Fernandez Jennifer M, Hendricks Aleksi J, Thompson Alyssa M, Mata Elizabeth M, Collier Erin K, Grogan Tristan R, Shi Vivian Y, Hsiao Jennifer L
University of Arizona, College of Medicine, Tucson, AZ, United States.
University of California Los Angeles, David Geffen School of Medicine, Los Angeles, CA, United States.
Int J Womens Dermatol. 2020 Jul 10;6(5):368-371. doi: 10.1016/j.ijwd.2020.07.002. eCollection 2020 Dec.
Hidradenitis suppurativa (HS) is a chronic inflammatory disorder that primarily affects women of childbearing age. There is a paucity of data on HS disease activity during menstruation, pregnancy, and menopause and the potential impact of HS on the method of delivery.
We aimed to characterize the natural history of HS symptoms during menses, pregnancy, and menopause. We also sought to evaluate the potential impact of HS on delivery method and whether there were delivery-related healing complications unique to women with HS.
An anonymous survey was distributed via social media to international HS support groups and patients at three HS specialty clinics in North America. Responses were collected from March to July 2019.
A total of 279 respondents answered questions on disease changes during pregnancy. Menstruation caused worsening of HS symptoms in 76.7%, no change in 22.2%, and improvement in 1.1%. During pregnancy, the distribution between symptoms worsening (34.8%), having no change (28.7%), and improving (36.6%) was relatively even. After menopause, participants typically reported either worsening (39.5%) or no change (44.2%) in HS symptoms. Among respondents with anogenital HS involvement who delivered vaginally, 3.1% believed that HS interfered with vaginal delivery (VD), and 23.5% believed that VD caused an HS flare. Cesarean section (C-section) delivery was reported by 44.2% of participants. Ten participants reported that they were advised by their doctor to have a C-section instead of a VD because of severe anogenital HS. Of those who underwent a C-section, 33.9% reported that HS interfered with incision healing, and 51.2% reported developing new HS lesions in their C-section scar.
To our knowledge, this is the first study describing the potential influence of HS on a patient's method of delivery. Multidisciplinary collaboration plays a pivotal role in developing individualized treatment and birth plans for pregnant women with HS.
化脓性汗腺炎（HS）是一种慢性炎症性疾病，主要影响育龄女性。关于HS在月经、妊娠和绝经期间的疾病活动情况以及HS对分娩方式的潜在影响的数据较少。
我们旨在描述HS症状在月经、妊娠和绝经期间的自然病程。我们还试图评估HS对分娩方式的潜在影响，以及HS女性是否存在与分娩相关的独特愈合并发症。
通过社交媒体向国际HS支持小组以及北美三家HS专科诊所的患者发放了一份匿名调查问卷。于2019年3月至7月收集回复。
共有279名受访者回答了关于妊娠期间疾病变化的问题。月经导致76.7%的HS症状加重，22.2%无变化，1.1%有所改善。在妊娠期间，症状加重（34.8%）、无变化（28.7%）和改善（36.6%）的分布相对均匀。绝经后，参与者通常报告HS症状加重（39.5%）或无变化（44.2%）。在有肛门生殖器HS累及且经阴道分娩的受访者中，3.1%认为HS干扰了阴道分娩（VD），23.5%认为VD导致HS发作。44.2%的参与者报告进行了剖宫产（C-section）。10名参与者报告，由于严重的肛门生殖器HS，医生建议他们进行剖宫产而不是VD。在进行剖宫产的人中，33.9%报告HS干扰了切口愈合，51.2%报告在剖宫产疤痕处出现了新的HS病变。
据我们所知，这是第一项描述HS对患者分娩方式潜在影响的研究。多学科协作在为患有HS的孕妇制定个性化治疗和分娩计划方面起着关键作用。
