenitis suppurativa workgroups discussed concerns of quality of life, instruments for symptom measurement, and screening tools. Additionally, a representative from the US Food and Drug Administration was in attendance and presented an update on topical drugs and generics. This report provides a summary of workgroup updates from the past year and future directions established during the meeting. KEY MESSAGES: This report summarizes progress made by each IDEOM workgroup at the 2021 IDEOM Virtual Annual Meeting. J Drugs Dermatol. 2022;21(8):867-874. doi:10.36849/JDD.6974.


Assuntos
Acne Vulgar , Alopecia em Áreas , Artrite Psoriásica , Dermatologia , Hidradenite Supurativa , Ceratose Actínica , Psoríase , Vitiligo , Artrite Psoriásica/diagnóstico , Criança , Humanos , Avaliação de Resultados em Cuidados de Saúde , Psoríase/tratamento farmacológico , Qualidade de Vida
2.
J Drugs Dermatol ; 21(8): 819-824, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35946977

RESUMO

BACKGROUND: Patients treated with biological therapy for hidradenitis suppurativa (HS) are at an increased risk of infectious complications. However, it is unclear whether these patients are at an increased risk of acquiring infections. The most common infection reported in patients taking biologic therapies are respiratory tract infections. The purpose of this study is to review the risk and incidence rate of upper respiratory tract infections (URTI), nasopharyngitis, and influenza in patients treated with biologics for HS. METHODS: A comprehensive literature search was completed using databases (MEDLINE and EMBASE) and clinical trial registries (clinicaltrials.gov) to identify trials that reported the risk and incidence rate of URTIs, nasopharyngitis, and influenza in patients using biological therapy for moderate to severe HS. Each study was assessed for bias using the GRADE system. FINDINGS: There were nine studies included in this review including five placebo-controlled studies of patients with moderate to severe HS treated with biological therapy. We found the risk of URTI, nasopharyngitis, and influenza was not significantly different in patients taking biological therapy when compared to placebo (RR 1.23; 95% CI 0.66-2.30and RR 0.93; 95% CI 0.66-1.31, RR 1.03; 95% CI 0.41-2.56, respectively). CONCLUSIONS: This systematic review and meta-analysis did not find significantly different risks of URTI, nasopharyngitis, and influenza in patients taking biological therapy when compared to placebo. However, these data were limited by the sample size and number of studies available. Future high-quality, high-power, and long-term studies are needed to support the data available on this topic. J Drugs Dermatol. 2022;21(8): 819-824. doi:10.36849/JDD.6433.


Assuntos
Produtos Biológicos , Hidradenite Supurativa , Nasofaringite , Infecções Respiratórias , Produtos Biológicos/efeitos adversos , Hidradenite Supurativa/tratamento farmacológico , Hidradenite Supurativa/epidemiologia , Humanos , Incidência , Infecções Respiratórias/epidemiologia
3.
Korean J Radiol ; 23(8): 785-793, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35914743

RESUMO

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease involving apocrine-bearing sites. It is characterized by recurrent painful nodules and abscesses that potentially rupture, resulting in sinus tract formation, fistulas, and scarring. HS tends to be found in the intertriginous areas (i.e., the axillary, inguinal, and perianal areas of the body). HS may be uncommon for radiologists because its diagnosis is usually based on clinical assessment. However, diagnosis based solely on clinical manifestations can underestimate the severity of HS. Ultrasonography and MRI play a critical adjunct role in determining the severity and extent of the disease and greatly aid its management. Given that MRI is an effective imaging tool, its role in the analysis of severe and anogenital HS lesions merits considerable attention. Unfortunately, anoperineal HS imposes diagnostic dilemmas. It has multiple symptoms and presentations and often mimics other diseases in the intertriginous areas. Therefore, a thorough understanding of HS is essential to avoid delayed diagnoses. This review highlights the typical MRI imaging features and staging of HS, emphasizing on the anoperineal location. The review also differentiates the disease from mimics to facilitate the prompt delivery of appropriate treatment and improve patients' quality of life.


