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Research in Review

Hidradenitis Suppurativa Review

July 2017

Group-Specific Prevalence Rates of Hidradenitis Suppurativa
Hidradenitis suppurativa (HS) in the United States is uncommon, but not rare, according to a recent study by Garg and colleagues published online in JAMA Dermatology.

Researchers conducted a retrospective analysis of more than 48 million patients to establish standardized overall and group-specific prevalence estimates for HS. Of the demographically heterogeneous population-based sample, researchers identified 47,690 patients with HS by October 27, 2016 using electronic health record data. Patients’ sex, age, and race were evaluated to determine the standardized overall point prevalence for HS.

The study found the overall prevalence of HS to be 0.10%, or 98 of 100,000 persons. Of the 47,690 patients identified with the disease, 26.2% were male and 73.8% were female. The prevalence of HS in women was more than twice the size of men, with 137 of 100,000 persons having HS compared with 58 of 100,000 persons. Patients aged 30 to 39 years had the highest prevalence of HS compared with all other age groups (172 per 100,000 persons).

Further examination found that among African Americans, HS was prevalent in 296 of 100,000 persons and in 218 of 100,000 biracial persons, while HS prevalence in white patients was 95 of 100,000 persons.

Though not common in the United States, HS disproportionally affects women, young adults, African Americans, and biracial patients, concluded the researchers. 

—Nina Farrell

Reference
Garg A, Kirby JS, Lavian J, Lin G, Strunk A. Sex- and age-adjusted population analysis of prevalence estimates for hidradenitis suppurativa in the United States [published online May 10, 2017]. JAMA Dermatol. doi:10.1001/jamadermatol.2017.0201

Pruritus Related to HS   
Pruritus is a frequent but underreported symptom in patients with HS, according to a recent study by Vossen and colleagues, published in The American Journal of Clinical Dermatology.

The researchers sought to determine the prevalence of pruritus and explore the characteristics of pruritus in a cohort of patients with HS. The academic, hospital-based, cross-sectional study was conducted in The Netherlands. The researchers used a numerical rating scale (NRS, 0-10) to determine the prevalence of HS-related itch (NRS score ≥3). Candidate predictors for pruritus were ascertained using logistic regression models, and the impact of pruritus was assessed using a modified 5-dimensional (5-D) itch scale.

The study demonstrated the prevalence rate of pruritus in 211 HS patients was 57.3%, with a mean NRS score of 6.1 ± 2.0. Patients with a pruritus NRS score ≥3 had more HS-affected body sites than patients with a score <3. The occurrence of a pruritus NRS score ≥3 was associated with Hurley III disease and pain. Pruritus affected sleep and activities of daily living in the majority of cases, with an associated modified 5-D itch score of 13.7 ± 3.6 (on a scale from 5 to 25) in 52 HS patients.

Histologic examination revealed eosinophilic granulocytes were present in 25% (2/8) of the perilesional skin and 63% (10/16) of the lesional skin. A perineural infiltrate was found in 25% (2/8) and 69% (11/16) of the perilesional and lesional skin, respectively.

Pruritus, although frequently underreported as an HS symptom, can occur with moderate to severe intensity and has a significant impact on daily activities. It has great potential to impair patients’ quality of life, the researchers concluded.

Reference
Vossen ARJV, Schoenmakers A, van Straalen KR, Prens EP, van der Zee HH. Assessing pruritus in hidradenitis suppurativa: a cross-sectional study [published online April 20, 2017]. Am J Clin Dermatol. doi:10.1007/s40257-017-0280-2


Mechanical Stress Plays Role in Obese Patients With HS
The Koebner phenomenon (KP) may help to explain the distribution of some HS, according to a recent study published in Dermatology. The removal of external stress factors that could lead to KP should be implemented as part of HS treatment, especially in obese patients.

In order to determine if environmental factors including friction and pressure could play a role in HS, researchers examined data from 14 patients with typical HS and additional HS lesions in previously uninvolved areas exposed to mechanical stress. The participants were all obese with a mean body mass index of 35.8, and all developed lesions at sites of friction that were clinically similar to HS.

