1
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Masood N. Hidradenitis suppurativa from the typical patient to the new clinical phenotype. Clin Dermatol 2024:S0738-081X(24)00074-9. [PMID: 38710291 DOI: 10.1016/j.clindermatol.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Affiliation(s)
- Nimra Masood
- Institution: Services Institute of Medical Sciences, 301 Mehran Block, Allama Iqbal Town, Jail Road, Lahore, Pakistan.
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2
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McGrath C, Steyn M, Rashidghamat E. Hidradenitis suppurativa in children and young adults: a retrospective cross-sectional observational study in the United Kingdom. Int J Dermatol 2024. [PMID: 38273707 DOI: 10.1111/ijd.17049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 01/03/2024] [Accepted: 01/11/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) in children and young adults (CYA) (<18 years) is uncommon. No previous observational studies have been carried out in a UK CYA HS population. METHODS This study was based on retrospective case note reviews of CYA HS patients attending tertiary-level care in the CYA HS service in a UK hospital. Patients <18 years old with a known diagnosis of HS were screened for inclusion. Exclusion criteria were those with less than one follow-up appointment. RESULTS Twenty-eight CYA HS patients were identified, with an M:F ratio of 1:8.3. Mean BMI was 25.2 (SD: 7.6). 17 (61%) of cases had a relevant family history. Long-term antibiotic monotherapy was the most common treatment initiated. Lymecycline was the most commonly prescribed antibiotic, accounting for 23 (56%) of the 41 courses prescribed. Additional treatments initiated included dual therapy with rifampicin and clindamycin, isotretinoin, and adalimumab, which were more commonly prescribed in patients with Hurley Stage II or III. CONCLUSIONS This group had a female predominance with an apparent strong genetic predisposition which is seen in other HS CYA cross-sectional research. Treatment was varied in this cohort, however long courses of antibiotics, including combined therapy with rifampicin and clindamycin, were the mainstay of treatment, similar to management in the adult population. This study therefore adds to the limited information on the demographics and management of the HS CYA population.
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Affiliation(s)
- Conn McGrath
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Mia Steyn
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Ellie Rashidghamat
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
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3
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van der Weijden DAY, Koerts NDK, van Munster BC, van der Zee HH, Horváth B. Hidradenitis suppurativa tarda: defining an understudied elderly population. Br J Dermatol 2023; 190:105-113. [PMID: 37665963 DOI: 10.1093/bjd/ljad317] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/24/2023] [Accepted: 08/25/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is a chronic, devastating, multifactorial skin disease. Patients generally develop HS after puberty and the prevalence of the disease is assumed to decrease with higher age. Data outside the usual age range are limited, especially for elderly patients. OBJECTIVES To investigate the prevalence, clinical characteristics and associated comorbidities among the elderly HS population. METHODS Data were collected through a population-wide survey-based study within the Lifelines Cohort Study in the Netherlands. The clinical characteristics of elderly patients with HS (≥ 60 years) were compared with an adult population (< 60 years) with HS. The comorbidities in elderly patients with HS were compared with those of a non-HS sex- and age-matched elderly population in a 1 : 4 ratio. HS in the elderly was defined as active HS in patients aged 60 years and older. Within the HS elderly group, two subgroups were defined, late-onset HS (HS developed after 60 years of age) and persistent HS (HS developed from a younger age but continuing after 60 years of age). RESULTS Within the Lifelines cohort 209 elderly patients with HS were identified as well as an adult (< 60 years) group with HS (n = 793) and a non-HS sex- and age-matched control elderly group (n = 810). The prevalence of HS among the elderly bootstrap analysis population was 0.8% [95% confidence interval (CI) 0.4-1.2]. A significantly higher age of HS symptom onset was found compared with the adult HS group: respectively, 40 vs. 23 years (odds ratio 1.056, 95% CI 1.05-1.07). Among the elderly HS cohort (in the Discussion, the HS tarda cohort) a female : male ratio of 1.7 : 1.0 and a higher family history for HS were found. Moreover, elderly patients with HS had a significantly higher risk of having HS-associated comorbidities compared with the sex- and age-matched controls. CONCLUSIONS The prevalence of HS in the elderly is not rare. Among the elderly a shift from female predominance towards a lower female : male ratio in HS is observed. In addition, HS in the elderly showed significant variation in age of onset and involved body areas. Moreover, elderly patients with HS were more susceptible to multimorbidity. Finally, we propose defining HS in the elderly as 'HS tarda' and subdividing it as late-onset and persistent HS tarda.
