Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.
Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.
Clin Dermatol. 2021 May-Jun;39(3):496-499. doi: 10.1016/j.clindermatol.2021.01.002. Epub 2021 Feb 16.
Although dissecting cellulitis (DC) and hidradenitis suppurativa (HS) are classified separately, they share many clinical, dermatoscopic, pathogenetic, and histologic aspects, as well as therapeutic options. The association between DC, HS, and acne conglobata represents the follicular occlusion triad or follicular occlusion tetrad, which may include a pilonidal sinus. DC, also known as "folliculitis et perifolliculitis capitis abscendes et suffoidens," is classified as a secondary cicatricial and neutrophilic alopecia. It occurs with perifolliculitis of the scalp, dermal abscesses, sinus tract development, and secondary scarring alopecia. HS, sometimes known as acne inversa, is a chronic relapsing inflammatory disease afflicting apocrine gland-rich areas of the body with painful nodules and abscesses, sinus tracts, and scarring. Given the overlap between the clinical features and the pathogenesis of DC and HS, it would be more appropriate to consider these conditions as two different localizations of the same disease rather than two different pathologies, being a follicular occlusion disease occurring on the scalp and on the apocrine gland-rich areas of the body.
虽然解剖性蜂窝织炎(DC)和化脓性汗腺炎(HS)被分开分类,但它们在临床、皮肤镜、发病机制和组织学方面以及治疗选择上有许多共同之处。DC、HS 和聚合性痤疮之间的关联代表了毛囊闭锁三联征或毛囊闭锁四联征,其中可能包括藏毛窦。DC 也称为“脱发性头皮毛囊和滤泡周围炎”,被归类为继发性瘢痕性和中性粒细胞性脱发。它发生在头皮滤泡周围炎、皮肤脓肿、窦道形成和继发性瘢痕性脱发。HS,有时称为反向痤疮,是一种慢性复发性炎症性疾病,影响富含大汗腺的身体区域,伴有疼痛结节和脓肿、窦道和瘢痕。鉴于 DC 和 HS 的临床特征和发病机制之间存在重叠,将这些情况视为同一疾病的两种不同定位而不是两种不同的病理学更为合适,即发生在头皮和富含大汗腺的身体区域的毛囊闭锁性疾病。