Author Topic: Hidradenitis Suppurativa Articles  (Read 135238 times)

0 Members and 1 Guest are viewing this topic.

Celery Peach

  • Guest
Re:Hidradenitis Suppurativa Articles
« Reply #40 on: Friday July 30, 2004, 05:49:10 PM »
Nodulocystic acne and hidradenitis suppurativa treated with acitretin: a case report.

Scheman AJ.

North Shore Center for Medical Aesthetics, Northbrook, Illinois 60062, USA.

Nodulocystic acne is a dermatologic disease that can result in significant damage to the skin of the face, chest, and back. Hidradenitis suppurativa is a scarring disease of the skin that causes deep cysts and abscesses on the axillae and anogenital areas. We review a case of a patient with severe nodulocystic facial acne and hidradenitis suppurativa that was treated with 2 full courses of isotretinoin. Although the patient's condition improved, some draining cysts persisted on the face and groin. Because of the inability of isotretinoin to achieve long-term remission of the patient's condition, acitretin was considered as a possible maintenance drug. The patient was almost completely improved after 5 months' therapy with acitretin, which also was effectively used for ongoing maintenance. Acitretin may be a promising treatment for severe nodulocystic acne and hidradenitis suppurativa, which require long-term suppression when isotretinoin fails to give long-term remission.

Celery Peach

  • Guest
Re:Hidradenitis Suppurativa Articles
« Reply #41 on: Friday July 30, 2004, 05:51:22 PM »
Perforator-based fasciocutaneous island flaps for the reconstruction of axillary defects following excision of hidradenitis suppurativa.

Geh JL, Niranjan NS.

St Andrew's Centre for Burns and Plastic Surgery, Broomfield Hospital, Chelmsford, UK.

Hidradenitis suppurativa is a chronic socially debilitating disorder of unknown aetiology. Treatments include simple incision and drainage, excision and healing by secondary intention, spilt-skin grafting, and local-flap reconstructions. All of these methods can leave unsightly scars. Recurrence of the disease can be significantly reduced only by wide local excision of all the hair-bearing skin. Most methods involve repeated hospital admission, and leave contour defects in the upper arm and axilla. We describe a new method using double opposing V-Y perforator-based flaps to recreate the axillary contour after wide excision of the hair-bearing skin of the axilla. This method allows both axillae to be treated in a single stage, and represents a new alternative in the treatment of axillary hidradenitis suppurativa. Four patients are described: three underwent bilateral excision and reconstruction, while the fourth had a unilateral procedure. All patients had a single surgical procedure with no flap loss. The result following known reconstructive procedures is far from satisfactory: skin grafting leaves a divot deformity, and when a local flap, such as the posterior arm or thoracodorsal flap, is used it leaves a large bulky flap in the axilla. In our technique the flaps maintain the diamond shape of the axilla. Copyright 2002 The British Association of Plastic Surgeons.

Celery Peach

  • Guest
Re:Hidradenitis Suppurativa Articles
« Reply #42 on: Friday July 30, 2004, 05:52:34 PM »
[Prevalence of hidradenitis suppurativa in Denmark]

[Article in Danish]

Jemec GB, Heidenheim M, Nielsen NH.

H:S Bispebjerg Hospital, dermatologisk afdeling D.

The morbidity of hidradenitis suppurativa can be considerable, but little is known about its epidemiology. Our purpose was to describe the one-year and point prevalences of hidradenitis suppurative and its potential precursor lesions. We obtained the histories and examined an unselected sample (599 persons) of the general population (one-year prevalence), and we performed physical examination for a consecutive sample of 507 persons undergoing screening for sexually transmitted diseases (point prevalence). The point prevalence was 4.1% (95% confidence interval [CI] = 3.0-6.0) on the basis of objective findings. The one-year prevalence of hidradenitis was 1.0% (CI = 0.4-2.2) on the basis of subject recollection only. The patients in the sample on which the point prevalence is based were younger than those in the unselected sample of the general population (p < 0.001). Hidradenitis was significantly more common in women (p = 0.037), which may result from a female preponderance of genitofemoral lesions (odds ratio [OR] = 5.4; CI = 1.5-19.3). No sex difference was found in the prevalence of axillary lesions. Hidradenitis suppurativa is significantly more common than hitherto estimated. A female preponderance of patients is confirmed, except for patients with axillary lesions. Additional longitudinal studies are necessary to assess the importance of potential precursor lesions such as non-inflamed nodules or comedones.

