Multidisciplinary Update on Genital Hidradenitis Suppurativa

Hamad, Judy; McCormick, Benjamin; Sayed, Christopher; Paci, Karina; Overton, Matthew; Daubert, Thomas; Figler, Bradley D.

doi:10.1001/jamasurg.2020.2611

Cited by 7 publications

(18 citation statements)

References 59 publications

(87 reference statements)

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“…Males with HS tend to have more anogenital lesions than females. 23 Anogenital HS lesions have been associated with stigmatization, shame, and lower quality of life, 56,57 similarly to other types of genital skin lesions. 58 In their 2020 review, Cuenca-Barrales et al 42 identified genital lesions as a significant factor related to higher rates of male sexual dysfunction in HS.…”

Section: Discussionmentioning

confidence: 99%

A systematic review and meta‐analysis of sexual dysfunction in patients with hidradenitis suppurativa

et al. 2022

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Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition associated with significant psychosocial comorbidity. To date, the relationship between HS and sexual dysfunction has not been assessed through meta‐analysis. A systematic review was performed by OVID Medline, EMBASE, Cochrane Central, PsycINFO via EBSCO, Web of Science, and LILACS. Original English language studies assessing HS and sexual function published prior to April 2020 were screened. Scores from the Female Sexual Function Index (FSFI), International Index of Erectile Function (IIEF), Arizona Sexual Experiences Scale (ASEX), Frankfurt Self‐Concept Scale for Sexuality (FKKS SEX), and Dermatology Life Quality Index (DLQI) were analyzed. Sixteen studies met inclusion criteria, and nine were eligible for meta‐analysis. Pooled mean FSFI score for female HS patients met criteria for sexual dysfunction (mean = 20.32, P < 0.001). Females with HS reported worse FSFI scores than controls (pooled mean difference = −5.704, P = 0.003, I2=0). Mean IIEF score among males with HS was 47.96 (P < 0.001). Males with HS also reported worse IIEF scores than controls (pooled mean difference = −18.77, P = 0.00, I2 = 0). Females with HS performed worse on sexual function inventories than males with HS (SMD = −0.72, P = 0.009, I2 = 0). Both male and female HS patients reported significantly more sexual impairment than same‐sex controls. Female HS patients also experience more sexual impairment than males and on average meet criteria for sexual dysfunction (FSFI <26.55). Clinicians should be aware that their patients with HS, especially females, may be suffering from sexual dysfunction and treated them appropriately.

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Section: Discussionmentioning

confidence: 99%

A systematic review and meta‐analysis of sexual dysfunction in patients with hidradenitis suppurativa

et al. 2022

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“…Patient-specific risk factors for poor graft take include obesity, diabetes mellitus/hyperglycemia, poor nutritional status, and the presence of an infected or colonized wound bed. Patients with an infected or colonized wound bed (e.g., those with hidradenitis suppurativa) typically benefit from a staged approach in which the wound is treated with wet to dry dressing changes or negative pressure therapy for 3-10 days before attempting skin grafting [5] .…”

Section: Discussionmentioning

confidence: 99%

“…In severe cases, chronic inflammation and infection of the dermis lead to abscess formation and scarring/contracture of the surrounding skin. Mild cases can be treated with topical and/or intralesional therapy, whereas severe cases require excision of the scarred and chronically inflamed skin [5] .…”

Section: Hidradenitis Suppurativamentioning

confidence: 99%

Skin grafting for penile skin loss

Demzik¹,

Peterson²,

Figler³

2020

PAR

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Penile skin grafting is an effective technique for managing skin deficiency resulting from a variety of causes. A thorough understanding of penile anatomy and the pathophysiology of the underlying condition being treated are essential. We provide an overview of penile anatomy as well as the pathophysiology of conditions that may lead to penile skin deficiency, as a result of either the underlying condition or its management. The conditions discussed include lichen sclerosus, buried penis, hidradenitis suppurativa, lymphedema, necrotizing fasciitis, cancer, and trauma. We also discuss surgical technique for penile skin grafting with an emphasis on technical considerations unique to the penis. Finally, we review the available literature on penile skin grafting.

