Publication: Hidradenitis süpürativa: Epidemiyoloji, klinik özellikler ve komorbid ilişkiler / Hidradenitis suppurativa: Epidemiology, clinical features and comorbid relations
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KAYA, GÖKHAN
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SU KÜÇÜK, ÖZLEM
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Hidradenitis süpürativa, aksilla, kasık ve meme altındaki apokrin bezi taşıyan deri alanını etkileyen, uzun süreli, tekrarlayıcı, ağrılı, sinüs traktüsleri ve skarla sonuçlanabilen derin yerleşimli nodül ve abseler ile giden kronik inflamatuar bir hastalıktır. Sıklıkla 2-4. 10 yılda ortaya çıkmakla birlikte kadınlarda erkeklere göre 3 kat daha fazla görülmektedir. HS'nın mekanizması tam olarak aydınlatılamamış olsa da, lezyon oluşumunun pilosebase-apokrin ünite içindeki foliküler hiperkeratoz ve oklüzyon gelişiminden kaynaklı olduğuna inanılmaktadır. İnflamatuar sitokinlerin merkezi rolünün yanı sıra genetik, mikroorganizmalar ve hormonlar gibi faktörlerin hastalık patogenezinde rol oynadığı gösterilmiştir. Tek merkezden yürütülen bu çalışmada HS'nın demografik ve klinik özelliklerini araştırdık ve hastalık şiddetinin risk faktörlerini belirledik. Toplamda 72 kadın ve 121 erkek hastayı içeren 193 hasta ile çalışma fırsatı bulduk. Çalışmaya katılan hastaların yaş ortalaması 34.51±12.11 yıl, ortalama hastalık süresi 5.94±6.65 yıl idi. Kohortumuzdaki HS'lı bireylerde ailesel geçiş oranı % 21,8 bulunmuştur. HS'nın önemli bir parçası olduğu foliküler oklüzyon tetratı sorgulamasında hastaların % 6.7'sinde saçlı derinin dissekan selüliti, % 10.9'unda akne konglobata ve %35.8'inde pilonidal sinüs mevcuttu. Toplamda 5 hasta FOT'nın tamamını karşılıyordu. Hastaların % 61.1'i Evre I, % 24.4'ü Evre II ve % 14.5'i Evre III idi. Çalışmaya dahil edilen popülasyonda 93 hastada (% 48,2) en az bir komorbidite eşlik etmekteydi ve en sık görüleni psikiyatrik komorbiditeler iken ikinci ve üçüncü sırada diyabetes mellitus ve hipertansiyon görülmektedir. Lojistik regresyon analizinde kategorik değişkenler ile cinsiyet değişkeni arasındaki ilişkiler irdelendiğinde ise vücut kitle indeksi grupları, alkol kullanımı, çalışma, akne vulgaris, saçlı derinin dissekan selüliti, akne konglobata, pilonidal sinus ve hurley değişkenleri için bulgular istatistiksel olarak anlamlı bulunmuştur. Daha şiddetli hastalık hastalık süresi, sigara paket/yıl sayısı, erkek cinsiyet, kasık, kalça, abdomen, baş-boyun, genital ve ense-sırt tutulumu ile ilişklendirildi. Çalışmaya ait sonuçlarımız HS hastalarının demografik, klinik ve komorbid özellikleri hakkında veri sağlamakta ve literatüre katkıda bulunmaktadır.
Hidradenitis suppurativa is a long-term, recurrent disease affecting the apocrine gland-bearing skin area under the axilla, groin and breast. It is a chronic inflammatory disease with painful, deep-seated nodules and abscesses that may result in sinus tracts and scarring. Although it occurs frequently in 2-4 10 years, it is seen 3 times more in women than in men. Although the mechanism of HS has not been fully elucidated, lesion formation is believed to result from follicular hyperkeratosis and occlusion development within the pilosebaceous-apocrine unit. In addition to the central role of inflammatory cytokines, factors such as genetics, microorganisms and hormones have been shown to play a role in the pathogenesis of the disease. In this single-center study, we investigated the demographic and clinical features of HS and determined the risk factors for disease severity. We had the opportunity to work with 193 patients, including 72 female and 121 male patients in total. The mean age of the patients participating in the study was 34.51±12.11 years, and the mean disease duration was 5.94±6.65 years. The familial transmission rate in individuals with HS in our cohort was 21.8%. In the investigation of follicular occlusion tetrad, of which HS is an important part, 6.7% of the patients had dissecting cellulitis of the scalp, 10.9% had acne conglobata, and 35.8% had pilonidal sinus. In total, 5 patients have the all follicular occlusion tetrad is a symptom complex. 61.1% of the patients were Stage I, 24.4% were Stage II and 14.5% were Stage III. In the population included in the study, 93 patients (48.2%) were accompanied by at least one comorbidity, and psychiatric comorbidities were the most common, followed by diabetes mellitus and hypertension in the second and third place. When the relationships between the categorical variables and the gender variable were examined in the logistic regression analysis, the findings for BMI groups, alcohol use, work, acne vulgaris, dissecan cellulitis of scalp, acne conglobata, pilonidal disease and hurley variables were found viii to be statistically significant. More severe disease was associated with disease duration, number of cigarette packs/year, male gender, groin, hip, abdomen, head- neck, genital, and neck-back involvement. Our results of the study provide data on the demographic, clinical and comorbid characteristics of HS patients and contribute to the literature.
Hidradenitis suppurativa is a long-term, recurrent disease affecting the apocrine gland-bearing skin area under the axilla, groin and breast. It is a chronic inflammatory disease with painful, deep-seated nodules and abscesses that may result in sinus tracts and scarring. Although it occurs frequently in 2-4 10 years, it is seen 3 times more in women than in men. Although the mechanism of HS has not been fully elucidated, lesion formation is believed to result from follicular hyperkeratosis and occlusion development within the pilosebaceous-apocrine unit. In addition to the central role of inflammatory cytokines, factors such as genetics, microorganisms and hormones have been shown to play a role in the pathogenesis of the disease. In this single-center study, we investigated the demographic and clinical features of HS and determined the risk factors for disease severity. We had the opportunity to work with 193 patients, including 72 female and 121 male patients in total. The mean age of the patients participating in the study was 34.51±12.11 years, and the mean disease duration was 5.94±6.65 years. The familial transmission rate in individuals with HS in our cohort was 21.8%. In the investigation of follicular occlusion tetrad, of which HS is an important part, 6.7% of the patients had dissecting cellulitis of the scalp, 10.9% had acne conglobata, and 35.8% had pilonidal sinus. In total, 5 patients have the all follicular occlusion tetrad is a symptom complex. 61.1% of the patients were Stage I, 24.4% were Stage II and 14.5% were Stage III. In the population included in the study, 93 patients (48.2%) were accompanied by at least one comorbidity, and psychiatric comorbidities were the most common, followed by diabetes mellitus and hypertension in the second and third place. When the relationships between the categorical variables and the gender variable were examined in the logistic regression analysis, the findings for BMI groups, alcohol use, work, acne vulgaris, dissecan cellulitis of scalp, acne conglobata, pilonidal disease and hurley variables were found viii to be statistically significant. More severe disease was associated with disease duration, number of cigarette packs/year, male gender, groin, hip, abdomen, head- neck, genital, and neck-back involvement. Our results of the study provide data on the demographic, clinical and comorbid characteristics of HS patients and contribute to the literature.