Journal of the American Academy of Dermatology
-
J. Am. Acad. Dermatol. · Nov 2015
Review Comparative StudyScientific evidence for the use of current traditional systemic therapies in patients with hidradenitis suppurativa.
Traditional systemic therapies are frequently prescribed for the treatment of hidradenitis suppurativa (HS). Clinicians consider antibiotics, retinoids, antiandrogens, immunosuppressants, and less common treatment, such as fumarates, in the management of HS. ⋯ This review explores the outcomes with the use of numerous medical therapies and postulates explanations for their efficacy or lack of response. Data on long-term safety and efficacy with traditional systemic therapies are lacking.
-
J. Am. Acad. Dermatol. · Nov 2015
ReviewAcute generalized exanthematous pustulosis (AGEP): A review and update.
Acute generalized exanthematous pustulosis is a severe cutaneous adverse reaction characterized by the rapid development of nonfollicular, sterile pustules on an erythematous base. It is attributed to drugs in the majority of cases. Antibiotics are the most common cause of acute generalized exanthematous pustulosis; however, a wide variety of drugs has been associated with this condition. ⋯ In severe cases there can be mucous membrane and systemic organ involvement. Histologic findings include intracorneal, subcorneal, and/or intraepidermal pustules with papillary dermal edema containing neutrophils and eosinophils. Treatment focuses on removal of the causative drug, supportive care, infection prevention, and the often beneficial use of a potent topical steroid.
-
J. Am. Acad. Dermatol. · Nov 2015
Review Comparative StudyHidradenitis suppurativa in the pediatric population.
Hidradenitis suppurativa (HS) generally appears after puberty, is infrequently seen in younger children, and early onset, which is associated with more widespread disease, is more common in children with a positive family history of HS. When compared with adults with HS, children with HS are more likely to have hormonal imbalances, making hormonal investigations integral to disease management in pediatric patients. HS affects intertriginous areas, presenting with double-ended comedones, tender subcutaneous nodules, purulent discharge, and the formation of sinus tracts, hypertrophic fibrotic scars, and dermal contractures. ⋯ Modalities like biologic agents, laser therapy, or surgery have been reserved for severe pediatric cases of HS. Early recognition and treatment are critical to minimize the effects of the disease on the life course. Given the significant impact of the condition on quality of life and self-esteem, there is a clear role for psychological support.
-
J. Am. Acad. Dermatol. · Nov 2015
Remission of refractory pyoderma gangrenosum, severe acne, and hidradenitis suppurativa (PASH) syndrome using targeted antibiotic therapy in 4 patients.
Pyoderma gangrenosum, severe acne, and suppurative hidradenitis (PASH) syndrome can prove refractory to treatment and is characterized by relapses and recurrences. The combination of antibiotic therapy and surgery can produce success in the management of the syndrome. ⋯ The response to antibiotic therapy is hypothesis generating, raising the issue of a modified host response. To date, anecdotal reports support the use of surgery and medical therapy, but controlled investigations with extended follow-up are necessary to substantiate preliminary data observed with individual cases.