Overweight, diabetes and disease duration influence clinical severity in hidradenitis suppurativa–acne inversa: evidence from the national Italian registry

Bettoli, Vincenzo; Naldi, Luigi; Cazzaniga, Simone; Zauli, Stefania; Atzori, Laura; Borghi, Alessandro; Capezzera, Rossana; Caproni, Marzia; Cardinali, Carla; DeVita, V. T.; Donini, Massimo; Fabbrocini, Gabriella; Gimma, Antonia; Pasquinucci, S.; Patrizi, Annalisa; Pinna, Al; Raone, Beatrice; Ricci, Michela; Virgili, Annarosa; Balestri, Riccardo

doi:10.1111/bjd.13864

Cited by 67 publications

(70 citation statements)

References 15 publications

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“…Most HS patients are active smokers (66-71 %) or ex-smokers (8-15 %), and 51-82 % of patients are overweight or obese, with a BMI [25 kg/m 2 [134][135][136][137]. Disease severity is positively correlated with BMI [134][135][136], and case reports have demonstrated remission of HS after extensive weight loss [138,139]. In one study patients were asked after bariatric surgery if they had suffered from HS before the operation and if the symptoms had changed after the operation.…”

Section: Lifestyle Changesmentioning

confidence: 99%

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An Update on Medical Treatment Options for Hidradenitis Suppurativa

Deckers

Prens

2015

Drugs

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Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by recurrent inflammatory nodules mostly located in the armpits and groin. Over the years multiple treatments for HS have been proposed; however, to date a cure is still lacking. In this update we provide an overview of most drug treatments reported on for HS, where possible with their mode of action and side effects. In mild cases, clindamycin lotion or resorcinol cream have proven effective. Tetracyclines are a first-line systemic option in more widespread or severe cases, followed by the combination of clindamycin and rifampicin. However, the recurrence rate is high after discontinuation of clindamycin plus rifampicin combination therapy. Long-term treatment with retinoids, especially acitretin is feasible, although teratogenicity has to be taken into account in females of reproductive age. Multiple antiinflammatory drugs have been suggested for HS, such as dapsone, fumarates or cyclosporine. However, their effectiveness in HS is based on small case series with varying results. If most common treatments have failed, biologics (e.g., infliximab or adalimumab) are the next step. Although not addressed in this review, surgical interventions are often needed to achieve remission. Key PointsHidradenitis suppurativa (HS) is a chronic inflammatory skin disease without a cure.Antibiotics (topical or oral) are often the first treatment option for HS.In cases of more extensive or therapy-resistant HS, biologicals (e.g., infliximab or adalimumab) are a good therapeutic option.

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Section: Lifestyle Changesmentioning

confidence: 99%

“…However, it is thought that smoking can trigger the onset of HS, and heavy smokers tend to have more severe disease than non-or mild smokers [134][135][136]. In a study on the clinical course, patients were asked 22 years after the diagnosis was made if they still suffered from HS.…”

Section: Lifestyle Changesmentioning

confidence: 99%

An Update on Medical Treatment Options for Hidradenitis Suppurativa

Deckers

Prens

2015

Drugs

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“…Our patient was 46 years old and was not diagnosed since 7 years. Metabolic syndrome, smoking, and obesity are factors that not only facilitate Demodex infestation but also affect the formation and severity of HS (1,5). We still monitor our patient with topical permethrin.…”

Section: Discussionmentioning

confidence: 99%

“…Chronic inflammatory reaction has been proven. HS is most commonly located in the axillary, inguinoperineal, gluteal, and submammarian regions, as well as in the nape of the neck and inner surface of the femoral area (1)(2)(3). Many patients are reported to be diagnosed late.…”

Section: Introductionmentioning

confidence: 99%

“…The frequency of skin cancer as a secondary condition to chronic inflammation on the skin has increased. Moreover, cardiovascular events are frequently observed in these patients (1)(2)(3). Smoking, increased body mass index, uncontrolled diabetes, not using any treatment for a long time, and late diagnosis have been reported as factors that increase the severity of HS (1, 2).…”

Section: Introductionmentioning

confidence: 99%

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Hidradenitis Suppurativa, Metabolic Syndrome, and Demodex spp. Infestation

Ünal

Akçınar

Arduç

2018

TurkiyeParazitolDerg

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Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease. This type of dermatosis with underlying chronic inflammation significantly affects the quality of life and may be accompanied by many comorbidities. In this case, Demodex spp. was associated with treatment-resistant and persistent course of skin diseases. A 46-year-old female patient applied to our clinic with complaints of lesions on the body and hip. Her dermatological examination revealed abscess formation and post-inflammatory pigmentation. Millimetric scar formation and improved folliculitis-like lesions were observed on both glutei. These complaints started 7 years ago and become more intense and severe by time. Owing to the diagnoses of diabetes mellitus, hypertension, and hyperlipidemia, the patient was monitored for metabolic syndrome. In the cultures taken from the lesions, no growth was seen. A standardized skin surface biopsy of the patient demonstrated demodicosis. The patient was treated with oral metronidazole and topical permethrin lotion, whereupon a pronounced recovery was observed in her clinical condition. In the light of this case, we recommend that patients with HS should be checked for the presence of Demodex spp., and if it is detected, an appropriate treatment should be applied. To our knowledge, this is the first case report presenting the relationship between HS and Demodex infestation.

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