Patient Communities
Catherine Arnott Smith, Alla Keselman in Consumer Health Informatics, 2020
This chapter discusses the importance of online patient communities and forums as sites for both information and data exchange. Patient communities are a phenomenon that predates the Web, since the desire of consumers and patients to seek support from each other is a very old one. Madara too describes the origins of patient communities in BBS. The benefits of virtual patient communities remained unclear in large part because no researchers had focused on the communities as interventions on their own. A search of PubMed MEDLINE on January 1, 2020, reveals 907 studies of patient communities published since 1998, focusing on diagnoses from hidradenitis suppurativa to breast cancer. Caregivers have an important role to play in patient communities, too. The challenge in patient communities is to understand the difference between questions that require this context-based assistance - informational support - and questions that require fact-based answers.
Genitalia
Richard Ashton, Barbara Leppard in Differential Diagnosis in Dermatology, 2021
Primary syphilis presents as a round painless ulcer with an indurated base about 3 weeks after infection. Any indurated ulcer on the genitalia which is negative on dark ground microscopy should be biopsied to exclude a squamous cell carcinoma or intra-epithelial neoplasia. Irregular shallow serpiginous erosions on the penis, scrotum or vulva should suggest secondary syphilis. Similar lesions can occur on the buccal mucosa and tongue. Hidradenitis Suppurativa is an uncommon condition where painful papules, nodules, discharging sinuses and scars occur at sites where apocrine glands are present, i.e. in the axillae, pubic area, labia majora, scrotum, groins, perianal skin, buttocks or the areolae of the breasts. There is a considerable body of evidence to suggest that genital infection with Herpes simplex type 2 is one of the causative factors in the development of carcinoma of the cervix.
Clinical applications of magnesium in cutaneous medicine
Kupetsky A. Erine in Magnesium, 2019
This chapter discusses potential applications of magnesium as adjunctive therapy in cutaneous conditions including pseudoxanthoma elasticum, psoriasis, hidradenitis suppurativa, cutaneous lupus erythematosus, mycosis fungoides, melanoma, acne vulgaris, melasma, Hailey–Hailey disease, and atopic dermatitis. Magnesium is a nutritionally essential element that is necessary for many physiologic processes in humans. It is a critical factor in bone mineralization, muscle contraction, nerve impulse transmission, and a necessary co-factor for over 300 enzymes. Magnesium has several dosage formulations pertaining to cutaneous treatment, including oral supplementation and topical variants. The dietary allowance of magnesium recommended by the Food and Drug Administration is up to 420 mg per day for adults. Fumaric acid esters (FAE) are another prospective oral supplementation of magnesium. Fumaderm is the only licensed FAE in Germany; it is comprised of dimethylfumarate and calcium, magnesium, and zinc salts of monoethyl hydrogen fumarate tablets.
Hidradenitis Suppurativa of the Periorbital Skin with Lacrimal Sac and Ethmoidal Involvement
Published in Orbit, 2014
Ali Sami Hassan, Manuel Saldana, Michael Wearne
Purpose: To highlight a rare case of hidradenitis suppurativa affecting the periorbital skin in which chronic nodules resulted in a sinus tract connecting the lacrimal sac and ethmoidal sinus. Methods: A single interventional case note review with clinical history, examination, results of investigations and details of medical and surgical management. Results: The patient showed no response to antibiotics and steroids. One attempt at local drainage was unsuccessful. MRI showed a defined ring enhancing lesion anterior to the orbital septum overlying the medial canthus. Surgical exploration revealed a cutaneous fistula which tracked through the left orbicularis oculi into the medial canthal tendon and into the left lacrimal sac. A further fistula connected the lacrimal sac to adjacent structures and the lacrimal bone was found to be eroded. Conclusions: Hidradenitis suppurativa is a chronic skin disease which can involve the face. Inflammation, scarring and sinus tract formation are common findings. Periorbital lesions can spread to involve surrounding adnexal structures.
An update on the pathogenesis of hidradenitis suppurativa: implications for therapy
Published in Expert Review of Clinical Immunology, 2018
Deborah Negus, Christine Ahn, William Huang
Introduction: Hidradenitis suppurativa is a chronic, inflammatory disease characterized by painful nodules, abscesses, and sinuses in the intertriginous areas, with significant associated comorbidities. The pathogenesis remains unclear, although advances have been made in understanding the disease process. Management of the disease is challenging, with a wide range of treatment options available with variable clinical response. Areas covered: This review discusses the most updated studies on the complex pathogenic mechanisms of hidradenitis suppurativa and the relevant literature on the current treatment options for this condition. Expert commentary: There is increasing evidence supporting the role of Th17 cells and enhanced expression of IL-17 and IL-1β, which represent potential targets for therapy. Bacteria and biofilms are likely contributory but secondary drivers of inflammation. There is also evolving evidence to suggest the presence of systemic comorbidities associated with HS, which underlie the importance of better understanding the pathogenesis and treatment of this disease.
The contradictory inefficacy of methotrexate in hidradenitis suppurativa: a need to revise pathogenesis or acknowledge disease heterogeneity?
Published in Journal of Dermatological Treatment, 2020
The pathogenesis of hidradenitis suppurativa (HS) centers around Th17/Treg dysfunction illustrated by lesional elevation of IL-17A, IL-6, and other inflammatory mediators resulting in a chronic feed-forward inflammatory cascade. Similar inflammatory mechanisms have been identified in psoriasis and rheumatoid arthritis (RA) in which traditional immunosuppressants (including methotrexate) are routinely used with reasonable levels of disease control. Methotrexate’s mechanism of action in these instances includes downregulation of the Th17 axis via alterations in dendritic cell and T-cell activity and maturation. Published data suggest methotrexate in an ineffective therapy in HS, which does not pair with our current understanding of the mechanisms of disease. The reasons behind this, including are discussed. Some HS patients may benefit from drugs such as methotrexate, and acknowledgment of the potential of disease heterogeneity will allow exploration of which factors may enable identification of such individuals.
Related Knowledge Centers
- Hidradenitis
- Hurley Stage 2 Disease
- Suppuration
- Bacterial Skin Diseases
- Hurley Stage 3 Disease
- Skin Disease
- Apocrine Sweat Glands