Increased serum tumour necrosis factor-alpha in hidradenitis suppurativa patients: is there a basis for treatment with anti-tumour necrosis factor-alpha agents?
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Hidradenitis suppurativa: a disease with male predominance in Tunisia.
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BACKGROUND: hidradenitis suppurativa (HS) is a chronic inflammatory, suppurating, fistulizing, and scar-producing disease of apocrine gland-bearing skin. The diagnosis is primarily clinical, based on the presence of both sinus tracts and abscesses with a characteristic distribution. OBJECTIVE: Review of epidemiological, clinical, and prognostic characteristics of HS and discussion of the etiopathogenic aspects of this chronic problem. PATIENTS AND METHODS: We retrospectively report all cases of HS followed at the Department of Dermatology between January 1985 and December 2008. RESULTS: Eleven patients (10 male and 1 female), with a mean age of 35.2 years (range 21 dash, vertical53 years) at HS diagnosis were followed for HS. The average age of disease onset was 23.9 years. The median delay between onset of symptoms and diagnosis was 144 months (range 1 dash, vertical408 months). Clinical features showed inflamed discharging papules or nodules, painful tender erythematous nodules, and double-ended comedones. The disease mainly affected the axillary, anal, perineal, and genital areas. Histologically, dermal features showed active folliculitis or abscess, sinus tract formation, fibrosis, and granuloma formation. Pathological associations (Darier's disease and Down syndrome) were noted in two patients. Treatment consisted of antibiotics in eight patients, retinoids (1 mg/kg/ day) in three patients, and surgery in three patients. The mean follow-up was 13 months (range 2 dash, vertical30 months). Recurrence of lesions was observed in all patients approximately 1 month after treatment withdrawal. The Down syndrome patient developed vaginal hydrocele of the testis as a complication of his staphylococcic ulcers. In all cases healing occurred with substantial scarring. DISCUSSION: An obvious male predominance was noted in our patients as well as a delay in the diagnosis of HS, which could be explained by non-recognition of the disease by non-specialists that see the patients at the primary-care level. (+info)
Psychophysical aspects of hidradenitis suppurativa.
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Chronic bacterial and parasitic infections and cancer: a review.
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BACKGROUND: A relatively underestimated facet of infectious diseases is the association of chronic bacterial and parasitic infections with cancer development. Therefore, we sought to evaluate the evidence regarding the association of such infections with the development of malignancy, excluding the overwhelming evidence of the association of Helicobacter pylori and cancer. METHODOLOGY: We searched Pubmed, Cochrane, and Scopus without time limits for relevant articles. RESULTS: There is evidence that some bacterial and parasitic infections are associated with cancer development. The level of evidence of this association varies from high to low; in any case, a long time interval is mandatory for the development of cancer. A high level of evidence exists for the association of Salmonella Typhi with gallbladder and hepatobiliary carcinoma; Opisthorchis viverrini and Clonorchis sinensis with cholangiocarcinoma; Schistosoma hematobium with bladder cancer; chronic osteomyelitis with squamous cell carcinoma of the skin; and hidradenitis suppurativa with squamous cell carcinoma of the skin. In contrast, the level of evidence regarding the association of Chlamydia spp. with cancer is low. Mycobacterium tuberculosis is associated with lung cancer, albeit probably not etiopathogenetically. CONCLUSIONS: A considerable number of bacterial infections and parasitic infections are associated with the development of cancer. Further research into recognizing additional associations of bacterial and parasitic infections with cancer is mandatory. (+info)
Surgical management of hidradenitis suppurativa.
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BACKGROUND: Hidradenitis suppurativa (HS) is a chronic, relapsing inflammatory disease of skin, characterized by recurrent draining sinuses and abscesses, predominantly in skin folds carrying terminal hairs and apocrine glands. METHOD: This study reviewed 54 sites in 27 patients with moderate to extensive chronic inflammatory skin lesions treated surgically in our hospital from 2004 through 2009, with a follow-up of at least 6 months. RESULT: A total number of 54 operative procedures were performed during the study period with 42% (23 sites) involving the axilla, 20% (11 sites) involving the gluteal area, %24 (13 sites) involving the perineal area and 12% (7 sites) involving the inguinal region. CONCLUSION: Conservative treatment methods have little or no effects especially on gluteal, perineal/perianal, axillary hidradenitis suppurativa. The morbidity associated with the established form of this disease is significant, and the only successful treatment is wide surgical excision. (+info)
Successful treatment of superficial pyoderma gangrenosum associated with hidradenitis suppurativa with adalimumab.
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Pyoderma gangrenosum (PG) and hidradenitis suppurativa (HS) are chronic inflammatory dermatoses that can be a challenge to treat. A role for TNF-alpha in their pathogenesis has been postulated in the literature. A therapeutic benefit of infliximab has been reported in recalcitrant cases of both conditions. To date, there is less evidence about the use of adalimumab for these conditions. We report a patient with severe superficial PG on a background of HS, which responded to adalumimab therapy after failure of infliximab therapy. (+info)
Gamma-secretase gene mutations in familial acne inversa.
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