Kontochristopoulos George, Agiasofitou Efthymia, Platsidaki Eftychia, Kapsiocha Anastasia, Gregoriou Stamatios, Rigopoulos Dimitrios
Department of Dermatology and Venereology, Andreas Sygros Hospital, Athens, Greece.
National and Kapodistrian University of Athens, Faculty of Medicine, 1st department of Dermatology-Venereology, Andreas Sygros Hospital, Athens, Greece.
Skin Appendage Disord. 2021 Jun;7(4):329-332. doi: 10.1159/000515002. Epub 2021 Mar 30.
The coexistence of hidradenitis suppurativa (HS) and acne fulminans (AF) has only recently been reported in the literature. We present a case of a 17-year-old man who presented with a 2 years history of severe acne and HS. He was initially started on oral clindamycin and rifampicin for 3 months with no clinical improvement. Acne lesions became worse with the presence of nodules and necrotic ulcers, while weight loss, low-grade fever, back and knee pain, and psychological distress were noted. We prescribed adalimumab in its standard dosing regimen. Remission of AF was achieved in 3 months, whereas adalimumab has not been as effective in treating the HS lesions. Its dosage was increased to 80 mg weekly and more than 80% clinical improvement of HS lesions was obtained in 2 months. The patient maintained on this dosage till this day and efficacy is sustained. TNF-α inhibitors are considered an effective option in the treatment of HS, while it has been also suggested as a treatment option in AF. Our patient was successfully treated with adalimumab. Since the coexistence of HS and AF has a devastating emotional effect on the patient, there is an urgent need to implement therapeutic approaches.
化脓性汗腺炎（HS）与暴发性痤疮（AF）并存的情况直到最近才在文献中有所报道。我们报告一例17岁男性患者，其有2年严重痤疮和HS病史。他最初口服克林霉素和利福平3个月，临床症状无改善。痤疮皮损因出现结节和坏死性溃疡而加重，同时伴有体重减轻、低热、背部和膝盖疼痛以及心理困扰。我们按照标准给药方案使用阿达木单抗。3个月时AF得到缓解，而阿达木单抗对HS皮损的治疗效果不佳。其剂量增加至每周80毫克，2个月内HS皮损临床改善超过80%。患者至今维持该剂量，疗效持续。肿瘤坏死因子-α抑制剂被认为是治疗HS的有效选择，同时也有人提出将其作为AF的治疗选择。我们的患者使用阿达木单抗治疗成功。由于HS和AF并存对患者有严重的情绪影响，迫切需要实施治疗方法。