“Mechanical stress factors or trauma play a role in obese patients with HS. It is suggested that these new induced lesions fit the concept of the KP. This phenomenon seems to occur in the so-called frictional furunculoid type of HS and may explain the unique distribution at certain localizations on the body of this follicular cutaneous eruption,” the researchers concluded. “Removal in an early stage of HS of external stress factors that can lead to the KP should be part of the treatment, especially in obese patients.”

—Michael Potts

Reference
Boer J. Should hidradenitis suppurativa be included in dermatoses showing Koebnerization? Is it friction or fiction [published online May 16, 2017]? Dermatology. doi:10.1159/000472252

Story continues on page 2

 

Survey Lack of Awareness of HS Among Health Care Providers
According to recent survey results, a lack of disease awareness contributes to misdiagnoses, frequent health care visits, and increased risk of depression in patients living with HS.

Scarred for Life: A National Report of the Patient Experience Living with Hidradenitis Suppurativa, conducted by the Canadian Skin Patient Alliance, included data from 167 individuals (71.1% from the United States, 29.9% from Canada), 95.8% of which were women of an average age of 36 years.

Among the results:
• The median path of diagnosis in patients from Canada (n=49) was 9 years, and the average age of diagnosis was 32 years.
• The majority of Canadian patients visited 1 to 3 different dermatologists, and half visited the emergency room. Seventy-nine percent of patients made at least 4 visits to a family physician.
• Diagnosis was most commonly made by a dermatologist (55%) or family physician (22%).
• More than 50% indicated the need for assistance with the management of secondary symptoms of HS, including depression, anxiety, and stress.
• More than 60% indicated a lack of disease awareness among health care providers.
• Less than 20% indicated that their pain was very well controlled.

The survey authors recommended the evaluation of HS patients for depression, integrating pain management discussion into interactions with HS patients, and the development of a coordinated multidisciplinary approach for the management of HS as ways to improve support of these patients. 

—Michael Potts

Reference
Canadian Skin Patient Alliance. Scarred for Life: A National Report of the Patient Experience Living with Hidradenitis Suppurativa. https://www.canadianskin.ca/images/Documents/CSPA_Report_March_22_2017_website_final.pdf. Accessed June 17, 2017.

Study: Intimate Partner Violence Higher in People with HS
A recent study published in Journal of Cutaneous Medicine and Surgery evaluated sexual assault and intimate partner violence in individuals with HS. This is a novel area of research; however, prior studies have shown higher incidences of intimate partner violence and sexual assault in individuals with disabilities, and HS meets criteria for a disability.

For the study, researchers examined whether individuals with HS are at significantly higher risk of intimate partner violence and sexual assault compared with individuals who have acne, a recognized disability. Participants who met criteria for HS and acne were recruited from a mid-sized university and a dermatology clinic. Participants spoke English and were over the age of sexual consent. Group (HS and acne) differences on intimate partner violence and sexual assault were analyzed. Victimization within the past 12 months was measured using the Checklist for Controlling Behaviors, a measure of intimate partner violence, as well as the Sexual Experiences Survey-Short Form Victim, a measure of sexual assault.

A total of 243 participants (n=128 for HS; n=115 for acne) were surveyed. Individuals with HS were significantly more likely to report being victimized by intimate partner violence.

“Intimate partner violence was more frequently observed in individuals with HS. Health care providers should be aware of this issue when interacting with patients with HS,” concluded the researchers.

Reference
Sisic M, Tan J, Lafreniere KD. Hidradenitis suppurativa, intimate partner violence, and sexual assault [published online May 1, 2017]. J Cutan Med Surg. doi:10.1177/1203475417708167

 

Study Examines Role of Double-Ended Pseudocomedones in HS
Double-ended pseudocomedones (DEP) should be considered the outcome of chronic and relapsing course of HS, according to the results of a recent study.