Celery Peach

  • Guest
Re:Hidradenitis Suppurativa Articles
« Reply #43 on: Friday July 30, 2004, 05:54:08 PM »
Radiation therapy for benign diseases: patterns of care study in Germany.

Seegenschmiedt MH, Katalinic A, Makoski H, Haase W, Gademann G, Hassenstein E.

Klinik fur Radioonkologie, Strahlentherapie und Nuklearmedizin, Alfried Krupp Krankenhaus, Essen, Germany.

BACKGROUND: Radiotherapy of benign diseases is controversial and rarely applied in Anglo-American countries, whereas in other parts of the world it is commonly practiced for several benign disorders. Similar to a European survey, a patterns of care study was conducted in Germany. METHOD: Using a mailed questionnaire, radiation equipment, treatment indication, number of patients, and treatment concepts were assessed in 1994, 1995, and 1996 in 134 of 152 German institutions (88%): 22 in East and 112 in West Germany; 30 in university hospitals and 104 in community hospitals. Average numbers of each institution and of all institutions were analyzed for frequencies and ratios between regions and among institutions. Radiation treatment concepts were analyzed. RESULTS: A mean of 2 (range 1-7) megavoltage and 1.4 (range 0-4) orthovoltage units were available per institution; 32 institutions (24%) had no orthovoltage equipment. A mean of 20,082 patients were treated annually: 456 (2%) for inflammatory diseases (221 hidradenitis, 78 local infection, 23 parotitis; 134 not specified) 12,600 (63%) for degenerative diseases (2711 peritendinitis humeroscapularis, 1555 epicondylitis humeri; 1382 plantar/dorsal heel spur; 2434 degenerative osteoarthritis; 4518 not specified); 927 (5%) for hyperproliferative diseases (146 Dupuytren's contracture, 382 keloids; 155 Peyronie's disease; 244 not specified); 1210 (6%) for functional disorders (853 Graves' orbitopathy; 357 not specified); and 4889 (24%) for other disorders (e.g., 3680 heterotopic ossification prophylaxis). In univariate analysis, there were geographic (West vs. East Germany) differences in using radiation therapy (RT) for inflammatory and degenerative disorders, and institutional differences (university versus community hospitals) in using RT for hyperproliferative and functional disorders (p < 0.05). The prescribed dose concepts were mostly in the low dose range, <10 Gy but varied widely and inconsistently within geographic regions and institutions. CONCLUSION: Radiation therapy is a well-accepted and frequently practiced treatment for several benign diseases in Germany; however, there are significant geographic and institutional differences. As the number of orthovoltage units decreases, an increasing patient load will demand more megavoltage units, which may compromise the cost-effectiveness of this treatment. Only 4% of all clinical institutions have been involved in controlled clinical trials. To maintain a high level of RT service to other disciplines, RT treatment guidelines, quality control, and continuing medical education are required.

Celery Peach

  • Guest
Re:Hidradenitis Suppurativa Articles
« Reply #44 on: Friday July 30, 2004, 05:55:40 PM »
[Radiotherapy of hidradenitis suppurativa--still valid today?]

[Article in German]

Frohlich D, Baaske D, Glatzel M.

Klinik fur Strahlentherapie, Zentralklinikum, Suhl.

