Section of Dermatology, Division of Paediatric Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
Section of Dermatology, Division of Paediatric Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
J Am Acad Dermatol. 2015 Nov;73(5 Suppl 1):S36-41. doi: 10.1016/j.jaad.2015.07.051.
Hidradenitis suppurativa (HS) generally appears after puberty, is infrequently seen in younger children, and early onset, which is associated with more widespread disease, is more common in children with a positive family history of HS. When compared with adults with HS, children with HS are more likely to have hormonal imbalances, making hormonal investigations integral to disease management in pediatric patients. HS affects intertriginous areas, presenting with double-ended comedones, tender subcutaneous nodules, purulent discharge, and the formation of sinus tracts, hypertrophic fibrotic scars, and dermal contractures. Treatment of HS in children has not been well studied. The goals of therapy in the pediatric setting are to alleviate pain, minimize inflammation and scarring, prevent disease progression, and postpone the need for surgery. Mild cases can be treated with topical antibiotics, while topical and oral antibiotics are the primary therapies for moderate forms of HS. Modalities like biologic agents, laser therapy, or surgery have been reserved for severe pediatric cases of HS. Early recognition and treatment are critical to minimize the effects of the disease on the life course. Given the significant impact of the condition on quality of life and self-esteem, there is a clear role for psychological support.
化脓性汗腺炎（HS）通常在青春期后出现，在儿童中少见，且发病年龄早与疾病更广泛有关，在有 HS 阳性家族史的儿童中更为常见。与 HS 成人患者相比，儿童 HS 更可能存在激素失衡，因此对儿科患者进行激素检查是疾病管理的重要组成部分。HS 影响皱褶部位，表现为双端粉刺、触痛的皮下结节、脓性分泌物以及窦道形成、肥厚性纤维化瘢痕和皮肤挛缩。儿童 HS 的治疗尚未得到充分研究。儿科治疗的目标是缓解疼痛、最大程度减少炎症和瘢痕形成、预防疾病进展以及推迟手术的需要。轻度病例可以用局部抗生素治疗，而局部和口服抗生素是中重度 HS 的主要治疗方法。对于严重的儿童 HS 病例，生物制剂、激光治疗或手术等方法已被保留。早期识别和治疗对于最大限度地减少疾病对生活轨迹的影响至关重要。鉴于该疾病对生活质量和自尊心的重大影响，心理支持显然具有重要作用。
