ABSTRACT
Introduction: Obesity is a growing global health problem; it may even be one of the worst public health issues. In Chile, 34.4% of the population is obese, therefore, is it important for clinicians to be aware of all the consequences of obesity. In this review, we will address the relation of four main dermatologic conditions with obesity: psoriasis, hidradenitis suppurativa, acanthosis nigricans and malignant melanoma. Material and methods: Search in pubmed for obesity and psoriasis, hidradenitis suppurativa, acanthosis nigricans and malignant melanoma. Results: Obesity has a direct impact in the prevalence and severity of psoriasis, hidradenitis suppurativa, acanthosis nigricans. The reduction on body weight has proven to reduce severity of psoriasis and hidradenitis suppurativa. Obese patients with psoriasis have a higher risk on adverse effects due to medication and less effectiveness of biological medications. Acanthosis nigricans is a clinical indicator of insulin resistance and a risk predictor for those with greater risk to develop diabetes in the future. The relationship between obesity and malignant melanoma is not clear and needs further research. Conclusion: Obesity is increasing, dermatologist will face this condition more frequently, it has a great impact over psoriasis, hidradenitis suppurativa, acanthosis nigricans and malignant melanoma, thus it should be considered in treatment decisions. (AU)
Subject(s)
Humans , Male , Female , Obesity/physiopathology , Psoriasis/physiopathology , Hidradenitis Suppurativa/physiopathology , Acanthosis Nigricans/physiopathology , Melanoma/physiopathology , Obesity/epidemiologyABSTRACT
La hidradenitis supurativa (HS) es una enfermedad inflamatoria de la piel, caracterizada por la aparición de nódulos profundos en zonas que poseen glándulas apocrinas. Aparece más frecuentemente en mujeres entre la segunda y la tercera década de la vida. Objetivo Reportar 2 pacientes portadoras de HS a edad prepuberal. Caso 1 Paciente de sexo femenino, 10 años de edad, Tanner I-II, con antecedentes de obesidad. Consultó por un cuadro de 4 meses de evolución caracterizado por lesiones recurrentes en región inguinal bilateral que ocasionalmente drenan material purulento. Se diagnosticó HS Hurley I, se trató con antibióticos tópicos y manejo nutricional, con buena respuesta. Caso 2 Paciente de sexo femenino, 10 años de edad, Tanner I-II, con antecedentes de obesidad. Consultó desde los 6 años por cuadros recurrentes de lesiones en cara interna de muslo izquierdo. Fue tratada con múltiples cursos de antibióticos con escasa respuesta. Se diagnosticó HS Hurley I y se decidió manejo con terapia fotodinámica y apoyo nutricional, con buena respuesta. Conclusiones La etiología de la HS no es clara. La presentación a edades tempranas se asocia a antecedentes familiares y compromiso más extenso a futuro. El tratamiento de la enfermedad depende de cada caso, no existiendo un protocolo establecido.
Hidradenitis suppurativa (HS) is an inflammatory follicular skin disease. It usually presents as recurrent, deep nodules in flexural apocrine gland bearing areas. It appears mainly in women, in the second and third decade of life. Objective To present 2 cases of patients with prepuberal HS. Case 1 A 10-year old female, Tanner stage I-II and obesity. History of 4 months of evolution with bilateral recurrent groin lesions that occasionally drain pus; HS Hurley stage I was diagnosed, and topical antibiotics and nutritional management were prescribed, with a good response. Case 2 A 10 years old female, Tanner stage I-II and obesity. Since the age of 6 years, recurrent episodes of lesions in the inner side of the left thigh were observed, and multiple antibiotics with poor response were prescribed. HS Hurley stage I was diagnosed, and photodynamic therapy and nutritional management were used, with good response. Conclusions The etiology of HS is unclear. Usually the presentation at early age is associated with a family history and more extensive compromise in the future. Treatment is difficult and depends on each case and severity.
Subject(s)
Humans , Female , Child , Hidradenitis Suppurativa/physiopathology , Nutritional Support/methods , Photochemotherapy/methods , Hidradenitis Suppurativa/therapy , Age of Onset , Anti-Bacterial Agents/administration & dosageABSTRACT
This corresponds to an inflammatory disease of the apocrine glands, distributed mainly in the axillary, perineal and perianal regions, clinically characterized by pain, swelling, and smelly discharge. Treatment is expensive, long and leaves large scars, generating economic and psychological problems for the patient. Magnetic resonance imaging (MRI) helps to confirm the diagnosis and determine its extension, which allows it to be distinguished from other entities and to choose the best treatment. To our knowledge, there is only one review of literature dedicated to the characteristics of this pathology using MRI, therefore we present an illustrated literature review in different patients treated at our center.
Corresponde a una enfermedad inflamatoria de las glándulas apocrinas, distribuidas principalmente a nivel axilar, perineal y perianal, caracterizado clínicamente por dolor, tumefacción y secreción mal oliente. Su tratamiento es costoso, largo y deja grandes cicatrices, generando problemas económicos y psicológicos para el paciente. La resonancia magnética (RM) ayuda a confirmar el diagnóstico y a determinar su extensión, lo que permite diferenciarlo de otras entidades y elegir el mejor tratamiento. A nuestro conocimiento, existe sólo una revisión de la literatura dedicada a las características de esta patología en resonancia magnética, por lo que presentamos una revisión de la literatura ilustrada en diferentes pacientes tratados en nuestro centro de atención.
Subject(s)
Humans , Hidradenitis Suppurativa/diagnosis , Magnetic Resonance Imaging , Hidradenitis Suppurativa/physiopathology , Hidradenitis Suppurativa/therapyABSTRACT
Revisão bibliográfica em um periodo de 5 anos (1998 a 2002) sobre Hidradenite supurativa, abordando-se desde sua fisiopatologia, aspectos clínicos e histopatológicos até as modalidades terapêuticas atualmente utilizadas, discutindo-se suas indicações e limitações à luz da bibliografia consultada. A determinação da técnica a ser utilizada vai depender da fase evolutiva da doença, a sua extensão e localização das lesões entre outras variáveis...