Mainville Laurence, MacHaalany Jimmy, Veillette Hélène
Division of Dermatology, Department of Medicine, CHU de Québec-Université Laval, Québec, QC, Canada.
Division of Cardiology, Department of Medicine, CHU de Québec-Université Laval, Québec, QC, Canada.
SAGE Open Med Case Rep. 2024 Aug 19;12:2050313X241274819. doi: 10.1177/2050313X241274819. eCollection 2024.
Hidradenitis suppurativa is a chronic inflammatory skin disease that usually presents in young adults with painful abscesses in intertriginous areas. We present a case of severe hidradenitis suppurativa (Hidradenitis Suppurativa Investigator Global Assessment (HS-IGA) = 5; Hurley stage III) investigated by cardiology and respirology specialists for dyspnea. The patient's symptoms required right-sided cardiac catheterization via the right femoral vein in the inguinal area. The patient was able to undergo this invasive cardiac procedure without infectious complications using multidisciplinary management (dermatology, cardiology, respirology, internal medicine, and infectious diseases specialists), intravenous ertapenem 1 g/day for 6 weeks perioperatively, biologic therapy, and treatment of diabetes with semaglutide. The administration of ertapenem preoperatively and postoperatively of an invasive procedure can be beneficial, particularly when the upcoming intervention requires access to skin areas severely affected by hidradenitis suppurativa. Comorbidities such as obesity and diabetes should be addressed as their treatment might contribute to improve hidradenitis suppurativa.
化脓性汗腺炎是一种慢性炎症性皮肤病,通常在年轻成年人的皮肤褶皱部位出现疼痛性脓肿。我们报告一例严重化脓性汗腺炎病例(化脓性汗腺炎研究者全球评估(HS-IGA)=5;Hurley Ⅲ期),因呼吸困难接受了心脏病学和呼吸病学专家的检查。患者的症状需要通过腹股沟区右侧股静脉进行右侧心导管检查。通过多学科管理(皮肤科、心脏病学、呼吸病学、内科和传染病专家),患者能够在无感染并发症的情况下接受这种侵入性心脏手术,围手术期静脉注射厄他培南1克/天,持续6周,进行生物治疗,并使用司美格鲁肽治疗糖尿病。在侵入性手术的术前和术后给予厄他培南可能是有益的,特别是当即将进行的干预需要进入受化脓性汗腺炎严重影响的皮肤区域时。肥胖和糖尿病等合并症应得到治疗,因为它们的治疗可能有助于改善化脓性汗腺炎。