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Affiliation(s)
| | | | - Barbara C van Munster
- Internal Medicine and Geriatrics, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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4
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Mintoff D, Agius R, Benhadou F, Das A, Frew JW, Pace NP. Obesity and hidradenitis suppurativa: targeting meta-inflammation for therapeutic gain. Clin Exp Dermatol 2023; 48:984-990. [PMID: 37171791 DOI: 10.1093/ced/llad182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/24/2023] [Accepted: 05/08/2023] [Indexed: 05/13/2023]
Abstract
Hidradenitis suppurativa (HS) is a chronic, inflammatory condition of the pilosebaceous unit. The typical patient with HS is characterized as someone with obesity, who smokes and who has nodules, abscesses and/or draining tunnels predominantly distributed in intertriginous skin. It has been established that lifestyle and genetic factors are the main pathophysiological drivers of HS. In this critical review, we explore the interrelatedness of meta-inflammation, obesity and HS and discuss if and how this relationship may be manipulated for a therapeutic end.
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Affiliation(s)
- Dillon Mintoff
- Department of Dermatology
- Department of Pathology, Faculty of Medicine and Surgery
| | - Rachel Agius
- Diabetes and Endocrine Centre, Mater Dei Hospital, Msida, Malta
- Faculty of Medicine and Surgery
| | - Farida Benhadou
- Department of Dermatology, Hôpital Erasme, Universite Libre de Bruxelles, Bruxelles, Belgium
| | - Anupam Das
- Department of Dermatology, Venereology and Leprosy; KPC Medical College & Hospital, Kolkata, India
| | - John W Frew
- Laboratory of Translational Cutaneous Medicine, Ingham Institute for Applied Medical Research, Sydney, NSW, Australia
- Department of Dermatology, Liverpool Hospital, Sydney, NSW, Australia
- University of New South Wales, Sydney, NSW, Australia
| | - Nikolai P Pace
- Faculty of Medicine and Surgery
- Centre for Molecular Medicine and Biobanking, University of Malta, Msida, Malta
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5
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Di Cesare A, Rosi E, Amerio P, Prignano F. Clinical and Ultrasonographic Characterization of Hidradenitis Suppurativa in Female Patients: Impact of Early Recognition of the Disease. Life (Basel) 2023; 13:1630. [PMID: 37629487 PMCID: PMC10455481 DOI: 10.3390/life13081630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 08/27/2023] Open
Abstract
Hidradenitis suppurativa (HS) is considered a post-pubertal disease; however, earlier onset is not infrequent. The burden of HS on the female population is very relevant, and early identification might reduce the quality of life impairment and improve the therapeutic approach. In this study, we investigated clinical biomarkers of HS that could impact the management of patients affected by HS. Female patients affected by stable HS were prospectively included in this study. Anamnestic data, clinical and ultrasonographic features were collected and analyzed. Overall, 53 patients were included in this study. The median age of onset was 19 (IQR: 14-25). Early onset was reported by 22/53 patients (median age of onset: 14; IQR: 11-16). Four patients had pre-menstruation occurrence. Early-onset patients had an earlier first-menstrual-cycle age and more frequent genital localization of HS, and were more often treated with biologics. Patients with early-onset-HS and genital localization had more severe disease with a higher number of areas affected, Hurley, and IHS4 scores. Genital involvement might be prevalent in patients with early-onset HS, leading to a worse impact on the global severity of the disease and tailored treatment protocols, including multidisciplinary approaches, in order to improve the early recognition of hidden lesions.
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Affiliation(s)
- Antonella Di Cesare
- Section of Dermatology, Department of Health Sciences, University of Florence, 50122 Florence, Italy; (A.D.C.); (E.R.)
| | - Elia Rosi
- Section of Dermatology, Department of Health Sciences, University of Florence, 50122 Florence, Italy; (A.D.C.); (E.R.)
| | - Paolo Amerio
- Dermatologic Clinic, Department of Medicine and Ageing Science, “G. D’Annunzio” University, 66100 Chieti, Italy;
| | - Francesca Prignano
- Section of Dermatology, Department of Health Sciences, University of Florence, 50122 Florence, Italy; (A.D.C.); (E.R.)
