Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
J Am Acad Dermatol. 2015 Nov;73(5 Suppl 1):S47-51. doi: 10.1016/j.jaad.2015.07.046.
Hidradenitis suppurativa (HS) is a chronic, relapsing, and painful inflammatory disease. HS patients' quality of life is severely impaired, and this impairment correlates strongly with their pain. Pain in HS can be acute or chronic and has both inflammatory and noninflammatory origins. The purpose of this review is to provide a summary of the existing literature regarding pain management in patients with HS. While there are no formal studies investigating pain management in HS, existing recommendations are based on general pain guidelines and expert opinion. Documentation of pain requires an assessment of the severity and timing of the pain. Although anti-inflammatory drugs and surgery for HS can alleviate pain, adjunctive pain medications are typically necessary. Topical analgesics, oral acetaminophen, and oral nonsteroidal anti-inflammatory drugs are considered first-line agents for the treatment of pain in patients with HS. If pain management is ineffective with those agents, oral opiates can be considered. In addition, anticonvulsants and selective serotonin reuptake inhibitors/serotonin-norepinephrine reuptake inhibitors possess neuropathic pain-relieving properties that offer not only control of HS-associated pain but beneficial effects on itch and depression. There is clearly a need for additional studies on pain management in patients with HS.
化脓性汗腺炎（HS）是一种慢性、复发性、疼痛性炎症性疾病。HS 患者的生活质量严重受损，这种损害与他们的疼痛密切相关。HS 患者的疼痛可以是急性的，也可以是慢性的，既有炎症性的，也有非炎症性的。本综述的目的是总结有关 HS 患者疼痛管理的现有文献。虽然没有正式研究调查 HS 中的疼痛管理，但现有的建议是基于一般疼痛指南和专家意见。疼痛的记录需要评估疼痛的严重程度和发生时间。虽然 HS 的抗炎药物和手术可以缓解疼痛，但通常需要辅助止痛药物。局部镇痛药、口服对乙酰氨基酚和口服非甾体抗炎药被认为是治疗 HS 患者疼痛的一线药物。如果这些药物对疼痛管理无效，可以考虑口服阿片类药物。此外，抗惊厥药和选择性 5-羟色胺再摄取抑制剂/5-羟色胺去甲肾上腺素再摄取抑制剂具有缓解神经性疼痛的特性，不仅可以控制与 HS 相关的疼痛，还可以对瘙痒和抑郁产生有益的影响。显然，需要对 HS 患者的疼痛管理进行更多的研究。