Assuntos
Hidradenite Supurativa , Abscesso , Hidradenite Supurativa/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Dor , Qualidade de Vida
4.
J Dtsch Dermatol Ges ; 20(8): 1061-1075, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35971574

RESUMO

Die Daten zu Hidradenitis suppurativa (HS)-bedingten Kosten sind begrenzt und inhomogen. Sie sind jedoch erheblich. Wir führten eine systematische Sichtung der Literaturberichte durch, in denen finanzielle Daten über jeden Gesundheitsbereich oder andere Ausgaben dokumentiert wurden, die durch HS und/oder HS-bedingte Auswirkungen auf Beschäftigung, Einkommen und persönliches wirtschaftliche Entwicklung entstanden sind (indirekte Kosten). Dafür wurden drei elektronische Datenbanken durchsucht (MEDLINE, ScienceDirect und die Cochrane Library -letzte Suche: 14. September 2021). Alle Kosten wurden inflationsbereinigt (2022) und in US-Dollar umgerechnet. Es wurden 23 Artikel eingeschlossen (18 Krankheitskostenstudien, 4 Beobachtungsstudien und 1 Fallserie), in denen ökonomische Daten von 77.287 HS-Patienten erfasst wurden. Die durch HS entstandenen durchschnittlichen jährlichen Kosten pro Patient reichten von 258 $ bis 8.078 $. Diese Zahl erhöhte sich bei chirurgischen Eingriffen, Krankheitsprogression, Antibiotika-Versagen und bestimmten Begleitkrankheiten. Der kostspieligste Faktor war die stationäre Versorgung, gefolgt von ambulanter und Notfallversorgung. Signifikante Unterschiede wurden zwischen den USA und den übrigen untersuchten Ländern beobachtet. Im Vergleich zu Psoriasis-Patienten waren Krankenhausaufenthalte bei HS wahrscheinlicher, länger und kostspieliger, während die weniger kostspielige ambulante Versorgung bei HS-Patienten verringert war. Das Vermeiden der Krankheitsprogression durch frühzeitige Diagnose und Optimierung der ambulanten dermatologischen Versorgung könnte HS-bedinge Ausgaben reduzieren.


Assuntos
Hidradenite Supurativa , Humanos
6.
Front Immunol ; 13: 960488, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35967376

RESUMO

Hidradenitis Suppurativa (HS) is a chronic multifactorial inflammatory skin disease with incompletely understood mechanisms of disease pathology. HS is characterized by aberrant activation of the innate immune system, resulting in activation of pathways that aim to protect against pathogenic microorganisms, and also contribute to failure to resolve inflammation. Imbalance in innate immunity is evident in deregulation of host antimicrobial peptides (AMPs) and the complement system associated with the microbiome dysbiosis. The pathology is further complicated by ability of pathogens associated with HS to overcome host immune response. Potential roles of major AMPs, cathelicidin, defensins, dermcidin, S100 proteins, RNAse 7 and complement proteins are discussed. Dysregulated expression pattern of innate immunity components in conjunction with bacterial component of the disease warrants consideration of novel treatment approaches targeting both host immunity and pathogenic microbiome in HS.


Assuntos
Hidradenite Supurativa , Proteínas do Sistema Complemento/metabolismo , Disbiose/metabolismo , Hidradenite Supurativa/patologia , Humanos , Imunidade Inata , Inflamação/metabolismo , Pele
7.
Wounds ; 34(2): 43-46, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-35801979

RESUMO

INTRODUCTION: Hidradenitis suppurativa can be a debilitating condition, particularly in the pediatric population. Axillary hidradenitis can be particularly challenging because of the risk of scar contracture and limited range of motion after definitive resection and reconstruction. A dermal regeneration template (DRT) and skin grafting have been used to reduce scar contracture in other areas of the body and may benefit this population. OBJECTIVE: This case series retrospectively reviewed and evaluated outcomes using DRT and skin grafting for axillary hidradenitis reconstruction to report the authors' initial experience. MATERIALS AND METHODS: After institutional review board approval, a retrospective review was conducted of a single surgeon's experience for all patients undergoing axillary hidradenitis resection and immediate reconstruction with DRT and skin grafting from 2015 through 2018. Preoperative characteristics, surgical details, and postoperative results were collected. RESULTS: Five patients undergoing 7 procedures were eligible for inclusion. The average age at the time of surgery was 18.2 years. Patients underwent an average of 4.9 negative pressure wound therapy changes prior to skin grafting. No complications, DRT loss, or skin graft loss occurred. All patients were reported to have normal range of motion of the surgically managed extremity after skin grafting. The average follow-up was 273.4 days after the last procedure. As of this writing, no patients had experienced any recurrence of hidradenitis in the surgically managed axilla. CONCLUSIONS: The use of DRT and subsequent skin grafting for the definitive management of axillary hidradenitis resulted in no recurrence and full range of motion of the affected extremity without complications. Surgeons should consider using this method of reconstruction for axillary hidradenitis, particularly in the pediatric population.