DEP are commonly seen as a clinical sign of HS. In order to evaluate the clinical, dermoscopic, and histopathological features of DEP and to identify a clinicopathological correlation, researchers evaluated 37 patients with current or past HS.

The researchers identified 64 DEP from 20 of the participants (14 with multiple DEP and 6 with a single DEP). The researchers assessed the DEP using dermoscopy at ×10 using polarized and incident light.

Dermoscopically, DEP appeared as coupled hollows surrounded by whitish cicatricial tissue. Keratin accumulation was observed within the hollows. Histopathologically, DEP corresponded to large hollows with dilated superficial openings.

“In our cases, we have noticed that all DEP resulted from the healing of previous inflammatory lesions, as confirmed by their constant presence within a cicatricial tissue. DEP may thus result from keratinization of the residual stump of 2 adjacent follicles undergoing cicatricial rearrangements,” the researchers wrote.

“Dermoscopy may enhance the diagnostic accuracy by revealing findings not appreciable at naked eye evaluation and may help to better understand some pathogenetic mechanisms underlying this ill-defined disorder.”

—Michael Potts

Reference
Lacarrubba F, Micali G, Musumeci ML, et al. Double-ended pseudocomedones in hidradenitis suppurativa: clinical, dermoscopic, and histopathological correlation. Presented at: the American Academy of Dermatology 75th Annual Meeting. March 4, 2017; Orlando, FL.

Group-Specific Prevalence Rates of Hidradenitis Suppurativa
Hidradenitis suppurativa (HS) in the United States is uncommon, but not rare, according to a recent study by Garg and colleagues published online in JAMA Dermatology.

Researchers conducted a retrospective analysis of more than 48 million patients to establish standardized overall and group-specific prevalence estimates for HS. Of the demographically heterogeneous population-based sample, researchers identified 47,690 patients with HS by October 27, 2016 using electronic health record data. Patients’ sex, age, and race were evaluated to determine the standardized overall point prevalence for HS.

The study found the overall prevalence of HS to be 0.10%, or 98 of 100,000 persons. Of the 47,690 patients identified with the disease, 26.2% were male and 73.8% were female. The prevalence of HS in women was more than twice the size of men, with 137 of 100,000 persons having HS compared with 58 of 100,000 persons. Patients aged 30 to 39 years had the highest prevalence of HS compared with all other age groups (172 per 100,000 persons).

Further examination found that among African Americans, HS was prevalent in 296 of 100,000 persons and in 218 of 100,000 biracial persons, while HS prevalence in white patients was 95 of 100,000 persons.

Though not common in the United States, HS disproportionally affects women, young adults, African Americans, and biracial patients, concluded the researchers. 

—Nina Farrell

Reference
Garg A, Kirby JS, Lavian J, Lin G, Strunk A. Sex- and age-adjusted population analysis of prevalence estimates for hidradenitis suppurativa in the United States [published online May 10, 2017]. JAMA Dermatol. doi:10.1001/jamadermatol.2017.0201

Pruritus Related to HS   
Pruritus is a frequent but underreported symptom in patients with HS, according to a recent study by Vossen and colleagues, published in The American Journal of Clinical Dermatology.

The researchers sought to determine the prevalence of pruritus and explore the characteristics of pruritus in a cohort of patients with HS. The academic, hospital-based, cross-sectional study was conducted in The Netherlands. The researchers used a numerical rating scale (NRS, 0-10) to determine the prevalence of HS-related itch (NRS score ≥3). Candidate predictors for pruritus were ascertained using logistic regression models, and the impact of pruritus was assessed using a modified 5-dimensional (5-D) itch scale.

The study demonstrated the prevalence rate of pruritus in 211 HS patients was 57.3%, with a mean NRS score of 6.1 ± 2.0. Patients with a pruritus NRS score ≥3 had more HS-affected body sites than patients with a score <3. The occurrence of a pruritus NRS score ≥3 was associated with Hurley III disease and pain. Pruritus affected sleep and activities of daily living in the majority of cases, with an associated modified 5-D itch score of 13.7 ± 3.6 (on a scale from 5 to 25) in 52 HS patients.

