Hidradenitis Suppurativa

By: Gregor Jemec (Editor), Jean Revuz (Editor), James J. Leyden (Editor)

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Hardcover | 5 October 2006

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224 Pages

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25.4 x 18.42 x 1.91

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This is the first and most comprehensive book perts to give their opinion and interpretation of dedicated to the understanding and treatment the disease, and left our own point of view to the of hidradenitis suppurativa. The most recent chapters summarizing pathogenesis and the- monograph on this disease was Dr Benedek's py. At points you may therefore find discussions supplement to Acta Dermatovenerologica in of e. g. apocrine glands with which the editors 1957 (1)! The long interval has not been justified may disagree, but rather than suppress infor- by a benign nature or quiet disposition of the tion we have sought to stimulate and inspire an disease. This is a common and debilitating dis- an open dialogue. The book is intended for both ease that significantly reduces the quality of life concrete factual information, as well as inspi- for patients. In spite of this it has not achieved a tion for further studies of aetiology, pathog- deserved level notoriety and scientific interest, esis and therapy. but remains an obscure an ill-understood men- We would like to thank our colleagues for ace to the patients. generously sharing their insight and knowledge. There may be several reasons for this neglect.

Industry Reviews

From the reviews:

"The book gives a good historical overview on HS emphasizing on the many confusing names the disease has been given since its first description more than a hundred years ago and the century long discussion of the involvement of apocrine glands in the pathology of the disease. ... In conclusion, this book is well structured, easy to read and are a great source of information ... . recommendable for all physicians with more than a superficial interest in HS." (Elisabeth Eiling, Archives of Dermatological research, Vol. 299, 2007)

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You Can Find This Book In

Non-Fiction Family & Health Popular Medicine & Health Women's Health Medicine Clinical & Internal Medicine Dermatology Gynaecology & Obstetrics Surgery Gastrointestinal & Colorectal Surgery Plastic & Reconstructive Surgery Gastroenterology