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6
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van Straalen KR, Ingram JR, Augustin M, Zouboulis CC. New treatments and new assessment instruments for hidradenitis suppurativa. Exp Dermatol 2022; 31 Suppl 1:33-39. [PMID: 35582833 PMCID: PMC9542859 DOI: 10.1111/exd.14609] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/08/2022] [Accepted: 05/15/2022] [Indexed: 11/26/2022]
Abstract
Research interest in Hidradenitis Suppurativa (HS) has grown exponentially over the past decades. Several groups have worked to develop novel scores that address the drawbacks of existing investigator assessed and patient reported outcome measures currently used in HS trials, clinical practice and research. In clinical trial settings, the drawbacks of the HiSCR have become apparent; mainly it's lack of a dynamic measurement of draining tunnels. The newly developed (dichotomous) IHS4 and HASI-R are backed up by adequate validation data and are good contenders to become the new primary outcome measure in HS clinical trials. Patient reported outcomes, as well as physician reported measures, are being developed by the HIdradenitis SuppuraTiva cORe outcomes set International Collaboration (HISTORIC). For example, the Hidradenitis Suppurativa Quality of Life (HiSQOL) score is a validated measure of HS-specific quality of life and is already being used in many HS trials. Magnitude of pain measurement via a 0-10 numerical rating scale is well-established, however consensus is still required to ensure consistent administration and interpretation of the instrument. A longitudinal measurement over multiple days rather than at one time point, such as for example the Pain Index could provide increased reliability and reduced recall bias. Ultimately, these newly developed scores and tools can be included in a standardized registry to be used in routine clinical practice.
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Affiliation(s)
- K R van Straalen
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA.,European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany
| | - J R Ingram
- Department of Dermatology, Division of Infection & Immunity, Cardiff University, Cardiff, UK.,European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany
| | - M Augustin
- Institute for Health Care Services Research in Dermatology and Nursing, University Hospital Medical Center Hamburg-Eppendorf, Hamburg, Germany.,European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany
| | - C C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, Dessau, Germany.,European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany
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7
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Garcovich S, Fania L, Caposiena D, Giovanardi G, Chiricozzi A, De Simone C, Tartaglia C, Ciccone D, Bianchi L, Abeni D, Peris K. Pediatric Hidradenitis Suppurativa: A Cross-Sectional Study on Clinical Features and Treatment Approaches. J Cutan Med Surg 2021; 26:127-134. [PMID: 34615396 DOI: 10.1177/12034754211039993] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Hidradenitis suppurativa is uncommon in patients of pediatric age, and differentiation with adult-onset disease is controversial. Treatment of pediatric hidradenitis suppurativa is scarcely standardized, and specific guidelines are lacking. OBJECTIVE We report the clinical features, relevant risk-factors, comorbidity profile, and treatment patterns of a hospital-based cohort of pediatric hidradenitis suppurativa. METHODS In a cross-sectional study data on patients' demographics, disease-specific characteristics, early/pre-pubertal onset of disease, comorbidities, and treatment management were retrieved. Reference population data and clinical data from the national hidradenitis suppurativa disease registry were used for comparison. RESULTS From a database of 870 patients with hidradenitis, 71 (15 males and 56 females) patients aged <18 years (mean age: 15.3 years; range 8-17 years), with mild (Hurley I, 45.1%) and moderate-severe disease (Hurley II-III, 54.9%), were retrieved. Smoking (23.9%) and overweight/obese frequencies (59.2%) were higher than reference population standards. Patient's older age at baseline (OR 1.43, 95% CI: 1.01 to 2.02) and higher BMI (OR 1.26, 95% CI: 1.07-1.48) were the only factors associated with moderate-severe disease. Family history and early/pre-pubertal onset of disease were not associated with severity or extent of disease. Sebaceous-follicular comorbid conditions were associated with cigarette smoking (P = .002). Among 81 treatment courses, clindamycin-based and zinc-sulphate-based combination regimens were most frequently used (59.3%). Female preponderance, family history of disease and extensive involvement were significantly different from the general hidradenitis suppurativa population. CONCLUSIONS Pediatric hidradenitis suppurativa presents a clinical spectrum comparable to adult-onset disease. Increased preventive measures should target obesity and smoking in this population.
