Back and Face Involvement in Hidradenitis Suppurativa

Abstract

Background: Hidradenitis suppurativa (HS) may be associated with face and back lesions which are considered as acne. Objective: To describe the skin lesions of a group of patients with HS. Methods: Twelve patients were selected from a series of 648 patients on the basis of their specific skin lesions. Results: The patients (mostly male) had typical hidradenitis. On their face or back they had one or several of the following skin lesions which are not seen in acne: hypertrophic rope-like bridged scars, raised plaques with multiple carbuncle-like openings or with ulcerations, ‘worm-eaten scars’ and coalescent nodules with round ulcerations. All patients had deep round scars. Several had a pilonidal cyst or large epidermal cysts. Isotretinoin had been used by 7 patients with no effect. Conclusion: Some HS patients have specific lesions of the face and back which are not acne and have to be treated differently.

Morphology of Pilonidal Sinus Disease: Some Evidence of Its Being a Unilocalized Type of Hidradenitis Suppurativa

“…This view is supported by Plewig’s suggestion that so-called acne keloidales nuchae and perifolliculitis capitis abscedens et suffodiens (Hoffmann’s disease) may also be subsumed into the category of HS [20,34,35]. Furthermore, very recently Poli et al [36] selected 12 of 648 HS patients with localized manifestations on the face and back, clinically different from acne and with high rates of unresponsiveness to isotretinoin. According to the authors, even these lesions may be nosologically regarded as HS.…”

Pyoderma Gangrenosum, Acne and Suppurative Hidradenitis Syndrome following Bowel Bypass Surgery

“…The acneiform eruption of our patient was characterized by a prevalence of retentional elements like comedones over inflammatory lesions such as pustules and papules. Considering that involvement of the face and/or back can occur in SH as recently described [13], the facial lesions called ‘acne’ in our patient might actually be a manifestation of SH. However, the clinical features in the face and back localizations of SH closely resemble those of acne conglobata, including nodules, burrowing abscesses, ulcerations, open comedones and hypertrophic scars; in contrast, our patient had mainly closed comedones, which are absent in SH.…”

Diagnostics différentiels de l’acné du visage sur peau noire

“…L'association rifampicine 600 mg et clindamycine 600 mg pendant 10 semaines est efficace sur la poussée inflammatoire; un traitement d'entretien par 200 mg de doxycycline est nécessaire. 10 La lèpre lépromateuse nodulaire du visage est un diagnostic différentiel fréquent en pays d'endémie.…”