PURPOSE: In a retrospective analysis the efficacy of radiotherapy in the treatment of hidradenitis suppurativa was assessed. PATIENTS AND METHODS: Data from 231 patients undergoing radiotherapy for hidradenitis suppurativa in the last years in 2 hospitals were analyzed. The patients were treated with an orthovoltage therapy unit with 175 kV, 0.5 mm copper-filtering. The single doses reached from 0.5 Gy to 1.5 Gy up to total doses between 3.0 Gy and 8.0 Gy in one series. In chronic recurrent disease 2 or more series with a total dose of more than 10.0 Gy were given. RESULTS: Complete relief of symptoms at the end of radiotherapy was achieved in 89 patients (38%). In 92 patients (40%) there was clear improvement of symptoms. Only 2 patients did not react to radiotherapy. No side effects of radiotherapy occurred. CONCLUSION: Radiotherapy should be given more consideration as a treatment option for hidradenitis suppurativa.

Celery Peach

  • Guest
Re:Hidradenitis Suppurativa Articles
« Reply #45 on: Friday July 30, 2004, 05:57:39 PM »
Sebum excretion in hidradenitis suppurativa.

Jemec GB, Gniadecka M.

Department of Dermatology D, Bispebjerg Hospital, University of Copenhagen, Denmark.

BACKGROUND: Clinical and histological similarities between hidradenitis suppurativa and acne have been pointed out. The possible role of sebaceous glands in hidradenitis has not previously been investigated. Acne treatment, in particular is however not effective in hidradenitis. No previous information was found on regional sebum excretion in hidradenitis. OBJECTIVE: Investigate the sebum excretion (SE) and markers of cutaneous virilization in hidradenitis patients. METHODS: Sebutapes and scores of acne, hirsutes and alopecia in 16 women with hidradenitis suppurativa were compared with 16 healthy controls. RESULTS: The SE and the number of active glands followed a similar pattern in both groups (face > axillae/genitofemoral fold, p < 0.0001) but no significant differences were seen between the two groups. No differences were seen in the median Body Mass Index, number of obese persons in either group or any of the clinical markers of virilization studied. CONCLUSION: No significant axillary, genitofemoral or facial seborrhea was found in hidradenitis. It is suggested that SE is not an important factor in the development of hidradenitis, and this may help explain the generally unsatisfactory therapeutic effect of retinoids in this disease. The results further suggest that general cutaneous virilization is not a feature of hidradenitis.

Celery Peach

  • Guest
Re:Hidradenitis Suppurativa Articles
« Reply #46 on: Friday July 30, 2004, 05:58:30 PM »
Squamous cell carcinoma in perineal inflammatory disease.

Gur E, Neligan PC, Shafir R, Reznick R, Cohen M, Shpitzer T.

Division of Plastic Surgery, Toronto Hospital, University of Toronto, Ontario, Canada.

Four patients with squamous cell carcinoma of the perineal region were diagnosed and treated during the last 4 years in our institutions. The underlying diagnoses consisted of recurrent pilonidal disease, Crohn's disease, and hidradenitis suppurativa. In all patients, a pattern of a long-term inflammatory process was evident. Current concepts regarding the pathophysiology of a chronic inflammatory state and malignant transformation are reviewed. We conclude that regardless of the original pathology, all chronic inflammatory processes in the perineal region should be evaluated for malignant degeneration. A high index of suspicion may potentiate an early diagnosis, possibly improving the chance of cure.

Celery Peach

  • Guest
Re:Hidradenitis Suppurativa Articles
« Reply #47 on: Friday July 30, 2004, 06:01:03 PM »
Subcutaneous fistulectomy in bridging hidradenitis suppurativa.

Golcman R, Golcman B, Tamura BM, Nogueira MA, Zoo CM, Germano JA.

Department of Dermatology, University of Sao Paulo Medical School, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Brazil.

