Gluteal and perineal Hidradenitis Suppurativa: diagnosis and therapeutic management A importância da pesquisa em cirurgia.
DOI:
https://doi.org/10.31837/cir.urug/8.1.7Keywords:
Hydradenitis, Escala Hurley, TreatmentAbstract
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that affects the apocrine sweat glands and causes inflammatory nodules, abscesses, and painful fistulas in areas such as the armpits, groin, and buttocks. Its impact on patients' quality of life is significant. HS affects 1-4% of the world's population and is associated with factors such as overweight, smoking, and family history. Its pathogenesis is complex, involving inflammation and immune dysfunction. Its diagnosis and treatment are challenging, especially in severe cases. Diagnosis is based on clinical presentation, which is often confused with other skin conditions. It is classified into Hurley stages based on severity. Treatment focuses on controlling symptoms and preventing recurrences. Includes patient education, medical treatment and surgery. The choice of antibiotic therapy depends on the severity and the bacterial strains present. For severe cases, biological therapies are investigated. Surgery, such as simple excision or skin grafts, is effective in controlling the disease. We present a clinical case of a patient with HS, we review the epidemiology, etiopathogenesis and its diagnosis accompanied by the existing therapeutic options
Downloads
Metrics
References
Chu CB, Yang CC, Tsai SJ. Hidradenitis suppurativa: Disease pathophysiology and sex hormones. Chin J Physiol. 202;64(6):257-265. doi: 10.4103/cjp.cjp_67_21.
Orenstein LAV, Nguyen TV, Damiani G, Sayed C, Jemec GBE, Hamzavi I. Medical and Surgical Management of Hidradenitis Suppurativa: A Review of International Treatment Guidelines and Implementation in General Dermatology Practice. Dermatology. 2020;236(5):393-412. doi: 10.1159/000507323.
Revuz JE, Canoui-Poitrine F, Wolkenstein P, Viallette C, Gabison G, Pouget F, et al. Prevalence and factors associated with hidradenitis suppurativa: results from two casecontrol studies. J Am Acad Dermatol. 2008;59(4):596-601. doi: 10.1016/j.jaad.2008.06.020.
Alikhan A, Lynch PJ, Eisen DB. Hidradenitis suppurativa: a comprehensive review. J Am Acad Dermatol. 2009;60(4):539-61; quiz 562-3. doi: 10.1016/j.jaad.2008.11.911.
Jemec GB. Clinical practice. Hidradenitis suppurativa. N Engl J Med. 2012;366(2):158-64. doi: 10.1056/NEJMcp1014163.
Zouboulis CC, Benhadou F, Byrd AS, Chandran NS, Giamarellos-Bourboulis EJ, Fabbrocini G, et al. What causes hidradenitis suppurativa ?-15 years after. Exp Dermatol. 2020;29(12):1154-1170. doi: 10.1111/exd.14214.
Nguyen TV, Damiani G, Orenstein LAV, Hamzavi I, Jemec GB. Hidradenitis suppurativa: an update on epidemiology, phenotypes, diagnosis, pathogenesis, comorbidities and quality of life. J Eur Acad DermatolVenereol. 2021;35(1):50-61. doi: 10.1111/jdv.16677.
Scala E, Cacciapuoti S, Garzorz-Stark N, Megna M, Marasca C, Seiringer P, et al. Hidradenitis Suppurativa: Where We Are and Where We Are Going. Cells. 2021;10(8):2094. doi: 10.3390/cells10082094.
Mendes-Bastos P, Martorell A, Magina S. Ertapenem for the treatment of Hidradenitis suppurativa: how much do we need it? Actas Dermosifiliogr (Engl Ed). 2018;109(7):582-3. doi: 10.1016/j.ad.2018.03.012.
Join-Lambert O, Coignard-Biehler H, Jais JP, Delage M, Guet-Revillet H, Poirée S, et al.Efficacy of ertapenem in severe hidradenitis suppurativa: a pilot study in a cohort of 30 consecutive patients. J AntimicrobChemother. 2016;71(2):513-20. doi: 10.1093/jac/dkv361.
Zouboulis CC, Desai N, Emtestam L, Hunger RE, Ioannides D, Juhász I, et al. European S1 guideline for the treatment of hidradenitis suppurativa/acne inversa. J Eur Acad Dermatol Venereol. 2015;29(4):619-44.doi: 10.1111/jdv.12966.
Posch C, Monshi B, Quint T, Vujic I, Lilgenau N, Rappersberger K. The role of wide local excision for the treatment of severe hidradenitis suppurativa (Hurley grade III): Retrospective analysis of 74 patients. J Am Acad Dermatol. 2017;77(1):123-9.e5. doi: 10.1016/j.jaad.2017.01.055.
Taylor EM, Hamaguchi R, Kramer KM, Kimball AB, Orgill DP. Plastic Surgical Management of Hidradenitis Suppurativa. PlastReconstr Surg. 2021;147(3):479-491. doi: 10.1097/PRS.0000000000007677.
Fertitta L, Hotz C, Wolkenstein P, Méningaud JP, Sawan D, HersantB,et al. Efficacy and satisfaction of surgical treatment for hidradenitis suppurativa. J EurAcad Dermatol Venereol. 2020;34(4):839-845. doi: 10.1111/jdv.16135.
Balik E, Eren T, Bulut T, Büyükuncu Y, Bugra D, Yamaner S. Surgical approach to extensive hidradenitis suppurativa in the perineal/perianal and gluteal regions. World J Surg. 2009;33(3):481-7. doi: 10.1007/s00268-008-9845-9.
Zouboulis CC, Bechara FG, Dickinson-Blok JL, Gulliver W, Horváth B, Hughes R, et al. Hidradenitis suppurativa/acne inversa: a practical framework for treatment optimization - systematic review and recommendations from the HS ALLIANCE working group. J Eur Acad Dermatol Venereol. 2019;33(1):19-31. doi: 10.1111/jdv.15233.
Danby FW, Hazen PG, Boer J. New and traditional surgical approaches to hidradenitis suppurativa. J Am Acad Dermatol. 2015;73(5 Suppl 1):S62-5. doi: 10.1016/j.jaad.2015.07.043.
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
All articles, videos and images published in Revista Cirugía del Uruguay are under the Creative Commons CC licenses, which is a complement to the traditional copyright, in the following terms: first, the authorship of the referred document must always be acknowledged and secondly none of the article or work published in the journal may have commercial purposes of any nature. The authors retain their copyrights and give the magazine the right of first publication of their work, which will be simultaneously subject to the Creative Commons Attribution-NonCommercial 4.0 International License license that allows the work to be shared whenever the initial publication is indicated in this journal.