Objectives To assess inflammatory serum markers including serum proinflammatory cytokines, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) according to the clinical inflammatory activity of patients with hidradenitis suppurativa (HS). Patients and Methods Seventy-four patients with HS were studied based on the Hidradenitis Suppurativa-Physician Global Assessment (HS-PGA) score and Hurley staging system. Proinflammatory cytokines were measured using a multiplex cytokine assay. Twenty-two healthy volunteers were recruited. Results Serum interleukin- (IL-) 6, IL-23, soluble tumour necrosis factor alpha (TNF-α) receptor I (sTNF-RI), CRP, and ESR were different in the patients with HS compared with those in the healthy controls (P < 0.05). The levels of IL-1β, IL-6, IL-8, IL-10, IL-12p70, IL-17A, sTNF-RII, CRP, and ESR were significantly elevated according to inflammatory activity based on HS-PGA scores (r > 0.25, P < 0.05). The levels of IL-6 (r = 0.53, P < 0.001), CRP (r = 0.54, P < 0.001), and ESR (r = 0.60, P < 0.001) were especially well correlated with clinical inflammatory activity based on HS-PGA scores. The levels of IL-6, IL-8, sTNF-RI, sTNF-RII, CRP, and ESR were significantly elevated according to Hurley staging system. Conclusions Serum proinflammatory cytokines, CRP, and ESR are increased in relation to the clinical inflammatory activity of patients with HS compared with healthy controls. Serum IL-6, CRP, and ESR are effective biomarkers for evaluating the severity of HS.

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Lee MS, Liang MG, Mulliken JB. Diffuse capillary malformation with overgrowth: A clinical subtype of vascular anomalies with hypertrophy. J Am Acad Dermatol 2013;69:589e94. Oduber CEU, van der Horst CMAM, Sillevis Smitt JH, Smeulders MJC, Mendiratta V, Harper JI, et al. A proposal for classification of entities combining vascular malformations and deregulated growth. Eur J Med Genet 2011;54: 262e71. Polubothu S, Kinsler VA. The ethnic profile of patients with birthmarks reveals interaction of germline and postzygotic genetics. Br J Dermatol 2017;176:1385e7. Shirley MD, Tang H, Gallione CJ, Baugher JD, Frelin LP, Cohen B, et al. SturgeeWeber syndrome and port-wine stains caused by somatic mutation in GNAQ. N Engl J Med 2013;368: 1971e9. Siegel DH, Cottrell CE, Streicher JL, Schilter KF, Basel DG, Baselga E, et al. Analyzing the genetic spectrum of vascular anomalies with overgrowth via cancer genomics. J Invest Dermatol 2018;138:957e67. Thomas AC, Zeng Z, Rivière JB, O'Shaughnessy R, Al-Olabi L, St-Onge J, et al. Mosaic activating mutations in GNA11 and GNAQ are associated with phakomatosis Pigmentovascularis and extensive dermal melanocytosis. J Invest Dermatol 2016;136:770e8. Vahidnezhad H, Youssefian L, Uitto J. Klippel-Trenaunay syndrome belongs to the PIK3CArelated overgrowth spectrum (PROS). Exp Dermatol 2016;25:17e9.

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Lichen planus follicularis tumidus (LPFT) represents an uncommon variety of lichen planus (LP). Clinically, it presents with prominent purplish lesions or white-pigmented yellowish cysts and comedones. Histopathologically, it is similar to lichen planopilaris, and it is additionally characterized by follicles and cysts surrounded by a lichenoid lymphocytic infiltrate. The most common location is the retroauricular region, and it may be associated with other variants of LP. Herein, we describe the case of a 50-year-old woman with a history of lower limb hypertrophic LP who subsequently presented with multiple pink, tumid, pruritic plaques with white-yellow cysts and comedones extensively affecting the bilateral face. Histopathologic examination revealed a lichenoid infiltrate surrounding the follicles and cysts. We diagnosed LPFT and began treatment with topical corticosteroids, antihistamines, systemic corticosteroids and oral acitretin without improvement. Subsequently, the patient had an acceptable response to cyclosporine at doses of 5 mg/kg/day with remission of itching and tumidity but with residual cysts and comedones remaining. To date, the literature contains only 16 cases of LPFT. To our knowledge, this is the most severe case and is the only one with cessation of disease activity in response to cyclosporine.