There are limited data evaluating the utilization of dermatologists for the care of patients with hidradenitis suppurativa.To determine the utilization of the dermatology ambulatory encounter among hidradenitis suppurativa patients, and to evaluate whether ... defined as having at least 1 ambulatory encounter with a dermatologist over a 3-year period.Overall, 21.8% (9,170/42 ...
... antagonistic cytokines IL-36Ra, IL-37, and IL38 in the skin of hidradenitis suppurativa (HS) patients.Skin samples from lesional and corresponding perilesional HS skin, and from healthy controls were included in this study and ... 37 and IL-38 were significantly higher in perilesional HS skin compared to healthy controls and decreased in lesional HS skin.Descriptive study and small sample size.Our results showed a ...
HS is a debilitating chronic skin disease of the hair follicle... Patients were treated with a pulse width of either 20 or 100 nm, using a fluence between 18 and 34 J/cm(2) depending on the area treated, pain response and skin type. Patients were treated every 4 to 6 weeks.
We performed a comparative cross-sectional study of the potential association of HS and the three outcome events: self-reported MI, self-reported stroke, and PAD measured by ankle-brachial index (ABI) ≤ 0.9. We included a self-reported HS group (n=430) identified in the general suburban population study (GESUS) using a validated questionnaire (2) (Table 1).The control group comprised participants from GESUS without HS, n=20,780. This article is protected by copyright. All rights reserved.
Necrotizing fasciitis is a severe type of necrotizing soft tissue infection involving the superficial fascia and subcutaneous tissues. Fournier's gangrene, a type of necrotizing fasciitis, affects the genitalia and/or perineum. While a rare health condition, Fournier's gangrene can result in significant morbidity and unnecessary mortality following delay in diagnosis and management. We provide a review of relevant presenting features to aid diagnosis and allow timely surgical management of this serious infectious condition.
Improvement in the visual analogue scale was reported by 20% and 85.7% of patients failing previous anti-TNF treatment. Ultrasound showed decreased neovascularization and lesion skin depth in the MABp1 group. MABp1 treatment was associated with decrease of circulating IL-8 and of stimulated production of IL-8 by whole blood.
BACKGROUND: Hidradenitis supppurativa (HS) is a chronic inflammatory disease of the apocrine sweat glands affecting 1-4% of the population. While surgical excision is a mainstay of therapy, lesions often recur. Biologic therapies, including tumor necrosis factor-α and IL-12/23 inhibitors, are effective for mild to moderate HS. However, longitudinal studies investigating biologic therapy in conjunction with surgery are limited. The purpose of this analysis was to investigate impact of surgery and biologic therapy on HS disease activity.
METHODS: Data from 68 HS patients were analyzed. Outcome measures included hidradenitis suppurativa Sartorius Score (HSS), active nodule (AN) count, Hurley stage, and probability of achieving 75% reduction in active nodule count (AN75).
RESULTS: Mean age was 40 ± 14 years; 66% were female and 72% were African American. Mean disease duration was 10 years, and Hurley stage III disease was seen in 63% of patients. Patients who received biologics had a larger drop in HSS and AN count than those who never received biologics (P = 0.002). Biologic treatment was associated with average reduction in 22 (15-29) HSS points (P < 0.0001). The effect of biologics was greater in patients who also underwent surgery (P = 0.013). Timing of biologics relative to surgery did not impact efficacy. Patients who received HS surgery with biologic therapy were most likely to achieve the AN75 (P = 0.017).
CONCLUSIONS: In this diverse cohort of patients with severe HS, biologic therapy was associated with a more rapid decline in disease activity, with the greatest effect in patients who also underwent HS surgery.
Hidradenitis Suppurativa (3), Necrosis (2), Neoplasms (2), more mentions
Clinical efficacy was measured by reduction in Sartorius score, Hidradenitis Suppurativa Clinical Response (HiSCR), Dermatology Life Quality Index (DLQI), or pain Visual Analog Scale (VAS... Large-scale, randomized, placebo-controlled trials in patients with skin of color, as well as weight-based dosing trials, are needed Keyword: Hidradenitis suppurativa. Keyword: acne inversa.
... focused diagnostic assessment may assist in correctly identifying the underlying etiology. For many of the high mortality cellulitis mimics, surgical intervention is necessary AbstractText: Cellulitis and its mimics present similarly due to the same physiologic responses to skin and soft tissue infections. A combination of history, physical examination, and diagnostic assessment will help the emergency physician differentiate cellulitis from mimics.
Muscular and Skeletal Diseases (1), Men's Health (1) Cellulitis (13), Deep Vein Thrombosis (2), Abscesses (2), more mentions
BACKGROUND: The relationship between hidradenitis suppurativa and diabetes mellitus is not well understood.
OBJECTIVE: To compare the prevalence of diabetes mellitus between patients with and without hidradenitis suppurativa.
METHODS: We conducted a systematic review and meta-analysis, which included primary observational studies that reported the prevalence of diabetes mellitus among patients with hidradenitis suppurativa in the PubMed, Embase, Cochrane Library, LILACS, and Scielo databases from 1947 to June 13, 2017. A random effects model for pooled odds ratio was used for data analysis. Publication bias was assessed by funnel plot and the Egger test.
RESULTS: The systematic review included 107,050 patients from 14 studies; the meta-analysis included 104,373 patients from 7 studies. On the basis of meta-analysis, the prevalence of diabetes mellitus was 10.6% in patients with hidradenitis suppurativa and 3.8% in patients without hidradenitis suppurativa. Compared with the general population, patients with hidradenitis suppurativa were nearly 3 times more likely to have diabetes mellitus (pooled odds ratio, 2.78; 95% confidence interval, 1.79-4.31).