BACKGROUND: The treatment of chronic lesions in hidradenitis suppurativa remains a challenge. For some clinical types surgical management is an excellent alternative. OBJECTIVE: This study evaluates an alternative surgical approach for the treatment of hidradenitis suppurativa of specific bridging lesions by subcutaneous resection of the tubular fibrotic tissue. METHODS: Periorificial fusiform skin incisions were made around the orifices parallel to the axillary or inguinal folds and the subcutaneous tubular fibrotic tissue was removed en bloc before skin suturing. RESULTS: The outcome was evaluated as satisfactory due to lower morbidity, minimizing the excised skin areas, prevention of bridles or adherences, shorter incisions, no healing difficulties, and less dehiscence or wound exposure. CONCLUSION: The subcutaneous fistulectomy is a surgical option in bridging hidradenitis suppurativa.

Offline Fortuna

  • SkinCell Grand
  • Giggler
  • *****
  • Posts: 2438
  • Gender: Female
  • The Mad Court Jester
Re:Hidradenitis Suppurativa Articles
« Reply #48 on: Wednesday September 08, 2004, 07:31:10 PM »
« Last Edit: Wednesday September 08, 2004, 07:32:33 PM by jesster00420 »
"Try anything once, come hot, come cold.  If we're not foolish young, we're foolish old."
Canterbury Tales, Geoffrey Chaucer
"It is easier to find men who will volunteer to die, than to find those who are willing to endure pain with patience." - Gaius Julius Caesar
Luceo Non Uro "I shine not burn

Celery Peach

  • Guest
Re:Hidradenitis Suppurativa Articles
« Reply #49 on: Thursday September 09, 2004, 02:49:43 PM »
Cellulitis Info a side effect sometimes found with HS

Symptoms and Signs

Infection is most common in the lower extremities. A cutaneous abnormality (eg, skin trauma, ulceration, tinea pedis, dermatitis) often precedes the infection; areas of lymphedema or other edema seem especially susceptible. Scars from saphenous vein removal for cardiac or vascular surgery are common sites for recurrent cellulitis, especially if tinea pedis is present. Frequently, however, no predisposing condition or site of entry is evident. The major findings are local erythema and tenderness, frequently with lymphangitis and regional lymphadenopathy. The skin is hot, red, and edematous, often with an infiltrated surface resembling the skin of an orange (peau d'orange) (see Plate 112-1). The borders are usually indistinct, except in erysipelas (see below), a type of cellulitis in which the raised margins are sharply demarcated. Petechiae are common; large areas of ecchymosis, rare. Vesicles and bullae may develop and rupture, occasionally with necrosis of the involved skin. Systemic manifestations (fever, chills, tachycardia, headache, hypotension, delirium) may precede the cutaneous findings by several hours, but many patients do not appear ill. Leukocytosis is common but not constant.

Diagnosis

The diagnosis usually depends on the clinical findings. Unless pus has formed or an open wound is present, the responsible organism often is difficult to isolate, even on aspiration or skin biopsy. Blood cultures are occasionally positive. Serologic tests, especially measurement of rising titers of anti-DNase B, confirm a streptococcal cause but are usually unnecessary.

Although cellulitis and deep vein thrombosis usually are easily differentiated clinically (see Table 112-1), many physicians confuse these entities when edema occurs in the lower extremities.

Course and Prognosis

Local abscesses form occasionally, requiring incision and drainage. Serious but rare complications include severe necrotizing subcutaneous infection (see below) and bacteremia with metastatic foci of infection. Even without antibiotics, most cases of superficial cellulitis resolve spontaneously; however, recurrences in the same area are common, sometimes causing serious damage to the lymphatics, chronic lymphatic obstruction, marked edema, and, rarely, elephantiasis. With antibiotics, such complications are uncommon. Symptoms and signs of superficial cellulitis usually resolve after a few days of antibiotic therapy.

