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Acne inversa (alias hidradenitis suppurativa)
I Jansen1, P Altmeyer, G Piewig
1Department of Dermatology, Ruhr-University Bochum, Germany.
Journal of the European Academy of Dermatology and Venereology : JEADV
|February 15, 2002
Summary
Acne inversa, a chronic follicular epithelium defect, presents with abscesses and scarring. Early surgical intervention is recommended as medications do not prevent disease progression.
Area of Science:
- Dermatology
- Genetics
Background:
- Acne inversa is a chronic, suppurative skin condition characterized by recurrent abscesses, fistulas, and scarring.
- Historically misattributed to apocrine glands, it is now understood as a defect of the follicular epithelium.
- Familial cases suggest autosomal dominant inheritance patterns.
Purpose of the Study:
- To clarify the etiology and pathophysiology of acne inversa.
- To evaluate the effectiveness of current treatments and recommend optimal management strategies.
Main Methods:
- Review of existing literature on acne inversa.
- Analysis of etiological factors, including genetic, environmental, and microbial influences.
- Assessment of treatment outcomes, focusing on surgical and pharmacotherapeutic interventions.
Main Results:
- Acne inversa originates from follicular epithelium defects, not apocrine glands, making 'hidradenitis suppurativa' a misnomer.
- While familial cases show autosomal dominant inheritance, common etiological factors like obesity or smoking are inconsistently associated.
- Bacterial involvement is secondary, and complications can be severe, including amyloidosis and squamous cell carcinoma.
Conclusions:
- Early, definitive surgical intervention, typically wide local excision with secondary intention healing, is advised due to the disease's progressive nature and rarity of spontaneous resolution.
- Pharmacotherapies like retinoids and antiandrogens are ineffective in halting disease progression.