Management of Severe Hidradenitis Suppurativa

Katzman, Ju Hee; Tahmasbi, Maryam; Ghayouri, Masoumeh; Nanjappa, Sowmya; Li, Michael C.; Greene, John N.

doi:10.7759/cureus.13483

Cited by 3 publications

(6 citation statements)

References 17 publications

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“…Intralesional injections of glucocorticoids also play a role in the treatment of mild HS with few nodules and have shown to be effective and alleviate pain rapidly [21,31].…”

Section: Treatmentmentioning

confidence: 99%

“…Even though their effects were demonstrated mostly in small case series, there is strong evidence based on large randomized controlled trials supporting the use of adalimumab (anti-TNF). In one of these studies, patients received weekly dose of adalimumab and 58.9% of them achieved at least 50% of reduction in acute lesion count, with no increase in abscesses [31][32][33]. More effective treatment involves several therapeutic strategies together, considering the severity and distribution of the lesions.…”

Section: Tablementioning

confidence: 99%

“…More effective treatment involves several therapeutic strategies together, considering the severity and distribution of the lesions. Clinical and social income conditions of the patient may be considered to guide the proper management [31][32][33].…”

Section: Tablementioning

confidence: 99%

“…It consists of careful unroofing and debridement of sinuses and inflamed tissue followed by scrubbing. This can be alternatively made with a carbon dioxide laser [31][32][33].…”

Section: Tablementioning

confidence: 99%

See 3 more Smart Citations

Hidradenitis Suppurativa Perineal and Perianal

Luporini¹,

Frizol²,

Segantini³

et al. 2023

Benign Anorectal Disorders - An Update

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Hidradenitis suppurativa (HS) is a chronic inflammatory, recurrent, and a debilitating skin disorder that affects the follicular epithelium, specifically of apocrine-gland-bearing regions (such as axillae, inframammary folds, groin, perineal, and/or perigenital). HS prevalence is around 1–4%, and the perineal disease is more common in males. HS is initially characterized by perifollicular lymphocytic infiltrate, which causes glands’ duct occlusion, dilation, rupture of the follicle, and increased inflammation. The result is the formation of tunnels (fistulas) connecting the glands to the skin’s surface. Secondary bacterial infections may occur. The etiological factors are obesity, smoking, and hormones, with a genetic predisposition of up to 40% of patients. HS usually occurs in early adulthood, with inflamed skin nodules, abscesses, pus discharge tunnels, and scarring developed in axillary, inguinal, gluteal, and perineal body sites. The diagnosis is made clinically based on typical lesions, affected regions, and progression (chronicity, persistent lesions, and recurrence). The therapy for HS must be individualized and guided by severity. They range from topical and systemic antibiotics, retinoids, immunosuppressive drugs, local therapies such as laser, phototherapy, hyperbaric, and even regulated and extensive surgical resections, which may be associated with skin grafts.

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“…Intralesional injections of glucocorticoids also play a role in the treatment of mild HS with few nodules and have shown to be effective and alleviate pain rapidly [21,31].…”

Section: Treatmentmentioning

confidence: 99%

Section: Tablementioning

confidence: 99%

Section: Tablementioning

confidence: 99%

“…It consists of careful unroofing and debridement of sinuses and inflamed tissue followed by scrubbing. This can be alternatively made with a carbon dioxide laser [31][32][33].…”

Section: Tablementioning

confidence: 99%

See 2 more Smart Citations

Hidradenitis Suppurativa Perineal and Perianal

Luporini¹,

Frizol²,

Segantini³

et al. 2023

Benign Anorectal Disorders - An Update

View full text Add to dashboard Cite

show abstract

“…It should be remembered that there are treatments for HS that should be based on the severity of the disease, and other medications such as clindamycin, rifampicin, hormonal therapies, and association with various surgical approaches can be used, from incision and drainage to control infectious foci to extensive resections to remove irreversible lesions. Important risk factors such as smoking, obesity, and improved skin hygiene should also be controlled ( 23 ).…”

Section: Studies Associating CD and Hsmentioning

confidence: 99%

Hidradenitis suppurativa: Coexistence or dermatological extraintestinal manifestation of Crohn's disease?

2023

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Psychiatric Influences on Hidradenitis Suppurativa: A Call for Help

Shan,

Huffman,

Bovill

et al. 2024

Arch Plast Surg

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Objective: Hidradenitis suppurativa (HS) is associated with a high prevalence of psychiatric disorders. However, no studies examine how psychiatric disorders influence surgical and financial outcomes. The study aim was to assess impact of a psychiatric diagnosis on patients treated for HS. Methods: Patients with HS were retrospectively identified at a single institution from 2010-2021. Cohorts were stratified by the presence of a psychiatric disorder. Demographics, comorbidities, and disease characteristics were collected. Outcomes assessed included the procedural interventions and emergency department (ED) visits. Financial distress was assessed via the COST-FACIT Version 2 survey. Results: Out of 138 patients, 40 (29.0%) completed the survey of which 19 (47.5%) had a pre-existing psychiatric diagnosis. No demographic differences were found between cohorts. Mean follow-up was 16.1+11.0 months. The psychiatric cohort had a higher median number of surgeries received (7.0 vs.1.5, p<0.001), a higher median number of ED visits (1.0 vs 0, p=0.006), and a similar hospital length of stay (p=0.456). The overall mean COST-FACIT score was 19.2+10.7 (grade one financial toxicity). The psych cohort had a lower mean COST-FACIT score (16.8 vs. 21.3, p=0.092) and reported greater financial hardship (3.3 vs. 1.7, p<0.001). On multivariate analysis a psychiatric diagnosis was predictive of lower credit scores, more ED visits, and a higher number of surgeries. Conclusion: Pre-existing psychiatric conditions in patients with HS are associated with increased healthcare utilization and surgical intervention with substantial financial distress. Plastic surgeons should be cognizant of such comorbid disorders to facilitate holistic care addressing all patient needs.

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Management of Severe Hidradenitis Suppurativa

Cited by 3 publications

References 17 publications

Hidradenitis Suppurativa Perineal and Perianal

Hidradenitis Suppurativa Perineal and Perianal

Hidradenitis suppurativa: Coexistence or dermatological extraintestinal manifestation of Crohn's disease?

Psychiatric Influences on Hidradenitis Suppurativa: A Call for Help

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