Tolaas Erlend, Knudsen Cathrine Wold, Sviland Lisbet, Tønseth Kim Alexander
Hudavdelingen, Haukeland universitetssykehus, 5021 Bergen.
Tidsskr Nor Laegeforen. 2009 May 14;129(10):992-6. doi: 10.4045/tidsskr.08.0078.
Hidradenitis suppurativa is a chronic inflammatory skin disease characterized by recurrent tender nodules and boils, usually in the armpits and groins. Draining fistulas and hypertrophic scarring are hallmarks of more severe disease. The objective of this article is to review the clinical presentation, diagnostic considerations and treatment of the disease.
The article is based on a non-systematic literature search in PubMed, review of dermatology textbooks and the author's personal clinical experience.
Hidradenitis suppurativa, also known as acne inversa, is a follicular occlusion disease that can severely reduce quality of life. Staphylococci and other pathogenic bacteria frequently colonize the lesions, but the disease is not primarily a bacterial infection. Smoking and obesity can worsen disease activity. Moderate and severe disease is usually treated with excisional surgery. Antibiotics, often tetracyclines, are indicated for mild disease and as an adjunct to surgery in more severe disease. Antibiotics, however, are not curative. New treatment options, such as TNF-alpha inhibitors and zinc gluconate should still be considered experimental.
Hidradenitis suppurativa is probably underdiagnosed. The disease is often recalcitrant to treatment. The effect of medical treatment is not supported by high quality evidence.
化脓性汗腺炎是一种慢性炎症性皮肤病，其特征为反复出现的疼痛性结节和疖肿，通常发生在腋窝和腹股沟。引流性瘘管和肥厚性瘢痕是更严重疾病的标志。本文的目的是综述该疾病的临床表现、诊断要点及治疗方法。
本文基于在PubMed上进行的非系统性文献检索、皮肤病学教科书的回顾以及作者的个人临床经验。
化脓性汗腺炎，也称为反向性痤疮，是一种毛囊闭锁性疾病，可严重降低生活质量。葡萄球菌和其他病原菌常定植于病变部位，但该疾病并非主要由细菌感染引起。吸烟和肥胖会使疾病活动加重。中重度疾病通常采用切除手术治疗。抗生素，通常为四环素类，适用于轻度疾病，并作为重度疾病手术治疗的辅助用药。然而，抗生素并不能治愈该病。新的治疗选择，如肿瘤坏死因子-α抑制剂和葡萄糖酸锌，仍应视为试验性治疗。
化脓性汗腺炎可能诊断不足。该疾病通常对治疗具有顽固性。药物治疗的效果缺乏高质量证据支持。