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Paperback

Published: 14th October 2010

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Hidradenitis Suppurativa Introduction
References	p. 3
Verneuil and Verneuil's Disease: an Historical Overview
Biographical Landmarks of a Surgeon-Venereologist	p. 4
L'Hidradenite Phlegmoneuse (Verneuil's Disease), Primary Observations	p. 5
Further Observations and Discussions in Europe and Overseas	p. 6
Hidrosadenitis and Acne Conglobata: Controversial Views	p. 8
Acne Inversa, the Last Metamorphosis of Verneuil's Disease?	p. 9
References	p. 9
Clinical Presentation
Introduction	p. 11
Individual Lesions	p. 12
Primary (Early) Lesions	p. 12
Secondary Lesions	p. 13
Tertiary Lesions	p. 14
Comedones	p. 15
Other Lesions	p. 15
Topography	p. 16
Involved Areas	p. 16
Two Main Zones	p. 16
The Two Less Frequently Involved Zones	p. 17
Atypical Localizations - Other Zones May Be Involved	p. 17
Distribution of Lesions	p. 18
Evolution of the Disease and its Severity	p. 19
Age at Onset and Resolution	p. 19
Clinical Course	p. 19
Intermittent/Benign Course of the Disease	p. 20
Intermediate Course of the Disease	p. 20
Continuous Disease: Moderate, Severe	p. 20
Severity Indexes	p. 21
Hurley's Clinical Staging [2]	p. 21
Sartorius [9]	p. 21
Diagnosis	p. 22
Diagnostic Criteria	p. 22
Delay in Diagnosis	p. 22
Differential Diagnoses	p. 23
References	p. 23
Pathology of Hidradenitis Suppurativa
Introduction	p. 25
Glandular Elements of the Skin	p. 26
Sebaceous Glands and the Pilosebaceous Unit	p. 26
Apocrine Glands	p. 27
Eccrine Glands	p. 27
Apoeccrine Glands	p. 27
Histological Appearance of HS	p. 27
Early Lesions	p. 27
Established Hidradenitis Suppurativa	p. 28
Immunohistochemistry of Hidradenitis Suppurativa	p. 30
Cytokeratin Expression in HS	p. 30
Comparison with Other Disorders	p. 31
Fox-Fordyce Disease	p. 31
Acne	p. 31
Follicular Occlusion Triad	p. 31
Pilonidal Sinus	p. 31
Crohn's Disease	p. 32
Conclusions	p. 32
Acknowledgements	p. 33
References	p. 33
Imaging
Introduction	p. 34
Ultrasound	p. 34
Magnetic Resonance Imaging (MRI)	p. 36
X-Ray Examination	p. 36
Discussion	p. 36
References	p. 37
Associated Diseases: Causality or Complications?
Introduction	p. 38
Cutaneous Diseases (Excluding Squamous Cell Carcinomas)	p. 39
Follicular Occlusion Diseases	p. 39
Acne Conglobata	p. 40
Dissecting Folliculitis of the Scalp	p. 40
Pilonidal Sinus	p. 41
Pigmentation Disorders of the Skin Folds: Dowling-Degos and Kitamura's Diseases	p. 41
Rheumatological Disorders	p. 42
Clinical Picture	p. 42
Radiographic Features	p. 42
Treatment	p. 42
Mechanisms	p. 43
Associated Cancers	p. 43
Non-Skin Cancers	p. 43
Squamous Cell Carcinoma	p. 44
Incidence and Prevalence	p. 44
Clinical Picture	p. 44
Differential Diagnosis	p. 45
Treatment	p. 45
Prognosis	p. 45
Other Co-Occurrences	p. 45
Conclusion	p. 46
References	p. 46
Hidradenitis Suppurativa and Crohn's Disease
Definition and Course of Crohn's Disease	p. 50
Pathophysiology	p. 50
Genetic Factors	p. 51
Enteric Microflora	p. 51
Immune-Mediated Tissue Injury	p. 51
Pathology	p. 51
Clinical Aspects	p. 52
Disease Location	p. 52
Clinical Presentation	p. 52
Therapeutic Aspects and Prognosis	p. 52
Cutaneous Crohn's Disease	p. 52
Clinical Presentation of Cutaneous Lesions	p. 53
Therapeutic Aspects and Prognosis	p. 53
Crohn's Disease and Hidradenitis Suppurativa	p. 53
Differential Diagnosis	p. 53
Co-Existence of HS and CD	p. 55
Treatment of Perianal Co-existent CD and HS	p. 55
References	p. 55
Epidemiology
Introduction	p. 58
Descriptive Epidemiology	p. 58
Analytic Epidemiology	p. 60
Clinical Epidemiology: Natural History and Prognosis	p. 62
Perspectives	p. 63
References	p. 64
Nosology and Classification
Introduction	p. 65
Morphology	p. 66
Anatomy	p. 66
Clinical Features	p. 66