LIMITATIONS: We were restricted by the quantity and quality of available data.
CONCLUSION: Hidradenitis suppurativa is significantly associated with an increased prevalence of diabetes mellitus.
Background: Yaws-like chronic ulcers can be caused by Treponema pallidum subsp. pertenue, Haemophilus ducreyi, or other still-undefined bacteria. To permit accurate evaluation of yaws elimination efforts programmatic use of molecular diagnostics is required. The accuracy and sensitivity of current tools remains unclear because our understanding of T. pallidum diversity is limited by the low number of sequenced genomes.
Methods: We tested samples from patients with suspected yaws collected in previous studies in the Solomon Islands and Ghana. All samples were from patients whose lesions had previously tested negative using the current CDC diagnostic assay in widespread use. However, some of these patients had positive serological assays for yaws on blood. We used direct whole genome sequencing to identify T.p subsp. pertenue strains missed by the current assay.
Results: From 45 Solomon Islands and 27 Ghanaian samples, 11 were positive for T. pallidum DNA using the species-wide qPCR, from which we obtained 6 previously undetected T. p. subsp. pertenue whole genome sequences. These sequences show that Solomon Islands sequences represent distinct T. p. subsp. pertenue clades. These isolates were invisible to the CDC diagnostic PCR assay in widespread current use, due to sequence variation in the primer binding site.
Conclusion: Our data double the number of published T. p. subsp. pertenue genomes. We show that Solomon Islands strains are undetectable by the PCR used in many studies and by health ministries. This assay is therefore not adequate for the eradication programme. Next-generation genome sequence data are essential for these efforts.
On the basis of multivariate analyses, patients with HS had more annual dermatology clinic visits compared with the general population enrollees (odds ratio [OR], 6.49; 95% confidence interval [CI], 7.06-5.97) and patients with psoriasis (OR, 1.32; 95% CI, 1.44-1.21), more annual surgical clinic visits (OR, 3.78; 95% CI ...
Dermatology (6) Psoriasis (5), Hidradenitis Suppurativa (3), more mentions
BACKGROUND: Fournier's gangrene is an uncommon but often devastating infection. There are few contemporary data on the risk factors and evolving microbiologic trends including drug-resistant organisms implicated in these life-threatening infections.
METHODS: A retrospective study of Fournier's gangrene from 2006 to 2015 at a large academic hospital was conducted. Cases were identified using ICD codes (ICD-9: 608.83, V13.89; ICD-10: N49.3, Z87.438), and a review of medical, radiographic, and pathology records was performed to confirm each case. Data collected included socio-demographics, medical conditions, bacterial pathogens and their resistance patterns, treatments, and outcome. Descriptive and univariate statistics were performed.
RESULTS: A total of 59 cases were evaluated with an overall incidence of 31.8 cases per 100,000 admissions which remained stable over the study period. Mean age was 56 years (range 18-91), 71% were male, and 44% white. Risk factors included overweight/obesity (61%), diabetes (44%, with a mean A1c of 9.6%), immunocompromised state (34%), and illicit use (20%). A causative organism was identified in all except 2 cases; 12 patients (21%) had a multidrug-resistant organism (MDRO) with MRSA being the most common pathogen (n = 8, 14% of all cases), followed by ESBL E. coli (n = 3) and MDRO Acinetobacter (n = 1). MRSA was the sole pathogen isolated in five (63%) of the eight cases involving this organism. Among those with an aerobic Gram-negative rod (GNR) isolated, 32% were fluoroquinolone-resistant. Overall, 30% of cases had a poor outcome (15% died and an additional 15% had loss of an organ/body part). Those with an MDRO were more likely to experience a poor outcome (42% vs. 28%), although this was not statistically significant (p = 0.48); of note, most (83%) MDRO cases were initially treated with an antibiotic that the organism was susceptible.
CONCLUSIONS: This report highlights the emergence of MDROs as an important cause of Fournier's gangrene including MRSA and drug-resistant GNRs. Antibiotics should be chosen with broad-spectrum, anti-MDRO activity given the high morbidity and mortality associated with these infections.
Infectious Diseases (2), Anti-Obesity and Weight Loss (2), Endocrine Disorders (1) Fournier Gangrene (5), Infections (3), Obesity (1), more mentions
... clinical trials: Visual Analog Scale (VAS) for pain, Total Work Productivity Impairment, Dermatology Life Quality Index; EuroQOL 5D VAS, and Short Form-36 Health Survey ... HS reported higher scores for VAS-pain (54.3 vs 36.1 [P < .0001]), Dermatology Life Quality Index (15.3 vs 11.3 [P < .0001]), EuroQOL 5D VAS (58.8 ...
Dermatology (9) Psoriasis (7), Hidradenitis Suppurativa (3), more mentions
I have read the article by Theut Riis et al proposing BMI based clinical subtypes of hidradenitis suppurativa (HS) patients with interest. In addition to giving valuable clinical information, the article is important in the discussion of the pathophysiology of such HS subgroups, with focus on the obese subtype. The papers main difference from earlier clinical proposals of subtyping is the focus on the body mass index (BMI) as a functional factor in the disease evolution. This article is protected by copyright. All rights reserved.
Anti-Obesity and Weight Loss (3) Hidradenitis Suppurativa (2), Obesity (1), more mentions