ABSTRACT
Se presenta un caso clínico con un cuadro de hidradenitis supurativa crónica que evolucionó a carcinoma epidermoide. Se realiza una revisión de la literatura de esta enfermedad. (AU)
A clinical case with a chronic suppurative hidradenitis syndrome that progressed to squamous cell carcinoma is presented. A review of the literature of this disease is made. (AU)
Subject(s)
Humans , Male , Female , Adult , Young Adult , Carcinoma, Squamous Cell/etiology , Hidradenitis Suppurativa/surgery , Hidradenitis Suppurativa/complications , Hidradenitis Suppurativa/drug therapy , Disease Progression , Early DiagnosisABSTRACT
La Hidradenitis Supurativa (HS) es una enfermedad inflamatoria crónica de la piel, en la que se han utilizado múltiples tratamientos, con respuesta variable. Se presenta el caso de una paciente con HS sin resistencia a la insulina, que fue tratada satisfactoriamente utilizando metformina oral. Paciente mujer de 22 años, consultó por HS de cuatro años de evolución. Presentaba sobrepeso, pero no resistencia a la insulina ni síndrome de ovario poliquístico. Durante los primeros seis meses de tratamiento recibió antibióticos orales, antibióticos tópicos, cloruro de aluminio tópico y corticosteroides intralesionales, con escasa respuesta. Después de estos tratamientos, se le indicó metformina y luego de doce días de tratamiento todas las lesiones inflamatorias remitieron. Un año después, no ha presentado nuevas lesiones. La metformina podría ser una excelente opción de tratamiento para los pacientes con HS no necesariamente asociada con resistencia a la insulina.
Hidradenitis suppurativa (HS) is a chronic and often devastating inflammatory skin disorder. Many treatments have been used, however none of them is consistently effective. We report the case of a patient with HS without insulin resistance who was successfully treated using oral metformin. A 22 years old woman consulted at our dermatology department with a four years history of HS. There was no insulin resistance or polycystic ovary syndrome. However, the patient was overweight. During the first six months of treatment the patient received oral antibiotics, topical antibiotics, oral zinc, topical aluminum chloride and intralesional corticosteroids with a poor response. After all these treatments, the patient was started metformin on a daily basis. After twelve days of treatment all inflammatory lesions resolved. One year later, no new lesions have appeared. Metformin might be an excellent treatment option for patients with HS not necessarily associated with altered glucose metabolism.
Subject(s)
Humans , Female , Adult , Hidradenitis Suppurativa/drug therapy , Metformin/therapeutic useABSTRACT
A hidradenite supurativa é doença inflamatória de difícil tratamento. Recentemente, a terapia anti-TNF alfa, com anticorpos monoclonais ("terapia biológica"), tem sido apontada como uma alternativa. No entanto, ensaios clínicos avaliando a eficácia destas drogas na hidradenite supurativa, ainda não foram publicados. Apresentamos um caso no qual o uso do infliximabe não resultou em melhora clínica expressiva.
Hidradenitis suppurativa is an inflammatory disease with difficult treatment. Currently, the anti-TNF alfa therapy, with monoclonal antibodies ("biological therapy"), has been shown as a new alternative. However, clinical trials assessing the efficacy of these drugs to treat hidradenitis suppurativa have not yet been published. A case in which the use of infliximab did not result in significant clinical improvement is described.