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“…11,24 Painful nodules and abscesses are typically the first manifestation of disease, which may evolve into secondary lesions including draining and nondraining tunneling sinus tracts, comedones, and scars. 12 Recently, 6 clinical phenotypes have been proposed (Table 1): (1) regular, (2) frictional furuncle, (3) scarring folliculitis, (4) conglobata, (5) syndromic, and (6) ectopic. The majority of patients meet the diagnostic criteria for the regular phenotype without any specific characteristic lesions.…”

Section: Clinical Features Diagnosis and Stagingmentioning

confidence: 99%

“…10 The general consensus at this time endorses medical treatment in combination with surgical management for disease control. 11,12 Current medical therapies target various inflammatory cytokines or underlying triggers such as the microbiome and androgens, but with our current knowledge gaps and broad therapeutic options, the response to treatment is highly variable among patients. 4 Surgical management in the form of wide local excision and subsequent reconstruction is often reserved for medically refractory disease, although local procedures, such as incision and drainage and "deroofing," have been used to treat acute abscesses or localized sinuses.…”

mentioning

confidence: 99%

Vulvoperineal Hidradenitis Suppurativa: Diagnosis, Treatment, and Management of Deformities

Ogunleye

Ndem

Bui³

et al. 2021

Obstetrical &Amp; Gynecological Survey

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Importance: Hidradenitis suppurativa (HS) is a chronic, inflammatory disorder affecting skin of intertriginous areas that is often encountered and treated by nondermatologic specialists.Objective: The purpose of this literature review is to provide a comprehensive, clinical source of information on HS as it relates to incidence of disease, pathophysiology, diagnosis, and overall management of this condition.Evidence Acquisition: Sources were obtained through a comprehensive literature search using PubMed and PMC. Various terms were used to query the database, including "hidradenitis suppurativa," "pathogenesis," "prevalence," "management," "surgery," "perineal," and "vulva."Results: Underreported prevalence and unknown pathogenesis have subsequently led to variable approaches in clinical management, often employing a combination of medical and surgical management.Conclusion: Early diagnosis and treatment of HS may lead to better disease control and minimize patients' associated morbidity related to disease.Relevance: Knowledge of vulvoperineal hidradenitis is necessary for gynecologists and primary care physicians to ensure early diagnosis, management, and referral for optimal patient outcomes.Target Audience: Obstetricians and gynecologists, family physicians.Learning Objectives: After completing this activity, the learner should be better able to describe the presentation and staging of hidradenitis suppurativa; explain possible medical and surgical treatments; and identify options for correction of vulvar deformities.Hidradenitis suppurativa (HS) is a chronic, inflammatory cutaneous disorder that occurs with a predilection for intertriginous locations such as the axilla, buttock, perineum, and groin. [1][2][3] It is a progressive disease characterized by the formation of abscesses, fistulas, and draining sinuses, as well as marked fibrosis leading to irregular, hypertrophic scarring. 1,2,4 Clinical staging is usually denoted using Hurley classification, although there are several additional verified schemata that can be used. Although historically considered rare, the overall prevalence of HS is likely anywhere between 0.1% and 4%. [5][6][7] Pathogenesis was originally felt to center on apocrine glands and follicular occlusion, but in recent years, it has been characterized as a chronic inflammatory disorder primarily centering on hair follicles. 8,9 In addition,

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Multidisciplinary Update on Genital Hidradenitis Suppurativa

Cited by 7 publications

References 59 publications

A systematic review and meta‐analysis of sexual dysfunction in patients with hidradenitis suppurativa

A systematic review and meta‐analysis of sexual dysfunction in patients with hidradenitis suppurativa

Skin grafting for penile skin loss

Vulvoperineal Hidradenitis Suppurativa: Diagnosis, Treatment, and Management of Deformities

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