Treatment

For streptococcal cellulitis, penicillin is the drug of choice: For mild outpatient cases, penicillin V 250 to 500 mg po qid or a single dose of benzathine penicillin 1.2 million U IM is adequate. For severe infections, which require hospitalization, aqueous penicillin G 400,000 U IV q 6 h is indicated. In penicillin-allergic patients, erythromycin 250 mg po qid is effective for mild infections, and parenteral clindamycin 150 to 300 mg IV q 6 h for severe infections. Although S. aureus rarely causes typical cellulitis, many clinicians prefer using antibiotics also active against this organism: dicloxacillin 250 mg po qid for mild infections, or oxacillin or nafcillin 1 g IV q 6 h for severe infections. For penicillin-allergic patients or those with suspected methicillin-resistant S. aureus infection, vancomycin 1 g IV q 12 h is the drug of choice. When pus or an open wound is present, results of a Gram stain should dictate antibiotic choice. Immobilization and elevation of the affected area help reduce edema, and cool, wet dressings relieve local discomfort.

Cellulitis in a neutropenic patient requires antibiotics effective against aerobic gram-negative bacilli (eg, tobramycin 1.5 mg/kg IV q 8 h and piperacillin 3 g IV q 4 h) until culture results are available. Penicillin is the drug of choice for P. multocida, an aminoglycoside (eg, gentamicin) is effective against A. hydrophila, and tetracycline is the preferred antibiotic for V. vulnificus.

Recurrent leg cellulitis is prevented by treating concomitant tinea pedis, which often eliminates the source of bacteria residing in the inflamed, macerated tissue. If such therapy is unsuccessful or not indicated, recurrent cellulitis sometimes can be prevented by benzathine penicillin 1.2 million U IM monthly, or penicillin V or erythromycin 250 mg po qid for 1 wk/mo

Celery Peach

  • Guest
Re:Hidradenitis Suppurativa Articles
« Reply #50 on: Thursday September 09, 2004, 02:52:45 PM »
I think I may have posted this allready, but it has been updated this August, so here it is again :

http://www.emedicine.com/derm/topic892.htm

Celery Peach

  • Guest
Re:Hidradenitis Suppurativa Articles
« Reply #51 on: Thursday September 09, 2004, 03:04:38 PM »
J Am Acad Dermatol 1998 Dec;39(6):971-4 Abstract quote

BACKGROUND: Antibiotics are often used to treat hidradenitis, but only topical clindamycin has been shown to be effective in a randomized controlled trial. The paucity of these trials may be the result of difficulties in disease assessment.

OBJECTIVE: We compare topical clindamycin with systemic tetracycline in the treatment of hidradenitis suppurativa, and study clinical disease assessment.
 
METHODS: A total of 46 patients with stage 1 or 2 hidradenitis suppurativa were treated in a double-blind, double dummy controlled trial.

RESULTS: No significant difference was found between the two types of treatment. Patients' global assessment of disease was significantly worse than physician's assessment in 3 of 5 evaluations (P = .0096 to .015), but the correlation between patients' and physicians' assessments was satisfactory after only one visit (rs = .761 to .895). Soreness was the key factor in patients' overall assessment of the disease.

CONCLUSION: Systemic therapy with tetracyclines did not show better results than topical therapy with clindamycin. Subjective factors, particularly soreness, appear to be a key factor in patients' assessment of the disease and should, therefore, be included as an outcome variable in future therapy studies

Offline missmash

  • Senior Member
  • ****
  • Posts: 387
  • Gender: Female
Re: Hidradenitis Suppurativa Articles
« Reply #52 on: Wednesday September 22, 2004, 10:27:42 PM »
updated emedicine article declaring HS to be very common in the USA..

http://www.emedicine.com/emerg/topic259.htm
The greatest danger for most of us is not that our aim is too high and we miss it, but it is too low and we reach it...  michelangelo

Offline symsharon

  • Registered member
  • *
  • Posts: 3
  • Gender: Female
  • GRANDAUGHTHER HAS BEEN DIAGNOSED!!!
Re: Hidradenitis Suppurativa Articles
« Reply #53 on: Tuesday October 12, 2004, 11:44:24 PM »
PLEASE HELP ,MY GRANDAUGHTHER HAS BEEN DIAGNOSED WITH THIS DISEASE ! IS IT CURABLE ??IS IT HEREDITARY ????I HAVE HAD BOILS ,CYSTS, LYMPH NODES REMOVED ,SKIN CANCER ,THYROID PROBLEMS ,ETC... FEEL GUILTY!!!!
NEED HELP!!!