Histologic examination revealed eosinophilic granulocytes were present in 25% (2/8) of the perilesional skin and 63% (10/16) of the lesional skin. A perineural infiltrate was found in 25% (2/8) and 69% (11/16) of the perilesional and lesional skin, respectively.

Pruritus, although frequently underreported as an HS symptom, can occur with moderate to severe intensity and has a significant impact on daily activities. It has great potential to impair patients’ quality of life, the researchers concluded.

Reference
Vossen ARJV, Schoenmakers A, van Straalen KR, Prens EP, van der Zee HH. Assessing pruritus in hidradenitis suppurativa: a cross-sectional study [published online April 20, 2017]. Am J Clin Dermatol. doi:10.1007/s40257-017-0280-2


Mechanical Stress Plays Role in Obese Patients With HS
The Koebner phenomenon (KP) may help to explain the distribution of some HS, according to a recent study published in Dermatology. The removal of external stress factors that could lead to KP should be implemented as part of HS treatment, especially in obese patients.

In order to determine if environmental factors including friction and pressure could play a role in HS, researchers examined data from 14 patients with typical HS and additional HS lesions in previously uninvolved areas exposed to mechanical stress. The participants were all obese with a mean body mass index of 35.8, and all developed lesions at sites of friction that were clinically similar to HS.

“Mechanical stress factors or trauma play a role in obese patients with HS. It is suggested that these new induced lesions fit the concept of the KP. This phenomenon seems to occur in the so-called frictional furunculoid type of HS and may explain the unique distribution at certain localizations on the body of this follicular cutaneous eruption,” the researchers concluded. “Removal in an early stage of HS of external stress factors that can lead to the KP should be part of the treatment, especially in obese patients.”

—Michael Potts

Reference
Boer J. Should hidradenitis suppurativa be included in dermatoses showing Koebnerization? Is it friction or fiction [published online May 16, 2017]? Dermatology. doi:10.1159/000472252

Story continues on page 2

 

Survey Lack of Awareness of HS Among Health Care Providers
According to recent survey results, a lack of disease awareness contributes to misdiagnoses, frequent health care visits, and increased risk of depression in patients living with HS.

Scarred for Life: A National Report of the Patient Experience Living with Hidradenitis Suppurativa, conducted by the Canadian Skin Patient Alliance, included data from 167 individuals (71.1% from the United States, 29.9% from Canada), 95.8% of which were women of an average age of 36 years.

Among the results:
• The median path of diagnosis in patients from Canada (n=49) was 9 years, and the average age of diagnosis was 32 years.
• The majority of Canadian patients visited 1 to 3 different dermatologists, and half visited the emergency room. Seventy-nine percent of patients made at least 4 visits to a family physician.
• Diagnosis was most commonly made by a dermatologist (55%) or family physician (22%).
• More than 50% indicated the need for assistance with the management of secondary symptoms of HS, including depression, anxiety, and stress.
• More than 60% indicated a lack of disease awareness among health care providers.
• Less than 20% indicated that their pain was very well controlled.

The survey authors recommended the evaluation of HS patients for depression, integrating pain management discussion into interactions with HS patients, and the development of a coordinated multidisciplinary approach for the management of HS as ways to improve support of these patients. 

—Michael Potts

Reference
Canadian Skin Patient Alliance. Scarred for Life: A National Report of the Patient Experience Living with Hidradenitis Suppurativa. https://www.canadianskin.ca/images/Documents/CSPA_Report_March_22_2017_website_final.pdf. Accessed June 17, 2017.

Study: Intimate Partner Violence Higher in People with HS
A recent study published in Journal of Cutaneous Medicine and Surgery evaluated sexual assault and intimate partner violence in individuals with HS. This is a novel area of research; however, prior studies have shown higher incidences of intimate partner violence and sexual assault in individuals with disabilities, and HS meets criteria for a disability.