Etiology; Pathogenesis	p. 67
Infection	p. 67
Inflammation	p. 68
Hormones	p. 68
Treatments	p. 68
Conclusion	p. 69
Genetics of Hidradenitis Suppurativa
Clinical Genetics of Hidradenitis Suppurativa	p. 70
Genodermatoses	p. 74
Methods for Identifying Disease Genes	p. 74
Genetic Markers	p. 75
Positional Cloning of Dominantly Inherited Disease Genes	p. 75
Genome-Wide Linkage Analysis in Familial HS	p. 77
Linkage of Hidradenitis Suppurativa to 6q25.2	p. 78
Identification of a Second HS Locus to Chromosome 19	p. 79
Candidate Genes Analysed in Linked HS Kindreds	p. 79
Oestrogen receptor-[alpha] and HS	p. 79
ZNF91 and HS	p. 79
TIZ Association with HS	p. 80
Potential Contribution of the VIP Gene to HS	p. 80
Additional Candidate Gene-Protein Systems in HS	p. 81
Interleukin 1-[alpha]	p. 81
TNF Signalling and HS	p. 81
Discussion	p. 81
Conclusions	p. 82
References	p. 83
Bacteriology of Hidradenitis Suppurativa
Normal Microflora of the Skin	p. 86
Bacteria Found in HS Lesions	p. 87
General Factors About Bacterial Involvement in HS Pathogenicity	p. 90
The Role of Antibiotics in the Treatment of HS	p. 91
Possible Consequences for Bacterial Ecology due to Antibiotic Treatment in HS	p. 92
References	p. 92
Endocrinology
Introduction	p. 95
Hyperandrogenism and the Skin	p. 95
Androgenization	p. 95
Androgen Metabolism	p. 96
Causes of Hyperandrogenism	p. 96
Lack of Association between HS and Endocrinopathies	p. 97
HS and Biological Hyperandrogenism	p. 97
End-Organ Androgen Sensitivity?	p. 98
References	p. 98
Immunity
Introduction	p. 100
Ancient and Modern: Innate and Acquired Immunity	p. 101
TLR/IL-1R Superfamily and their Signaling Pathways in the Skin	p. 102
Members of the TLR Family Expressed by Keratinocytes	p. 102
IL-1 Receptors in the Skin	p. 104
Signaling Pathways via TLR/IL-1R	p. 104
MyD88-Dependent Signaling Pathway	p. 104
MyD88-Independent Signaling Pathway	p. 105
Keratinocyte-Derived Effector Molecules in the Innate Immune System of the Skin	p. 105
Antimicrobial Peptides	p. 105
[Beta]-Defensins	p. 106
Cathelicidins	p. 106
RNase7	p. 107
Antileukoprotease (ALP)	p. 107
Pro-Inflammatory Chemokines	p. 107
Pro-Inflammatory Cytokines	p. 108
TLR Recognition and the Commensal Microbiota of the Skin	p. 109
Skin Infections and Innate Immune Responses of the Epidermis	p. 110
Hidradenitis Suppurativa and the Skin Immune System	p. 110
Conclusions	p. 112
References	p. 112
Quality of Life in Hidradenitis Suppurativa
Introduction	p. 116
Concept and Measure of Quality of Life	p. 116
Why Try to Measure Quality of Life?	p. 116
Reporting the Viewpoint of Patients: Methods of Measurement of Quality of Life	p. 117
Reporting the Viewpoint of Physicians: Uniform Outcome Variables	p. 117
Practical Approach Reconciling the Viewpoints of Patients and Physicians	p. 117
Impact of HS upon Quality of Life	p. 117
Altered Self-Reported Health: Qualitative Approach	p. 117
Measure of Quality of Life: Quantitative Approach	p. 118
Impaired Quality of Life: What Conclusion?	p. 118
Conclusion for Patients	p. 118
Conclusion for Physicians	p. 119
References	p. 119
Antibiotic Therapy
Introduction	p. 120
Clinical Experience	p. 121
Therapy	p. 121
References	p. 123
Antiandrogens
Introduction	p. 124
Antiandrogens and Antiandrogen Therapies	p. 124
Cyproterone Acetate	p. 125
Spironolactone	p. 125
Finasteride	p. 125
Antiandrogenic Progestins	p. 125
Oral Contraceptives	p. 125
Antiandrogens in HS	p. 126
Cyproterone Acetate	p. 126
Spironolactone	p. 126
Finasteride	p. 126
References	p. 127
Oral Retinoids for Hydradenitis Suppurativa
Introduction	p. 128
Isotretinoin	p. 128
Mechanism of Action [1, 2]	p. 128
Clinical Experience	p. 129
Isotretinoin Monotherapy for HS	p. 129
Isotretinoin Therapy in Patients with Acne and Coexistent HS	p. 129