Offline froggy

  • Registered member
  • *
  • Posts: 10
Re: Hidradenitis Suppurativa Articles
« Reply #54 on: Wednesday December 01, 2004, 02:58:55 AM »
Dear Ice Queen,
     This is so sad...what a great life we all have to look forward to.  I just met the man that accepts all this cr--. :-\
     Froggy

Offline timnray03

  • Junior Member
  • **
  • Posts: 60
  • Gender: Male
Re: Hidradenitis Suppurativa Articles
« Reply #55 on: Wednesday December 15, 2004, 05:02:22 PM »
Hi, I have some info that I`d like to pass along. There is nothing published yet but HS suffers are about to get a new name for our medical condition or thats the rumors in PUBMED. With the new laser stuff, surgury type, they have found a host of new things about our condition many they did not know before. Myself, I`am not real happy with my HS being assocated with everything from a nose bleed to an in-grown toe nail, if you get my drift. Take care, timnray
The black sheep boys of Hidradenitis, smiles. We are a father and son with Hidradenitis. Mine since 1972, Tim`s about 9 years now. Sharing information is so very important and thanks for the Forum! timnray

Offline timnray03

  • Junior Member
  • **
  • Posts: 60
  • Gender: Male
Re: Hidradenitis Suppurativa Articles
« Reply #56 on: Thursday December 16, 2004, 10:06:05 PM »
 ;D Hi Gales and Guys, Wanted to pass on what Tim & I use our our HS outbreaks. The product we is called Hydrogen Peroxide-3%. It has been very effective for us and its very easy an cheap to use. This is not snake oil nor am I a snake oil sale salemans! Tim had an outbreak a few months age and it was one of the bad ones. It healed completely in about 17 days to a smooth round scar about the size of a dime. My disclamer, It works for us. Take care, timnray
The black sheep boys of Hidradenitis, smiles. We are a father and son with Hidradenitis. Mine since 1972, Tim`s about 9 years now. Sharing information is so very important and thanks for the Forum! timnray

Offline timnray03

  • Junior Member
  • **
  • Posts: 60
  • Gender: Male
Re: Hidradenitis Suppurativa Articles
« Reply #57 on: Tuesday December 21, 2004, 09:02:22 PM »
Hi Ice Woman ;), Thank you very much for all the info that you worked so hard on in this section.  You are a credit to the Forum and to all those that suffer from HS. Best Regards, Ray  -------- Merry Christmas and Merry New Year for you ;D
The black sheep boys of Hidradenitis, smiles. We are a father and son with Hidradenitis. Mine since 1972, Tim`s about 9 years now. Sharing information is so very important and thanks for the Forum! timnray

Offline timnray03

  • Junior Member
  • **
  • Posts: 60
  • Gender: Male
Re: Hidradenitis Suppurativa Articles
« Reply #58 on: Tuesday December 21, 2004, 09:04:47 PM »
Hi, OPS, Ice Queen, sorry bout` that. Ray
The black sheep boys of Hidradenitis, smiles. We are a father and son with Hidradenitis. Mine since 1972, Tim`s about 9 years now. Sharing information is so very important and thanks for the Forum! timnray

Celery Peach

  • Guest
Re: Hidradenitis Suppurativa Articles
« Reply #59 on: Tuesday December 21, 2004, 10:27:22 PM »
 :-* aww shucks Ray  :-[ thanks  ;D

Seasons greetings to you and yours !  ;D