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Affiliation(s)
- Simone Garcovich
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Dermatologia, Rome, Italy.,602349371 Università Cattolica del Sacro Cuore, Dermatologia, Rome, Italy
| | - Luca Fania
- 9363 Dermatology Department, IDI-IRCCS, Rome, Italy
| | - Dante Caposiena
- 9318 Dermatology Department, Department of Systems Medicine, University of Rome Tor Vergata, Italy
| | - Giulia Giovanardi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Dermatologia, Rome, Italy.,602349371 Università Cattolica del Sacro Cuore, Dermatologia, Rome, Italy
| | - Andrea Chiricozzi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Dermatologia, Rome, Italy.,602349371 Università Cattolica del Sacro Cuore, Dermatologia, Rome, Italy
| | - Clara De Simone
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Dermatologia, Rome, Italy.,602349371 Università Cattolica del Sacro Cuore, Dermatologia, Rome, Italy
| | - Chiara Tartaglia
- 9318 Dermatology Department, Department of Systems Medicine, University of Rome Tor Vergata, Italy
| | | | - Luca Bianchi
- 9318 Dermatology Department, Department of Systems Medicine, University of Rome Tor Vergata, Italy
| | | | - Ketty Peris
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Dermatologia, Rome, Italy.,602349371 Università Cattolica del Sacro Cuore, Dermatologia, Rome, Italy
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8
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Țarcă E, Cojocaru E, Caba B, Luca AC, Roșu ST, Țarcă V, Stătescu L, Chiriac A, Lupu VV, Moroșan E, Trandafir L. Multidisciplinary Management of Adolescents with Hidradenitis Suppurativa - Series of Cases and Literature Review. J Multidiscip Healthc 2021; 14:2205-2216. [PMID: 34429610 PMCID: PMC8378912 DOI: 10.2147/jmdh.s324325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 07/29/2021] [Indexed: 11/24/2022] Open
Abstract
Hidradenitis suppurativa (HS) is a recurrent chronic inflammatory condition of the skin with a debilitating potential, especially in adolescents who may experience psychosocial disorders and impaired quality of life. Recognition of typical, recurrent lesions, history of the disease and family investigation establishes the diagnosis. The rarity of the disease in males and the appearance of this condition in children, which is also rare, in two of our adolescent patients, respectively, are the reasons for publishing this article. We reviewed the literature and found that variation exists across international treatment for this HS, and much collaboration is needed to put forth unified and updated recommendations. It is of major importance that the early recognition of the condition and the establishment of treatment in the multidisciplinary team. Psychotherapy, health education, the adoption of a healthy lifestyle, the application of local prevention measures, and long-term medical treatment are components of a correct management. Extensive surgical treatment should be restricted only to severe cases because it may lead to complications, extend the hospitalization period and increase psychological problems in adolescents. The treatment will be personalized, performed according to the stage of evolution, and the approach will be a multidisciplinary one. ![]()
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Affiliation(s)
- Elena Țarcă
- Department of Surgery II-Pediatric Surgery, "Grigore T. Popa" University of Medicine and Pharmacy, Iaşi, 700115, Romania.,"Saint Mary" Emergency Children's Hospital, Iași, Romania
| | - Elena Cojocaru
- "Saint Mary" Emergency Children's Hospital, Iași, Romania.,Department of Morphofunctional Sciences I - Pathology, "Grigore T. Popa" University of Medicine and Pharmacy, Iaşi, 700115, Romania
| | - Bogdan Caba
