Moschella Samuel L
Harvard Medical School, Boston, and Lahey Clinic, Burlington, MA, USA.
Int J Dermatol. 2007 Dec;46(12):1287-91. doi: 10.1111/j.1365-4632.2007.03293.x.
Hidradenitis suppurativa is one of the follicular occlusion diseases favoring the flexural areas of the body. Because of the past failure of medical therapy, surgery is today the definitive therapeutic approach. There is a need for effective medical anti-inflammatory therapy to control the disease and minimize the pathologic and socioeconomic consequences of the disease process. Generally the patients fail to respond to topical or systemic antibiotics and retinoids. Temporary responses are achieved with intralesional steroids and cyclosporin.
The association of hidradenitis suppurativa with inflammatory bowel disease permitted the opportunity to utilize infliximab and to observe not only its impact on the bowel, but also skin.
Infliximab dramatically and favorably impacted on three cases of hidradenitis, but also in one of the patients who also had pyoderma gangrenosum.
Infliximab appears to be an effective medical approach to the management of hidradenitis suppurativa and also to prepare the patient for "curative" surgery. However, one must be cognizant of the potential of acquired drug resistance or adverse drug reactions, which can be minimized by "no vacations" from this systematic therapy and the use of methotrexate to minimize the above potential problems.
化脓性汗腺炎是一种好发于身体屈侧部位的毛囊闭锁性疾病。由于过去药物治疗效果不佳，目前手术是其确定性治疗方法。需要有效的医学抗炎治疗来控制该病，并将疾病过程的病理和社会经济后果降至最低。一般来说，患者对局部或全身使用抗生素及维甲酸类药物无反应。局部注射类固醇和环孢素可取得暂时疗效。
化脓性汗腺炎与炎症性肠病的关联为使用英夫利昔单抗提供了契机，不仅可观察其对肠道的影响，还能观察对皮肤的影响。
英夫利昔单抗对3例化脓性汗腺炎患者产生了显著且良好的影响，对1例同时患有坏疽性脓皮病的患者也有效果。
英夫利昔单抗似乎是治疗化脓性汗腺炎的一种有效医学方法，也可为患者接受“根治性”手术做准备。然而，必须认识到获得性耐药或药物不良反应的可能性，通过持续进行这种系统性治疗以及使用甲氨蝶呤来尽量减少上述潜在问题，可将其降至最低。