Assuntos
Contratura , Hidradenite Supurativa , Procedimentos Cirúrgicos Reconstrutivos , Axila/cirurgia , Criança , Cicatriz , Contratura/cirurgia , Hidradenite Supurativa/cirurgia , Humanos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Estudos Retrospectivos , Transplante de Pele
8.
J Dtsch Dermatol Ges ; 20(8): 1061-1072, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35821567

RESUMO

Data regarding hidradenitis suppurativa (HS)-related expenditure is limited and non-homogeneous, but HS does incur significant expenses. We performed a systematic review of literature reports documenting financial data regarding any healthcare domain or other expenditure incurred by HS and/or HS impact on work, income and personal economic growth (indirect costs). Three electronic databases were searched (MEDLINE, ScienceDirect, and the Cochrane Library - last search date: September 14th , 2021). All costs were adjusted for inflation (2022) and converted into US dollars. Twenty-three papers were included (18 cost-of-illness studies, 4 observational studies and 1 case series), drawing economic data from 77,287 HS patients. The total mean cost incurred by HS per patient per year ranged from $ 258 to $ 8,078. This number increased in case of surgical intervention, disease progression, antibiotic failure and certain comorbid diseases. The costliest healthcare sector was inpatient care, followed by outpatient and emergency care. Significant differences were observed between the USA and the rest of studied countries. Hospitalization was likelier, lengthier, and costlier for HS compared to psoriasis patients, whereas the less costly outpatient care appeared to be reduced among HS patients. Preventing disease progression by optimizing early diagnosis and dermatology outpatient care could decrease HS-related expenditure.


Assuntos
Hidradenite Supurativa , Atenção à Saúde , Progressão da Doença , Gastos em Saúde , Hidradenite Supurativa/diagnóstico , Hidradenite Supurativa/terapia , Hospitalização , Humanos
10.
Saudi Med J ; 43(7): 751-754, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35830985

RESUMO

Genital lymphedema usually develops after 4-30 years of chronic hidradenitis suppurativa (HS). However, our patient exhibited signs of it as early as 2 years after being diagnosed with HS. Renal amyloidosis is a rarely reported complication of HS. Unfortunately, our patient was asymptomatic but was found to have end-stage renal disease secondary to advanced renal amyloidosis. We report a case of a 42-year-old Indian gentleman who had HS for 9 years presenting with 2 rare complications: penoscrotal lymphedema and end-stage renal disease secondary to renal amyloidosis. The patient was treated with prednisolone and adalimumab to treat both his HS and renal amyloidosis, and was referred to general surgery to manage his genital lymphedema. We recommend following adult patients with moderate-to-severe HS and clinical duration of greater than 3 years and screening for amyloidosis before they reach end-stage organ disease, similar to what happened to our patient with end-stage renal disease.


Assuntos
Amiloidose , Hidradenite Supurativa , Falência Renal Crônica , Linfedema , Adulto , Amiloidose/complicações , Hidradenite Supurativa/complicações , Hidradenite Supurativa/diagnóstico , Hidradenite Supurativa/tratamento farmacológico , Humanos , Falência Renal Crônica/complicações , Linfedema/complicações , Linfedema/cirurgia
11.
J Drugs Dermatol ; 21(7): 800-802, 2022 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-35816064

RESUMO

Dissecting cellulitis of the scalp (DCS) also known as perifolliculitis capitis abscedens et suffodiens (PCAS) is a chronic, relapsing, inflammatory dermatosis consisting of edematous sterile pustules and nodules resulting in sinus tracts and scarring alopecia. Although first described as infectious in 1903, DCS is primarily an inflammatory process that can precede a secondary infection; this is similarly true of the other conditions within the follicular occlusion tetrad: hidradenitis suppurativa (HS), acne conglobata, and pilonidal sinus.


