ハイドラデネチス スプーラティブ: 診断 と 治療 の 進歩
Ditte Marie Lindhardt Saunte1, Gregor Borut Ernst Jemec1
1Department of Dermatology, Zealand University Hospital, Roskilde, Denmark; Health Sciences Faculty, University of Copenhagen, Denmark.
JAMA
|November 29, 2017
まとめ
ヒドラデニティス・スプーラティバ (HS) は,一般的な皮膚疾患で,しばしば治療が不十分である. 最近の進歩により 抗生物質や 生物学的治療法や 外科手術の選択肢が 新たに生まれています
科学分野:
- 皮膚科
- 免疫学
- エピデミオロジー
背景:
- ヒドラデネチス・スプーラティバ (HS) は,人口の0. 05%から4. 10%に影響します.
- 発症率が高いにもかかわらず 多くのHS患者は不十分な治療を受けています
- HSは,肥満,代謝症候群,糖尿病,関節炎を含む重大な障害と併発症につながる可能性があり,全因死亡率の増加と関連しています.
研究 の 目的:
- HSの診断,流行病学,治療について見直す.
- 過去5年間のHS管理における最近の進歩を強調する.
主な方法:
- 2011年9月1日から2017年5月1日に出版された治療試験に関するPubMed,MEDLINE,EMBASEの包括的な文献検索.
- レビュー,ガイドライン,会議要約,および10人未満の患者を対象とした研究を除外した.
- 複数の検索エンジンでHSガイドラインをインターネットで検索する.
主要な成果:
- HSの診断は,病変の形状,位置 (例えば,頭,股関節),および慢性性に基づいています.
- 流行病学的なデータは,HSが以前に推定されたより一般的であることを示しています.
- 効果的な治療には,抗生物質の組み合わせ (クリンダミシン/リファンピシン,エルタペネムベースの治療),アダリムマブ,および潜在的にIL-1/IL-12を標的とする治療が含まれています.
- 手術技術とレーザー治療は,臨床的結果に関する限られた証拠を示しています.
結論:
- ヒドラデネチス・スプーラティバは,特定の病変の種類と場所の差異診断に考慮する必要がある一般的な状態です.
- 現行および新興の治療には,薬学的な (抗生物質,生物学的) および外科的な方法が含まれます.
- 手術とレーザー介入の臨床結果を確立するためにさらなる研究が必要である.
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