ABSTRACT
BACKGROUND: Hidradenitis suppurativa (HS) is a chronic, recurrent, inflammatory disorder of follicular occlusion, resulting in abscesses with tunnel formation and severe scarring. Our objectives were to identify the clinical patterns and the prevalence of metabolic syndrome (MetS) among our HS patients and to determine the role of ultrasonography in the clinical assessment of HS. METHODS: This was a cross-sectional study carried out from September 2016 to August 2017 at three tertiary hospitals in Northern Peninsular Malaysia. RESULTS: A total of 62 patients were recruited, 83.9% of whom were male. The mean age was 29.2 with the median age of onset at 18 years old. The median duration of delay in diagnosis was 3 years. A quarter of them had positive family history. Nearly three-quarters were overweight and obese. About 12/62 (19.4%) had MetS, and it was comparable to healthy controls (15/62, 24.2%). HS patients had a significant higher risk of low-high-density lipoprotein (HDL) and obesity. Based on Hurley staging, 15/62 (24.2%) were in stage I, 38/62 (61.3%) and 9/62 (14.5%) in stages II and III, respectively. However, sonographic scoring showed 50% had severe stage of disease, and 56.9% of the patients had subclinical lesions. There was only a fair agreement between ultrasonography and Hurley staging of disease severity (k = 0.25; P = 0.004). CONCLUSION: There was a male preponderance among HS patients in Northern Peninsular Malaysia with early age of onset and more severe disease. Only one-fifth had MetS, but they had significantly higher risks of obesity and low HDL. Ultrasonography examination was useful to detect subclinical lesions and providing a better understanding on disease severity.
Subject(s)
Hidradenitis Suppurativa/diagnostic imaging , Hidradenitis Suppurativa/epidemiology , Metabolic Syndrome/epidemiology , Obesity/epidemiology , Adolescent , Adult , Age of Onset , Comorbidity , Cross-Sectional Studies , Female , Hidradenitis Suppurativa/blood , Humans , Lipoproteins, HDL/blood , Malaysia/epidemiology , Male , Middle Aged , Phenotype , Prevalence , Severity of Illness Index , Sex Factors , Ultrasonography , Young AdultABSTRACT
This is a case of an adult patient with hypertensive intraventricular haemorrhages complicated by hydrocephalus that failed to respond to endoscopic third ventriculostomy (ETV). High-resolution 3D Fast Imaging Employing Steady State Acquisition (FIESTA) magnetic resonance imaging (MRI) revealed underlying multiloculated hydrocephalus. This case report highlights the appropriate sequence and its attributes that offer adequate preoperative information detailing the ventricular system.