- "Saint Mary" Emergency Children's Hospital, Iași, Romania.,Department of Biomedical Sciences, "Grigore T. Popa" University of Medicine and Pharmacy, Iaşi, 700115, Romania
| | - Alina Costina Luca
- "Saint Mary" Emergency Children's Hospital, Iași, Romania.,Department of Mother and Child Medicine-Pediatrics, "Grigore T. Popa" University of Medicine and Pharmacy, Iaşi, 700115, Romania
| | - Solange Tamara Roșu
- "Saint Mary" Emergency Children's Hospital, Iași, Romania.,Department of Nursing, "Grigore T. Popa" University of Medicine and Pharmacy, Iaşi, 700115, Romania
| | - Viorel Țarcă
- County Statistics Department, Iaşi, 700115, Romania
| | - Laura Stătescu
- Department of Dermatology, "Grigore T. Popa" University of Medicine and Pharmacy, Iaşi, 700115, Romania
| | - Anca Chiriac
- Department of Dermatophysiology, Apollonia University, Iasi, 700613, Romania
| | - Valeriu Vasile Lupu
- "Saint Mary" Emergency Children's Hospital, Iași, Romania.,Department of Mother and Child Medicine-Pediatrics, "Grigore T. Popa" University of Medicine and Pharmacy, Iaşi, 700115, Romania
| | - Eugenia Moroșan
- "Saint Mary" Emergency Children's Hospital, Iași, Romania.,Department of Morphofunctional Sciences I - Pathology, "Grigore T. Popa" University of Medicine and Pharmacy, Iaşi, 700115, Romania
| | - Laura Trandafir
- "Saint Mary" Emergency Children's Hospital, Iași, Romania.,Department of Mother and Child Medicine-Pediatrics, "Grigore T. Popa" University of Medicine and Pharmacy, Iaşi, 700115, Romania
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9
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Zouboulis CC, von Stebut E. [Hidradenitis suppurativa/acne inversa: From "orphan disease" to a curable inflammatory skin disorder]. Hautarzt 2021; 72:647-650. [PMID: 34324067 DOI: 10.1007/s00105-021-04863-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Christos C Zouboulis
- Hochschulklinik für Dermatologie, Venerologie und Allergologie, Immunologisches Zentrum, Städtisches Klinikum Dessau, Medizinische Hochschule Brandenburg Theodor Fontane und Fakultät für Gesundheitswissenschaften Brandenburg, Auenweg 38, 06847, Dessau, Deutschland. .,Hidradenitis Suppurativa Foundation e. V., Dessau, Deutschland.
| | - E von Stebut
- Klinik und Poliklinik für Dermatologie und Venerologie, Uniklinik Köln, Köln, Deutschland
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10
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Kirsten N, Frings V, Nikolakis GD, Presser D, Goebeler M, Zouboulis CC, Augustin M. [Epidemiology, patient quality of life, and treatment costs of hidradenitis suppurativa/acne inversa]. Hautarzt 2021; 72:651-657. [PMID: 34223939 DOI: 10.1007/s00105-021-04851-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2021] [Indexed: 12/14/2022]
Abstract
Hidradenitis suppurativa/acne inversa (HS) is associated with numerous and relevant restrictions on the quality of life for those affected and their relatives. The exact prevalence of HS varies significantly across studies, but it is likely to be higher than suggested in previous publications. HS care is associated with high costs for the healthcare system and for those affected. The introduction of biologic therapy has led to additional costs, but also to considerable additional benefits in terms of care. In view of the complexity of diagnostics and therapy, there is a particular need for optimized care concepts in order to reduce the burden on those affected, their relatives and the healthcare system.
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Affiliation(s)
- N Kirsten
- Institut für Versorgungforschung in der Dermatologie und bei Pflegeberufen, Universitätsklinikum Hamburg-Eppendorf, Gebäude West 38 (W38), Martinistr. 52, 20246, Hamburg, Deutschland. .,Hidradenitis Suppurativa Foundation e. V., Dessau, Deutschland.