Isotretinoin in the Pre- and Postoperative Phase	p. 131
Isotretinoin in Combination Treatment of HS	p. 131
Side-Effects	p. 131
Etretinate and Acitretin	p. 132
Mechanism of Action	p. 132
Clinical Experience: Etretinate and Acitretin for HS	p. 132
Side-Effects	p. 134
References	p. 134
Immunosuppressive Therapy in Hidradenitis Suppurativa
Introduction	p. 136
What Can We Achieve With Therapy?	p. 137
Immunosuppressive Therapies	p. 137
Prednisolone and Other Corticosteroids	p. 138
Ciclosporin	p. 138
Dapsone	p. 138
Methotrexate	p. 138
Hidradenitis Suppurativa as a Side-Effect of Immuno-suppressive Drugs	p. 139
Practical Use of Immuno-suppressive Therapy	p. 139
References	p. 140
Zinc and Other Experimental Medical Treatments
Introduction	p. 141
Zinc Salts	p. 141
Mechanisms of Action: Modulation of the Proliferation and Differentiation of Keratino-cytes and Cell Apoptosis	p. 141
Anti-Inflammatory Activity	p. 142
Activity Against 5[alpha]-Reductase	p. 142
Healing	p. 142
Zinc Salts in Verneuil's Disease	p. 142
Other Experimental Drugs	p. 143
References	p. 144
Biologics For Hidradenitis Suppurativa (Verneuil's Disease in the Era of Biologics)
Introduction	p. 145
Background	p. 145
Crohn's Disease and Hidradenitis Suppurativa Co-Occurrence: A Rationale for Anti-TNF Therapy	p. 147
Anti-TNF Drugs in HS	p. 147
Future Prospects	p. 148
References	p. 149
Topical Treatment
Introduction	p. 150
Antibiotics	p. 151
Topical Clindamycin	p. 152
Keratolytics	p. 152
Resorcinol as a Keratolytic Agent in Hidradenitis Suppurativa	p. 152
Indications	p. 154
Mechanism of Action	p. 154
Side-Effects of Resorcinol	p. 155
Treatment Schedule with Resorcinol Creams	p. 156
Clinical Experience	p. 156
Topical Anti-Inflammatory Therapy	p. 157
Azelaic Acid	p. 157
Fusidic Acid	p. 157
Intralesional Therapy	p. 157
The Use of Local Therapy	p. 158
Publication Bias	p. 158
References	p. 159
Surgery
Introduction	p. 161
Methods of Closure	p. 164
Anatomical Regions Involved	p. 165
Axillary HS	p. 165
Inguinal Disease	p. 165
Gluteal-Perianal-Perineal Disease	p. 165
Excision Margins	p. 166
Complications	p. 166
Recurrent Disease After Surgery	p. 167
Carbon Dioxide Laser Surgery in HS	p. 167
Anesthesia	p. 168
Postoperative Wound Care	p. 168
Practical Hints and Comments	p. 168
The Carbon Dioxide Laser Technique	p. 168
The Use of Scanners	p. 169
How Radical Should the Therapy Be?	p. 170
Concluding Remarks	p. 171
References	p. 171
Radiation Therapy
Introduction	p. 174
Treatment Regimens	p. 175
Case Series Reports	p. 175
Conclusion	p. 175
References	p. 175
Experimental Physical Therapies
Introduction	p. 177
Photodynamic Therapy	p. 177
Depilation	p. 179
Cryosurgery	p. 179
Discussion	p. 180
Practical Guidelines for Testing New Physical Therapies	p. 180
References	p. 181
Treatment
Introduction	p. 183
Staging the Disease	p. 183
Treatment of Hidradenitis Suppurativa Hurley Stage I	p. 184
Treatment of Hidradenitis Suppurativa Hurley Stage II	p. 184
Treatment of Hidradenitis Suppurativa Hurley Stage III	p. 185
Hidradenitis Suppurativa with Cysts	p. 185
Experimental Therapies	p. 186
General Requirements for Treatment	p. 186
Hidradenitis Suppurativa - Patients' Frequently Asked Questions
General Questions	p. 187
Heredity	p. 188
Pregnancy	p. 188
Treatment	p. 189
Practical Questions	p. 189
Hints For Daily Life	p. 190
Relations To Other Factors	p. 190
Psychological Aspects	p. 191
Children and Adolescents	p. 192
Social Security	p. 192
An Uncommon Valor
Kevin	p. 194
Deborah	p. 195
Elizabeth	p. 195
Melony	p. 195
Kerrie	p. 196
John	p. 197
Caroline	p. 197
Arnold	p. 197
Mabel	p. 198
Nassim	p. 199
Mira	p. 199
Mindy	p. 200
Subject Index	p. 201
Table of Contents provided by Ingram. All Rights Reserved.

Hidradenitis Suppurativa

At a Glance

Hardcover

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