Gill Liza, Williams Melissa, Hamzavi Iltefat
College of Human Medicine, Michigan State University 965 Fee Road, Room A110, East Lansing, MI 48824 USA.
Department of Dermatology Henry Ford Hospital, 3031 W. Grand Boulevard, Suite 800, Detroit, MI 48202 USA.
F1000Prime Rep. 2014 Dec 1;6:112. doi: 10.12703/P6-112. eCollection 2014.
Hidradenitis suppurativa (HS) is a debilitating skin disease characterized by recurrent abscesses, sinus tract formation, and scarring. Prevalence estimates range from 0.053% to 4.1%, although HS is likely an underdiagnosed disease. Although the first reports of HS date back to the mid-19th century, the disease continues to plague patients and physicians desperate for a definitive treatment. Advances in the understanding of the disease process include the possibility of a defective basement membrane at the sebofollicular junction of the folliculopilosebaceous unit (FPSU; that is, where the sebaceous gland empties into the hair follicle) as an initiating event followed by secondary bacterial colonization. New evidence suggests that bacteria living in a community, known as a biofilm, rather than single planktonic bacteria in HS lesions may explain why HS can be resistant to current antibiotic treatment regimens. Available treatment options have expanded to include triple-antibiotic therapy, tumor necrosis factor (TNF-α) and interleukin-1 (IL-1) inhibitors (biologics), laser therapy, and surgical excision, including the skin tissue-sparing excision with electrosurgical peeling procedure. Despite the array of treatments available, many patients continue to struggle with the embarrassment, pain, odor, and frustration that accompany this often isolating disease. Physicians should address comorbidities in HS, including the psychosocial issues patients with HS frequently encounter. Patients can be directed to HS support groups, where they can openly discuss their frustrations, share their experiences in dealing with HS, and band together to advocate for themselves. HS is misunderstood by both patients and physicians, often resulting in a delay in clinical presentation and diagnosis. Patients and physicians across multiple specialties must work together to expand awareness of and interest in HS, so that one day, individuals with HS can be freed from this crippling disease.
化脓性汗腺炎（HS）是一种使人衰弱的皮肤病，其特征为反复出现脓肿、窦道形成和瘢痕。患病率估计在0.053%至4.1%之间，不过HS可能是一种诊断不足的疾病。尽管HS的首次报告可追溯到19世纪中叶，但这种疾病仍在困扰着患者和渴望获得确切治疗方法的医生。对疾病过程认识的进展包括，在毛囊皮脂腺单元（FPSU，即皮脂腺通向毛囊的部位）的皮脂毛囊交界处存在有缺陷的基底膜可能是起始事件，随后继发细菌定植。新证据表明，在HS皮损中，生活在生物膜中的细菌群落而非单个浮游细菌，可能解释了HS为何会对当前的抗生素治疗方案产生耐药性。现有的治疗选择已扩大到包括三联抗生素疗法、肿瘤坏死因子（TNF-α）和白细胞介素-1（IL-1）抑制剂（生物制剂）、激光治疗以及手术切除，包括采用电外科剥离程序的保留皮肤组织的切除手术。尽管有一系列治疗方法可供选择，但许多患者仍在与这种常使人孤立的疾病所带来的尴尬、疼痛、气味和沮丧作斗争。医生应关注HS患者的合并症，包括HS患者经常遇到的心理社会问题。可以引导患者加入HS支持小组，在那里他们可以公开讨论自己的挫折，分享应对HS的经验，并团结起来为自己争取权益。HS常被患者和医生误解，这往往导致临床表现和诊断的延迟。多个专业领域的患者和医生必须共同努力，提高对HS的认识和关注度，以便有朝一日，HS患者能够摆脱这种致残性疾病。