For the study, researchers examined whether individuals with HS are at significantly higher risk of intimate partner violence and sexual assault compared with individuals who have acne, a recognized disability. Participants who met criteria for HS and acne were recruited from a mid-sized university and a dermatology clinic. Participants spoke English and were over the age of sexual consent. Group (HS and acne) differences on intimate partner violence and sexual assault were analyzed. Victimization within the past 12 months was measured using the Checklist for Controlling Behaviors, a measure of intimate partner violence, as well as the Sexual Experiences Survey-Short Form Victim, a measure of sexual assault.

A total of 243 participants (n=128 for HS; n=115 for acne) were surveyed. Individuals with HS were significantly more likely to report being victimized by intimate partner violence.

“Intimate partner violence was more frequently observed in individuals with HS. Health care providers should be aware of this issue when interacting with patients with HS,” concluded the researchers.

Reference
Sisic M, Tan J, Lafreniere KD. Hidradenitis suppurativa, intimate partner violence, and sexual assault [published online May 1, 2017]. J Cutan Med Surg. doi:10.1177/1203475417708167

 

Study Examines Role of Double-Ended Pseudocomedones in HS
Double-ended pseudocomedones (DEP) should be considered the outcome of chronic and relapsing course of HS, according to the results of a recent study.

DEP are commonly seen as a clinical sign of HS. In order to evaluate the clinical, dermoscopic, and histopathological features of DEP and to identify a clinicopathological correlation, researchers evaluated 37 patients with current or past HS.

The researchers identified 64 DEP from 20 of the participants (14 with multiple DEP and 6 with a single DEP). The researchers assessed the DEP using dermoscopy at ×10 using polarized and incident light.

Dermoscopically, DEP appeared as coupled hollows surrounded by whitish cicatricial tissue. Keratin accumulation was observed within the hollows. Histopathologically, DEP corresponded to large hollows with dilated superficial openings.

“In our cases, we have noticed that all DEP resulted from the healing of previous inflammatory lesions, as confirmed by their constant presence within a cicatricial tissue. DEP may thus result from keratinization of the residual stump of 2 adjacent follicles undergoing cicatricial rearrangements,” the researchers wrote.

“Dermoscopy may enhance the diagnostic accuracy by revealing findings not appreciable at naked eye evaluation and may help to better understand some pathogenetic mechanisms underlying this ill-defined disorder.”

—Michael Potts

Reference
Lacarrubba F, Micali G, Musumeci ML, et al. Double-ended pseudocomedones in hidradenitis suppurativa: clinical, dermoscopic, and histopathological correlation. Presented at: the American Academy of Dermatology 75th Annual Meeting. March 4, 2017; Orlando, FL.

Group-Specific Prevalence Rates of Hidradenitis Suppurativa
Hidradenitis suppurativa (HS) in the United States is uncommon, but not rare, according to a recent study by Garg and colleagues published online in JAMA Dermatology.

Researchers conducted a retrospective analysis of more than 48 million patients to establish standardized overall and group-specific prevalence estimates for HS. Of the demographically heterogeneous population-based sample, researchers identified 47,690 patients with HS by October 27, 2016 using electronic health record data. Patients’ sex, age, and race were evaluated to determine the standardized overall point prevalence for HS.

The study found the overall prevalence of HS to be 0.10%, or 98 of 100,000 persons. Of the 47,690 patients identified with the disease, 26.2% were male and 73.8% were female. The prevalence of HS in women was more than twice the size of men, with 137 of 100,000 persons having HS compared with 58 of 100,000 persons. Patients aged 30 to 39 years had the highest prevalence of HS compared with all other age groups (172 per 100,000 persons).

Further examination found that among African Americans, HS was prevalent in 296 of 100,000 persons and in 218 of 100,000 biracial persons, while HS prevalence in white patients was 95 of 100,000 persons.

Though not common in the United States, HS disproportionally affects women, young adults, African Americans, and biracial patients, concluded the researchers. 