| | - V Frings
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - G D Nikolakis
- Hidradenitis Suppurativa Foundation e. V., Dessau, Deutschland.,Hochschulklinik für Dermatologie, Venerologie und Allergologie, Immunologisches Zentrum, Städtisches Klinikum Dessau, Medizinische Hochschule Brandenburg Theodor Fontane und Fakultät für Gesundheitswissenschaften Brandenburg, Dessau, Deutschland
| | - D Presser
- Hidradenitis Suppurativa Foundation e. V., Dessau, Deutschland.,Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - M Goebeler
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - C C Zouboulis
- Hidradenitis Suppurativa Foundation e. V., Dessau, Deutschland.,Hochschulklinik für Dermatologie, Venerologie und Allergologie, Immunologisches Zentrum, Städtisches Klinikum Dessau, Medizinische Hochschule Brandenburg Theodor Fontane und Fakultät für Gesundheitswissenschaften Brandenburg, Dessau, Deutschland
| | - M Augustin
- Institut für Versorgungforschung in der Dermatologie und bei Pflegeberufen, Universitätsklinikum Hamburg-Eppendorf, Gebäude West 38 (W38), Martinistr. 52, 20246, Hamburg, Deutschland.,Hidradenitis Suppurativa Foundation e. V., Dessau, Deutschland
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11
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Marasca C, Fabbrocini G, Barrea L, Capasso G, DI Guida A, Cinelli E, Fontanella G. Endocrinological disorders and inflammatory skin diseases during COVID-19 outbreak: a review of the literature. MINERVA ENDOCRINOL 2020; 45:345-353. [PMID: 32969629 DOI: 10.23736/s0391-1977.20.03248-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION In the next future, dermatologists, endocrinologist and physicians may cope with the impact of extent SARS-CoV-2 (COVID-19) infection over chronic inflammatory skin diseases and their treatment. COVID-19 pandemic obliged many countries to impose social restrictions, resulting in the need to adapt daily lifestyle habits and working activities. These changes have drastically reduced physical activity and social interactions, with the possible increase of anxiety, eating disorders and weight gain. EVIDENCE ACQUISITION We searched for relevant studies (trials, real-life studies and case reports, meta-analysis, pooled data analysis, reviews) on endocrine disorders and inflammatory skin diseases. The database used was PubMed. The studies included were those published in the English language between January 1, 2018 and May 5, 2020. EVIDENCE SYNTHESIS Several studies have been previously showed the association of overweight and obesity, with the metabolic syndrome and insulin-resistance. It has been demonstrated how these conditions correlate with the worsening of such chronic inflammatory skin diseases, such as psoriasis, hidradenitis suppurativa and acne. Many evidences suggest an important role of adipose tissue in the production of pro-inflammatory cytokines (Leptin, adiponectin, TNFα, IL-6, MCP-1, PAI-1), involved in the pathogenesis and the exacerbations of these skin diseases. In addition, we should expect an increasing incidence rate of hypovitaminosis D in the next future due to reduced sun exposure caused by isolation at home and missed holidays. Scientific evidences already show the important immunomodulating role of vitamin D in inflammatory skin diseases. CONCLUSIONS Our study pays attention on medium-long term effects of COVID-19 outbreak on inflammatory skin disorders, due to the lifestyle changes. In such context this review considers how a multidisciplinary approach, involving dermatologists, nutritionists and endocrinologists, may lead to a better management of dermatologic patients.
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Affiliation(s)
- Claudio Marasca
- Section of Dermatology, Department of Clinical Medicine and Surgery, Federico II University Hospital, Naples, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, Federico II University Hospital, Naples, Italy
| | - Luigi Barrea
- , Section of Endocrinology, Department of Clinical Medicine and Surgery, Federico II University Hospital, Naples, Italy
| | - Gianmarco Capasso
- Section of Dermatology, Department of Clinical Medicine and Surgery, Federico II University Hospital, Naples, Italy -
| | - Adriana DI Guida
- Section of Dermatology, Department of Clinical Medicine and Surgery, Federico II University Hospital, Naples, Italy
| | - Eleonora Cinelli
- Section of Dermatology, Department of Clinical Medicine and Surgery, Federico II University Hospital, Naples, Italy
| | - Giuseppina Fontanella
- Section of Dermatology, Department of Clinical Medicine and Surgery, Federico II University Hospital, Naples, Italy
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Choi E, Ooi XT, Chandran NS. Hidradenitis suppurativa in pediatric patients. J Am Acad Dermatol 2020:S0190-9622(20)32436-1. [PMID: 32822788 DOI: 10.1016/j.jaad.2020.08.045] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/12/2020] [Accepted: 08/14/2020] [Indexed: 12/11/2022]
Abstract
Interest in and research on hidradenitis suppurativa (HS) have increased during the past decade, resulting in expanded knowledge about associated comorbidities and treatment efficacy. Knowledge about pediatric-onset HS is still limited, based on case studies, small case series, and extrapolation from adult studies. With increasing prevalence of childhood obesity, decreasing pubertal age, and increasing awareness of HS, physicians may start encountering younger HS patients. This review presents an updated discussion on the epidemiology, pathophysiology, and associated comorbidities in HS, with a focus on pediatric and adolescent patients. It also suggests recommendations for investigation and treatment based on current evidence.
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