Department of Dermatology, Tallaght University Hospital, Tallaght, Dublin 24, Ireland.
Department of Dermatology, Henri-Mondor Hospital (AP-HP), University Paris XII, Créteil, France.
Clin Exp Dermatol. 2019 Oct;44(7):777-780. doi: 10.1111/ced.13944. Epub 2019 Mar 22.
We report eight cases of patients with severe acne who were treated with isotretinoin and developed painful nodules in the axillae and groin, consistent with hidradenitis suppurativa (HS). The pathogenesis of HS is still not completely understood; recent research from a study in 2011 of biopsies from HS lesions showed a reduction or absence of sebaceous glands compared with normal skin in patients with HS, with the report suggesting that this contributes to the pathogenesis of the disease. Interestingly, the main effect of isotretinoin is to decrease the size and action of sebaceous glands, so hypothetically, as isotretinoin acts by reducing the sebaceous glands further it could potentially aggravate HS. Our experience has instilled caution in our prescribing of isotretinoin, and we question patients, particularly those with acne conglobata, about symptoms of HS prior to and during treatment.
我们报告了 8 例重症痤疮患者，他们在接受异维 A 酸治疗后，腋窝和腹股沟出现疼痛性结节，符合化脓性汗腺炎（HS）的表现。HS 的发病机制仍不完全清楚；最近一项 2011 年的研究对 HS 病变活检进行研究，发现与 HS 患者的正常皮肤相比，HS 患者的皮脂腺减少或缺失，报告表明这有助于该疾病的发病机制。有趣的是，异维 A 酸的主要作用是减小皮脂腺的大小和功能，因此理论上，由于异维 A 酸通过进一步减少皮脂腺起作用，它可能潜在地加重 HS。我们的经验在我们开具异维 A 酸处方时引起了警惕，我们在治疗前后询问患者，特别是患有聚合性痤疮的患者，有关 HS 的症状。