Assuntos
Hidradenite Supurativa , Dermatoses do Couro Cabeludo , Dermatopatias Genéticas , Celulite (Flegmão)/diagnóstico , Celulite (Flegmão)/tratamento farmacológico , Humanos , Dermatoses do Couro Cabeludo/diagnóstico , Dermatoses do Couro Cabeludo/tratamento farmacológico
12.
Front Immunol ; 13: 883811, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35720358

RESUMO

Hidradenitis Suppurativa (HS) is a chronic suppurative disease of the pilosebaceous unit. The current model of HS pathophysiology describes the condition as the product of hyperkeratinisation and inflammation at the hair follicular unit. Environmental factors (such as smoking and obesity), gender, genetic predisposition, and skin dysbiosis are considered the main pathogenic drivers of the disease. Autoinflammatory syndromes associated with HS are rare but may help to highlight the potential roles of autoinflammation and dysregulated innate immune system in HS. Therefore, it is of major relevance to increase the awareness about these diseases in order to improve the understanding of the disease and to optimize the management of the patients. Herein, we report for the first time, to our knowledge, two clinical cases of Hyper-IgD syndrome-associated HS. Hyper-IgD is an autoinflammatory syndrome caused by a mevalonate kinase deficiency (MKD), a key kinase in the sterol and isoprenoid production pathway. We describe the potentially shared pathophysiological mechanisms underpinning comorbid MKD-HS and propose therapeutic options for the management of these patients.


Assuntos
Hidradenite Supurativa , Deficiência de Mevalonato Quinase , Comorbidade , Hidradenite Supurativa/complicações , Humanos , Inflamação/complicações , Deficiência de Mevalonato Quinase/complicações , Deficiência de Mevalonato Quinase/diagnóstico , Pele , Síndrome
17.
Cutis ; 109(3): 160-162, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35659142

RESUMO

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that most commonly affects women of childbearing age. The symptoms of the disease are managed with a multitude of topical and systemic medications. The course of HS changes during pregnancy, and some women can experience postpartum flares. Thus, it is important to be aware of how pregnancy may alter the treatment plan for women and impact their choice to breastfeed. The following review summarizes medical management for HS and its safety during pregnancy and breastfeeding.


Assuntos
Hidradenite Supurativa , Aleitamento Materno , Feminino , Hidradenite Supurativa/diagnóstico , Humanos , Gravidez , Pele
19.
Adv Skin Wound Care ; 35(7): 381-384, 2022 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-35723957

RESUMO

OBJECTIVE: Hidradenitis suppurativa (HS) is a chronic autoinflammatory skin disease with a higher prevalence in women. The disease results in a low quality of life as well as physical and psychological comorbidities. The authors sought to determine the effects of HS on women's self-perception and life experiences. METHODS: Semistructured interviews were conducted with 22 women of varying age and family status. The content was transcribed and subjected to both thematic and content analyses. RESULTS: Five themes and a number of subthemes were revealed, involving physical, emotional, coping, and functional aspects. Somatic features, especially pain, were the most troubling issues, along with the emotional burden of shame and loss of femininity and intimacy. However, women also revealed strength and expressed optimism. CONCLUSIONS: These findings reveal the inner world of women coping with HS, addressing multiple dilemmas, problems, and concerns. Healthcare providers should pay special attention to the specific needs of these patients. Additional research is needed to further shed light on the impact of HS on women.


Assuntos
Hidradenite Supurativa , Comorbidade , Feminino , Hidradenite Supurativa/diagnóstico , Hidradenite Supurativa/epidemiologia , Hidradenite Supurativa/terapia , Humanos , Dor , Prevalência , Qualidade de Vida
20.
Adv Skin Wound Care ; 35(6): 1-8, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-35703854

RESUMO

ABSTRACT: Diagnosing and treating neutrophilic dermatoses (NDs) in clinical practice can be challenging because of various presentations and stubborn treatment responses. Establishing a diagnosis is necessary, though, because many NDs are associated with underlying conditions, including malignancy. In this article, the authors provide information about Sweet syndrome, pyoderma gangrenosum, and other NDs and describe their clinical presentation, pathophysiology, diagnostic criteria, and associated conditions. The authors also present a case report describing the coexistence of two NDs and hidradenitis suppurativa in one patient and review the treatment modalities for those conditions.


Assuntos
Dermatite , Hidradenite Supurativa , Pioderma Gangrenoso , Síndrome de Sweet , Hidradenite Supurativa/complicações , Hidradenite Supurativa/diagnóstico , Hidradenite Supurativa/terapia , Humanos , Pioderma Gangrenoso/tratamento farmacológico , Pioderma Gangrenoso/terapia , Síndrome de Sweet/diagnóstico , Síndrome de Sweet/tratamento farmacológico , Síndrome de Sweet/patologia
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