Hidradenitis suppurativa: epidemiological study of cases diagnosed at a dermatological reference center in the city of Bauru, in the Brazilian southeast State of São Paulo, between 2005 and 2015

Abstract: Background: Hidradenitis is a chronic inflammatory disease of the hair follicles. A treatment is necessary due to chronicity and psychological changes that patient present. Objective: To investigate epidemiological aspects and elaborate a risk group profile, promote early diagnosis and contribute to the knowledge about the disease. Methods: This cross-sectional descriptive study with retrospective analysis of medical records of 194 patients diagnosed with hidrosadenitis in a dermatological reference center in the city of Bauru (SP) between 2005 and 2015. Results: Females accounted for 74% of cases. The age at diagnosis ranged from 10 to 67 years and the majority was within the 3rd and 4th decade of life. It occurred Association with diabetes mellitus in 33%, obesity in 55% and smoking in 61% was observed. Mean time between the onset of the disease and diagnosis was nine years. Hurley stage II was the most common at diagnosis. The therapeutic option mostly used in Hurley I and II was systemic antibiotics and in Hurley III was surgery. Study limitations: the main limitation of this study is its retrospective design, which does not allow the true clinical confirmation of the disease by investigators. Conclusion: we outlined the following profile: women, caucasian, between 3rd and 4th decade of life, associated with obesity, smoking, late diagnosis and multiple potential therapeutic modalities. We highlight the importance of studies like this in order to identify risk groups and encourage early diagnosis.

Hidrosadenitis supurativa (Parte I) / Hdradenitis suppurativa (Part I)

La hidradenitis supurativa es una entidad crónica, debilitante, que afecta las regiones axilares, perineo y submamarias. Se describe una prevalencia del 4 por ciento y su causa tiene que ver con oclusión folicular más que con un proceso de inflamación o de infección de las glándulas apocrinas. Su inicio es en la pubertad con nódulos inflamatorios recurrentes que se rompen espontáneamente o coalescen formando lesiones dérmicas y abscesos dérmicos profundos y dolorosos que dejan eventualmente cicatrices fibrosas, extensas y deformantes. Los tratamientos médicos clásicos o más recientes como inhibidores de FNT- alfa se pueden realizar en etapas tempranas pero la cirugía y últimamente el láser es lo que da mejor resultado en etapas más avanzadas. En esta primera parte abordamos el tema con su epidemióloga, etiología, clínica, diagnóstico y diagnóstico diferencial. En la parte II se revisará enfermedades asociadas, complicaciones y tratamiento.

Hidradenitis suppurativa is a chronic and often debilitating disease affecting primaraly the axillae, perineum, and inframammary regions. A prevalence of 4 percent has been estimated and its etiology includes follicular occlusion rather than an inflammatory and infectious process of the apocrine glands. It start usually in puberty with recurrent inflammatory nodules, that rupture spontaneously or coalesce forming painful and deep dermal abscesses followed eventually by extensive, fibrous and disfigured scars. Medical treatments are useful ininitial stages of the disease like alpha tumor necrosis factor inhibitors but surgery and recently lasers are the solution for better results in advanced stages. In this first section epidemiology, etiology, clinical picture, diagnosis and differential diagnosis are reviewed. In the second section associated diseases, complications and treatment will be revised.

Hidradenitis suppurativa / Hidradenitis suppurativa

Introducción: la hidradenitis supurativa es una enfermedad inflamatoria, crónica, recurrente, originada en las glándulas apocrinas; se puede localizar en axila, ingle, periné, región anoperineal y cuero cabelludo. Objetivo: conocer la frecuencia y el manejo terapéutico. Material y métodos: se trató de un estudio retrospectivo, transversal y descriptivo, Se incluyeron los pacientes portadores de hidradenitis supurativa atendidos en la Unidad de Coloproctología del Servicio de Gastroenterología, Hospital General de México, de enero de 1995 a diciembre de 2004. Resultados: se revisaron 12,689 expedientes clínicos y se identificaron 15 pacientes (0.12 %), de los cuales nueve cumplieron los criterios de inclusión. Conclusiones: la hidradenitis supurativa es una enfermedad compleja que constituye un reto diagnóstico y terapéutico.

BACKGROUND: Hidradenitis suppurativa is an inflammatory, chronic and recurrent disease of appocrine glands, located in inguinal, axillar, perineal, perianal areas and scalp. OBJECTIVE: To determine the frequency and therapeutic management. METHODS: A retrospective, transverse, and descriptive study was carried out. All patients with hidradenitis suppurativa, and who were managed by the Coloproctology Unit from the Gastroenterology Service of the General Hospital of Mexico City from January 1995 to December 2004, were included. RESULTS: We reviewed 12,689 files and identified 15 patients (0.12%) with hidradenitis suppurativa; nine fulfilled inclusion criteria. CONCLUSIONS: This is a complex disease with a diagnostic and therapeutic challenge.