Unit of Plastic Surgery, Department of General Surgery, Hôpital Bichat C.B., Paris, France.
Surgery. 2013 Nov;154(5):1126-30. doi: 10.1016/j.surg.2013.04.018. Epub 2013 Jul 25.
Hidradenitis suppurativa (HS), or acne inversa, is a chronic inflammatory skin disease characterized by abscesses, fistulating sinus tracts, and scarring. The exact pathogenesis of this disease remains unclear. We present our experience with HS and a possible cause of the disease and offer a surgical and clinical treatment that allows for disease resolution.
We studied 12 patients who presented with axillary and perineal fistulas and underwent surgical excision (repaired by skin grafts or healing by secondary intention) or localized treatments followed by diet modification. All patients were found to have a specific immunology IgG reaction to brewer's yeast and wheat and were put on a controlled brewer's yeast-free diet for 12 months and followed monthly.
The diet demonstrated immediate stabilization of their clinical symptoms, and the skin lesions regressed over the 12-month treatment period. Similarly, all the patients demonstrated an immediate recurrence of skin lesions following accidental or voluntary consumption of beer or other foods containing brewer's yeast or wheat. The patients also demonstrated a return of their quality of life and activities, including the reestablishment of sexual activity in the patients with inguinal and perigenital lesions.
The results of the investigation suggested that the patients had severe reactions to brewer's yeast. Surgery followed by the elimination of the foods containing or made with the yeast resulted in a rapid stabilization of the dermatologic manifestation and a slow, but complete, regression of the skin lesions within a year. Despite the small number of patients in our study, our study could provide the basis for extensive and multicentric studies in order to better investigate this disabling and rare disease.
化脓性汗腺炎（HS），又称反向痤疮，是一种慢性炎症性皮肤病，其特征为脓肿、窦道瘘和瘢痕。该病的确切发病机制尚不清楚。我们报告了我们在化脓性汗腺炎方面的经验和该病的一个可能病因，并提供了一种手术和临床治疗方法，可使疾病得到缓解。
我们研究了 12 例腋窝和会阴瘘患者，他们接受了手术切除（通过皮片移植或二期愈合修复）或局部治疗，然后进行饮食调整。所有患者均对啤酒酵母和小麦具有特定的免疫 IgG 反应，并接受了为期 12 个月的无控制啤酒酵母饮食控制，并每月进行随访。
饮食立即稳定了他们的临床症状，皮肤病变在 12 个月的治疗期间消退。同样，所有患者在意外或自愿饮用啤酒或其他含有啤酒酵母或小麦的食物后，皮肤病变立即复发。患者还恢复了生活质量和活动能力，包括腹股沟和会阴病变患者恢复了性生活。
调查结果表明，患者对啤酒酵母有严重反应。手术切除含酵母或用酵母制成的食物后，皮肤科表现迅速稳定，皮肤病变在一年内缓慢但完全消退。尽管我们的研究中患者人数较少，但我们的研究可以为广泛的多中心研究提供基础，以更好地研究这种致残且罕见的疾病。
