Kathju Sandeep, Lasko Leslie-Ann, Stoodley Paul
Division of Plastic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA.
FEMS Immunol Med Microbiol. 2012 Jul;65(2):385-9. doi: 10.1111/j.1574-695X.2012.00946.x. Epub 2012 Mar 12.
Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the skin that results in a relapsing course of painful draining sinuses and abscesses. The disease manifests largely in the apocrine gland-bearing regions of the body (axillary, inguinal and anogenital areas) and is usually treated by antibiotics and/or surgery. The exact pathogenesis of HS is still in dispute, but likely multifactorial; in some instances, a genetic component has been demonstrated. While much attention has been given to the cellular and molecular biology of the host tissues affected by HS, rather less has been given to the bacteria involved (most commonly Staphylococci or Streptococci). We note that the characteristics of HS comport exactly with the features of bacterial biofilm-based infections, and examined a case where HS of the buttocks had progressed to an advanced stage. Physical examination of the sinus tracks at surgery revealed a mucinous accumulation consistent with biofilm formation. Confocal microscopic examination using Live/Dead staining revealed clusters of bacteria attached to the sinus luminal surfaces. The paradigmatic clinical features of HS, coupled with the adherent bacterial communities we observe here, suggest that HS should be considered in the expanding spectrum of bacterial biofilm-based disorders.
化脓性汗腺炎（HS）是一种皮肤慢性炎症性疾病，会导致疼痛性引流窦道和脓肿反复发作。该疾病主要表现在身体的顶泌汗腺分布区域（腋窝、腹股沟和肛门生殖器区域），通常采用抗生素和/或手术进行治疗。HS的确切发病机制仍存在争议，但可能是多因素的；在某些情况下，已证实存在遗传因素。虽然人们对受HS影响的宿主组织的细胞和分子生物学给予了很多关注，但对其中涉及的细菌（最常见的是葡萄球菌或链球菌）关注较少。我们注意到HS的特征与基于细菌生物膜的感染特征完全相符，并研究了一例臀部HS进展到晚期的病例。手术时对窦道进行体格检查发现有黏液积聚，符合生物膜形成。使用活/死染色的共聚焦显微镜检查发现细菌聚集附着在窦腔表面。HS的典型临床特征，加上我们在此观察到的附着细菌群落，表明在基于细菌生物膜的疾病不断扩大的范围内应考虑HS。