—Nina Farrell

Reference
Garg A, Kirby JS, Lavian J, Lin G, Strunk A. Sex- and age-adjusted population analysis of prevalence estimates for hidradenitis suppurativa in the United States [published online May 10, 2017]. JAMA Dermatol. doi:10.1001/jamadermatol.2017.0201

Pruritus Related to HS   
Pruritus is a frequent but underreported symptom in patients with HS, according to a recent study by Vossen and colleagues, published in The American Journal of Clinical Dermatology.

The researchers sought to determine the prevalence of pruritus and explore the characteristics of pruritus in a cohort of patients with HS. The academic, hospital-based, cross-sectional study was conducted in The Netherlands. The researchers used a numerical rating scale (NRS, 0-10) to determine the prevalence of HS-related itch (NRS score ≥3). Candidate predictors for pruritus were ascertained using logistic regression models, and the impact of pruritus was assessed using a modified 5-dimensional (5-D) itch scale.

The study demonstrated the prevalence rate of pruritus in 211 HS patients was 57.3%, with a mean NRS score of 6.1 ± 2.0. Patients with a pruritus NRS score ≥3 had more HS-affected body sites than patients with a score <3. The occurrence of a pruritus NRS score ≥3 was associated with Hurley III disease and pain. Pruritus affected sleep and activities of daily living in the majority of cases, with an associated modified 5-D itch score of 13.7 ± 3.6 (on a scale from 5 to 25) in 52 HS patients.

Histologic examination revealed eosinophilic granulocytes were present in 25% (2/8) of the perilesional skin and 63% (10/16) of the lesional skin. A perineural infiltrate was found in 25% (2/8) and 69% (11/16) of the perilesional and lesional skin, respectively.

Pruritus, although frequently underreported as an HS symptom, can occur with moderate to severe intensity and has a significant impact on daily activities. It has great potential to impair patients’ quality of life, the researchers concluded.

Reference
Vossen ARJV, Schoenmakers A, van Straalen KR, Prens EP, van der Zee HH. Assessing pruritus in hidradenitis suppurativa: a cross-sectional study [published online April 20, 2017]. Am J Clin Dermatol. doi:10.1007/s40257-017-0280-2


Mechanical Stress Plays Role in Obese Patients With HS
The Koebner phenomenon (KP) may help to explain the distribution of some HS, according to a recent study published in Dermatology. The removal of external stress factors that could lead to KP should be implemented as part of HS treatment, especially in obese patients.

In order to determine if environmental factors including friction and pressure could play a role in HS, researchers examined data from 14 patients with typical HS and additional HS lesions in previously uninvolved areas exposed to mechanical stress. The participants were all obese with a mean body mass index of 35.8, and all developed lesions at sites of friction that were clinically similar to HS.

“Mechanical stress factors or trauma play a role in obese patients with HS. It is suggested that these new induced lesions fit the concept of the KP. This phenomenon seems to occur in the so-called frictional furunculoid type of HS and may explain the unique distribution at certain localizations on the body of this follicular cutaneous eruption,” the researchers concluded. “Removal in an early stage of HS of external stress factors that can lead to the KP should be part of the treatment, especially in obese patients.”

—Michael Potts

Reference
Boer J. Should hidradenitis suppurativa be included in dermatoses showing Koebnerization? Is it friction or fiction [published online May 16, 2017]? Dermatology. doi:10.1159/000472252

Story continues on page 2

 

Survey Lack of Awareness of HS Among Health Care Providers
According to recent survey results, a lack of disease awareness contributes to misdiagnoses, frequent health care visits, and increased risk of depression in patients living with HS.

Scarred for Life: A National Report of the Patient Experience Living with Hidradenitis Suppurativa, conducted by the Canadian Skin Patient Alliance, included data from 167 individuals (71.1% from the United States, 29.9% from Canada), 95.8% of which were women of an average age of 36 years.

