What causes hidradenitis suppurativa?

Paus, Lübeck Ralf; Kurzen, Hjalmar; Kurokawa, Ichiro; Jemec, Gregor B.E.; Emtestam, Lennart; Sellheyer, Klaus; Giamarellos‐Bourboulis, Evangelos J.; Nagy, István; Bechara, Falk G.; Sartorius, Karin; Lapins, Jan; Krahl, Dieter; Altmeyer, Peter; Revuz, J.; Zouboulis, Christos C.

doi:10.1111/j.1600-0625.2008.00712.x

Cited by 234 publications

(16 citation statements)

References 134 publications

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“…Prior studies have proposed multiple possible factors to explain the relationship between HS and DM. First, HS is thought to develop from a hyperandrogenic state, with increased aromatization of androgenic hormones in peripheral adipose tissue . There is also clinical evidence to support an association between HS and polycystic ovarian syndrome, which is also a hyperandrogenic state .…”

Section: Discussionmentioning

confidence: 97%

Hidradenitis suppurativa and diabetes mellitus: updated systematic review and adjusted meta‐analysis

2019

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Summary Background Hidradenitis suppurativa (HS) is a debilitating and distressing chronic inflammatory skin disease. There is also evolving evidence supporting the association between HS and cardiovascular risk factors, including smoking, obesity, hyperlipidaemia and metabolic syndrome. Notably, these are clinical features and risk factors that are closely associated with type 2 diabetes mellitus (DM). Aims We performed a pooled adjusted meta‐analysis of comparative studies to investigate the relationship between HS and DM. Methods A systematic review and meta‐analysis was performed according to recommended Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. OR was used as the summary effect size. Results From pooled analysis of unadjusted data from 12 studies, we found a significantly higher proportion of DM in HS cases compared with non‐HS healthy controls (16.1% vs. 15.7%; OR = 2.17; 95% CI 1.85–2.55; P < 0.001). Adjusted effect sizes from five studies were also pooled. A significantly higher proportion of DM was found for HS compared with healthy controls, although the effect size was attenuated compared with unadjusted analyses (OR 1.69; 95% CI 1.50–1.91; P < 0.001). Conclusions To our knowledge, our systematic review and meta‐analysis is the first to pool adjusted effect sizes. We found that HS was associated with a 1.69‐fold increased odds of diabetes; however, the absolute risk difference was small (16.1% vs. 15.7%) and is probably not clinically relevant. Treating clinicians should be aware of this association, but there may not be an urgent need to perform screening for impaired glucose tolerance or diabetes.

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Section: Discussionmentioning

confidence: 97%

Hidradenitis suppurativa and diabetes mellitus: updated systematic review and adjusted meta‐analysis

2019

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“…The etiology of the follicular occlusion tetrad including PCAS remains unknown but several mechanisms have been proposed; for example, mechanical disruption and immunological dysfunction of the affected hair follicles due either to bacterial stimulation or to the activation of innate immune responses . The pathogenesis of HS involves a primarily immunological reaction as characterized by the early appearance of lymphocytes.…”

Section: Discussionmentioning

confidence: 99%

Perifolliculitis capitis abscedens et suffodiens treatment with tumor necrosis factor inhibitors: A case report and review of published cases

Takahashi

Yamasaki

Terui

et al. 2019

The Journal of Dermatology

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Perifolliculitis capitis abscedens et suffodiens (PCAS) or dissecting cellulitis is a rare condition presenting deep follicular occlusions, follicular ruptures and follicular infections in the scalp area with unknown etiology, which consequently cause primary neutrophilic cicatricial alopecia by the repeated follicular inflammation. PCAS is categorized as one of the “follicular occlusion tetrad” along with hidradenitis suppurativa, acne conglobata and pilonidal cyst. In the pathogenesis of the follicular occlusion tetrad, the involvement of neutrophils and its activator tumor necrosis factor (TNF) have been discussed. Here, we report a case of PCAS that was successfully treated with adalimumab, a human anti‐TNF monoclonal antibody. This is the first Asian case of PCAS that was improved by a TNF inhibitor.

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“…Overall, there is still no absolute consensus as to the etiology of HS, but the hair follicle likely plays an integral role. Localization to intertriginous areas may be explained by shear forces in these areas leading to micro tears in the hair follicle, which is exacerbated by larger skin folds in the obese [10].…”

Section: Resultsmentioning

confidence: 99%

Efficacy of Nd:YAG Laser for the Treatment of Hidradenitis Suppurativa

Nosrati¹,

Hunter²,

Kelly³

2012

JCDSA

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Hidradenitis suppurativa (HS) is an inflammatory skin disease that involves sebaceous glands and hair follicles of intertriginous areas, including axillary and inguinal regions. It is often chronic, painful, disabling, and can worsen over time. Besides surgically excising affected areas, effective treatments are currently lacking. The long-pulsed neodymium:yttrium-aluminium-garnet (Nd:YAG) laser is a device that has traditionally been used for hair removal, but has recently shown promise in clearing old lesions of HS and preventing new eruptions. In accordance with studies in the current literature, we hypothesize that the Nd:YAG laser will significantly improve subjects with hidradenitis suppurativa compared to standard, uninvasive treatment with topical antibiotics [1,2]. Study aims include: to treat subjects with hidradenitis suppurativa with Nd:YAG laser therapy once monthly for 3 consecutive months, with a one month followup; to compare the effectiveness of Nd:YAG treatment on one side of the subject (e.g., right) to treatment with topical antibiotics on the subject's other side (e.g., left); to assess treatment response using a visual analogue scale; to assess subject satisfaction with treatment using a questionnaire; and to photodocument treatment response at each visit.

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What causes hidradenitis suppurativa?

Cited by 234 publications

References 134 publications

Hidradenitis suppurativa and diabetes mellitus: updated systematic review and adjusted meta‐analysis

Hidradenitis suppurativa and diabetes mellitus: updated systematic review and adjusted meta‐analysis

Perifolliculitis capitis abscedens et suffodiens treatment with tumor necrosis factor inhibitors: A case report and review of published cases

Efficacy of Nd:YAG Laser for the Treatment of Hidradenitis Suppurativa

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