Painful Hidradenitis Suppurativa

Abstract

Hidradenitis suppurativa (HS) is a chronically relapsing skin disorder characterized by recurring inflammatory lesion in hair and apocrine gland-bearing skin creases in the axilla; groin or perineum, buttocks, and/or breast. HS may lead to painful eruptions and malodorous discharge significantly detracting from quality of life. HS causes a high degree of morbidity with the highest scores obtained for the level of pain caused by the disease. The majority of patients rated their pain on a Numerical Rating Scale-11 ranging from 4/10 to 10/10 and described it at various times as hot, burning, pressure, stretching, cutting, sharp, taut, splitting, gnawing, pressing, sore, throbbing, and aching. Despite the severe pain associated with this disease, HS has been essentially ignored in the pain medicine literature. It is hoped that greater understanding of the diagnosis, pathophysiology, and potential treatment options available for patients with HS, may help put pain specialists in a better position to contribute to the overall care of patients with significantly painful HS. This article reviews HS and pain. Potential mechanisms of modulating nociceptive processes in the skin are presented. A greater understanding of the diagnosis, pathophysiology, and potential treatment options for HS patients may help providers to be better able to contribute to care of patients with painful hidradenitis suppurativa.

Abordagem da Dor em Dermatologia (Parte I)

“…Revista SPDV 75 (3) 38 ao da presença paternal. O uso deste tipo de estratégias ansiolíticas adjuvantes deve ser encorajado também em cirurgia dermatológica, contribuindo para um aumento da adesão ao tratamento e facilitando a atividade do cirurgião, sempre desafiante em crianças e jovens.…”

“…1,2 A dor aguda é uma das principais causas de procura de cuidados de saúde e de insatisfação do doente com a atividade cirúrgica e o seu tratamento ineficaz é um preditor reconhecido de cronificação. 3 Apesar de nas últimas décadas se terem verificado avanços substanciais no âmbito do controlo álgico, a dor aguda pós-operatória continua a ser frequentemente desvalorizada e inadequadamente tratada. Mais de 50% dos doentes referiu dor grave a intolerável após cirurgia ou trauma no estudo PATHOS.…”

“…8 Uma proporção significativa de doenças cutâneas está associada a apresentações dolorosas de contexto agudo e/ ou crónico, muitas vezes com quadros fisiopatológicos complexos e de tratamento difícil. A hidradenite supurativa, 3 a úl-cera de perna 9 ou a nevralgia pós-herpética 10 são exemplos paradigmáticos onde a sintomatologia álgica se reflete negativamente em várias dimensões de qualidade de vida dos doentes. Os procedimentos de diagnóstico e terapêuticos em Dermatovenereologia desencadeiam dor pós-operatória, a qual contribui para morbilidade cirúrgica.…”

Exploring Coping Strategies for Patients With Hidradenitis Suppurativa

“…Patients with HS can experience severe pain and discharge which may be malodorous. 1 HS may lead to negative impacts on work and income, interpersonal relationships, self-worth, psychological health, as well as sexual dysfunction and distress. 2,3 However, studies on the impact of HS on patients' quality of life (QOL) do not comprehensively address patients' coping and resilience strategies.…”

Acneiform Eruptions and Pregnancy

“…It is destructive in nature and manifests as painful inflammatory nodules and sterile abscesses located in hair and apocrine gland-bearing skin creases in the axilla; groin or perineum, buttocks, and/or breast [59]. The disease often progresses with the formation of draining sinus tracts and due to subcutaneous extension with induration, destruction of skin appendages, and subsequent scarring [2,60].…”