Among the results:
• The median path of diagnosis in patients from Canada (n=49) was 9 years, and the average age of diagnosis was 32 years.
• The majority of Canadian patients visited 1 to 3 different dermatologists, and half visited the emergency room. Seventy-nine percent of patients made at least 4 visits to a family physician.
• Diagnosis was most commonly made by a dermatologist (55%) or family physician (22%).
• More than 50% indicated the need for assistance with the management of secondary symptoms of HS, including depression, anxiety, and stress.
• More than 60% indicated a lack of disease awareness among health care providers.
• Less than 20% indicated that their pain was very well controlled.

The survey authors recommended the evaluation of HS patients for depression, integrating pain management discussion into interactions with HS patients, and the development of a coordinated multidisciplinary approach for the management of HS as ways to improve support of these patients. 

—Michael Potts

Reference
Canadian Skin Patient Alliance. Scarred for Life: A National Report of the Patient Experience Living with Hidradenitis Suppurativa. https://www.canadianskin.ca/images/Documents/CSPA_Report_March_22_2017_website_final.pdf. Accessed June 17, 2017.

Study: Intimate Partner Violence Higher in People with HS
A recent study published in Journal of Cutaneous Medicine and Surgery evaluated sexual assault and intimate partner violence in individuals with HS. This is a novel area of research; however, prior studies have shown higher incidences of intimate partner violence and sexual assault in individuals with disabilities, and HS meets criteria for a disability.

For the study, researchers examined whether individuals with HS are at significantly higher risk of intimate partner violence and sexual assault compared with individuals who have acne, a recognized disability. Participants who met criteria for HS and acne were recruited from a mid-sized university and a dermatology clinic. Participants spoke English and were over the age of sexual consent. Group (HS and acne) differences on intimate partner violence and sexual assault were analyzed. Victimization within the past 12 months was measured using the Checklist for Controlling Behaviors, a measure of intimate partner violence, as well as the Sexual Experiences Survey-Short Form Victim, a measure of sexual assault.

A total of 243 participants (n=128 for HS; n=115 for acne) were surveyed. Individuals with HS were significantly more likely to report being victimized by intimate partner violence.

“Intimate partner violence was more frequently observed in individuals with HS. Health care providers should be aware of this issue when interacting with patients with HS,” concluded the researchers.

Reference
Sisic M, Tan J, Lafreniere KD. Hidradenitis suppurativa, intimate partner violence, and sexual assault [published online May 1, 2017]. J Cutan Med Surg. doi:10.1177/1203475417708167

 

Study Examines Role of Double-Ended Pseudocomedones in HS
Double-ended pseudocomedones (DEP) should be considered the outcome of chronic and relapsing course of HS, according to the results of a recent study.

DEP are commonly seen as a clinical sign of HS. In order to evaluate the clinical, dermoscopic, and histopathological features of DEP and to identify a clinicopathological correlation, researchers evaluated 37 patients with current or past HS.

The researchers identified 64 DEP from 20 of the participants (14 with multiple DEP and 6 with a single DEP). The researchers assessed the DEP using dermoscopy at ×10 using polarized and incident light.

Dermoscopically, DEP appeared as coupled hollows surrounded by whitish cicatricial tissue. Keratin accumulation was observed within the hollows. Histopathologically, DEP corresponded to large hollows with dilated superficial openings.

“In our cases, we have noticed that all DEP resulted from the healing of previous inflammatory lesions, as confirmed by their constant presence within a cicatricial tissue. DEP may thus result from keratinization of the residual stump of 2 adjacent follicles undergoing cicatricial rearrangements,” the researchers wrote.

“Dermoscopy may enhance the diagnostic accuracy by revealing findings not appreciable at naked eye evaluation and may help to better understand some pathogenetic mechanisms underlying this ill-defined disorder.”

—Michael Potts

Reference
Lacarrubba F, Micali G, Musumeci ML, et al. Double-ended pseudocomedones in hidradenitis suppurativa: clinical, dermoscopic, and histopathological correlation. Presented at: the American Academy of Dermatology 75th Annual Meeting. March 4, 2017; Orlando, FL.

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