Hidradenitis suppurativa is a chronic skin disorder characterized by recurrent inflammatory nodules, fistulas, abscesses, and scarring mainly in the intertriginous areas with terminal hair and apocrine glands. Hidradenitis suppurativa manifests usually after puberty, in the third life decade and persists for many years. The prevalence of the disease is estimated to be 0,5 % in the Czech Republic. Women are most often affected in the axillary and inguinal parts, while men in the perianal and gluteal areas. The exact pathogenesis is still unknown. It is assumed that hyperkeratosis of the hair follicle leads to its occlusion, dilatation and further rupture when keratin and bacteria are spilled into the dermis causing a massive inflammatory reaction. Smoking and obesity belong to the main triggering factors. Without therapy, the disease is chronic and progressive. The standard therapy depends on the extension of the disorder. For not extensive lesions, treatment consists of topical antiseptics, antibiotics or long- term therapy with systemic antibiotics. In more advanced stages, systemic therapy with TNF-α antagonists is needed. Further therapeutic modality is surgical intervention and wide excision of the affected area. Nevertheless, recurrences in the adjacent tissue cannot be avoided.

• Klíčová slova
• acne inversa, hidradenitis suppurativa, therapy adalimumab.,
• MeSH
• antibakteriální látky terapeutické užití   MeSH
• chronická nemoc MeSH
• hidradenitis suppurativa * komplikace   diagnóza   terapie   MeSH
• lidé MeSH
• TNF-alfa MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH
• Názvy látek
• antibakteriální látky MeSH
• TNF-alfa MeSH

INTRODUCTION: Hidradenitis suppurativa is a chronic, recurrent inflammatory disease causing significant changes and damage to skin. Predilection sites are the axilla and the anogenital region. Chronic and severe forms of the diseases may cause both physical and psychological injury to the patient. PATIENTS: We present the cases of two female patients with severe hidradenitis suppurativa in the axillae and in the anogenital region. The patients had been unsuccessfully treated for eight and four years respectively with antibiotics and by limited surgery. Different methods of closing the defects following radical surgical excision (local flap reconstruction, healing by granulation) had to be used with respect to the extent of the disease and the site of involved skin. CONCLUSION: Radical wide excision of the skin area involved is the only appropriate surgical procedure which prevents recurrence of the disease. Selection of the therapeutic method must be done very carefully with respect to the individual characteristics of the disease and the patients attitude to therapy.

• MeSH
• axila chirurgie   MeSH
• chirurgické laloky * MeSH
• dospělí MeSH
• hidradenitis suppurativa diagnóza   chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• stupeň závažnosti nemoci MeSH
• zákroky plastické chirurgie metody   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

Hidradenitis suppurativa is a chronic immune-mediated inflammatory disease that is manifested by formation of painful nodules, abscesses and suppurating fistulas, primarily in the intertriginous spaces. This painful, often under-diagnosed disease affects much more women. They are also exposed to certain specific challenges in the management of this disease, especially during menstruation or pregnancy. The treatment requires the interdisciplinary cooperation of a dermatologist, gynaecologist, obstetrician and last but not least an algesiologist and psychotherapist. Above all, early and correct diagnosis, initiation of therapy in the early stages of the disease, is a key, which also plays a fundamental role in controlling inflammatory activity, preventing complications and further prognosis.

• Klíčová slova
• Hidradenitis suppurativa, autoimmune inflammation, comprehensive management, early diagnosis, specifics in the female population,
• MeSH
• gynekologie * metody   MeSH
• hidradenitis suppurativa * terapie   MeSH
• interprofesionální vztahy MeSH
• lidé MeSH
• těhotenství MeSH
• týmová péče o pacienty MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• dospělí MeSH
• hidradenitis suppurativa * diagnóza   MeSH
• lidé MeSH
• nemoci penisu * diagnóza   patologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• dopisy MeSH
• kazuistiky MeSH

Hidradenitis suppurativa (HS) is a chronic, inflammatory disease characterized by recurring abscesses, nodules, and fistulas predominantly in the area of the groin and axillae. The association between HS and Crohn's disease (CD) has already been documented. We report on a case of a patient with CD associated HS, refractory to multiple local and systemic agents.A complete resolution of both diseases was finally achieved after treatment with adalimumab. Our case report supports the co-occurrence of both diseases and suggests that adalimumab approved for CD might also be a safe and effective therapeutic option in the treatment of HS.

• MeSH
• adalimumab terapeutické užití   MeSH
• antiflogistika terapeutické užití   MeSH
• chronická nemoc MeSH
• Crohnova nemoc komplikace   farmakoterapie   MeSH
• hidradenitis suppurativa komplikace   farmakoterapie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Názvy látek
• adalimumab MeSH
• antiflogistika MeSH

INTRODUCTION: Perianal hidradenitis suppurativa is a chronic recurrent inflammatory, suppurative, and fistulising disease of apocrine glands, adjacent anal canal and soft tissues. Perianal area is the second most common affected area after axilla. There are three grades of the disease. Hidradenitis suppurativa represents a chronic, recurrent, deep-seated folliculitis resulting in abscesses, followed by the formation of sinus tracts and subsequent scarring. Perianal hidradenitis suppurativa is the last and the most serious grade of the disease and a specific access is needed for patient preparation and surgical treatment alone. The currently preferred method of treatment for patients with extensive perianal hidradentitis is excision and closure with combination of skin flaps, primary suture and skin graft in one or two stages. CASE REPORTS: There are three case reports of perianal hidradenitis suppurativa in this article. The local and overall initial treatment of patients followed by a radical excision and closure with a rotation skin flaps and skin grafts is described. The final results were satisfactory, with no recurrence or serious complication.

• Klíčová slova
• Verneuil disease, perianal hidradenitis suppurativa, rotation flap, skin graft,
• MeSH
• axila MeSH
• chirurgické laloky MeSH
• hidradenitis suppurativa * chirurgie   MeSH
• lidé MeSH
• perineum * MeSH
• transplantace kůže MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

BACKGROUND AND OBJECTIVES: Deroofing has proven to be an effective method to treat mild to moderate forms of hidradenitis suppurativa (HS). The basic procedure includes removal of the sinus roof, followed by secondary intention healing, while fibrotic tissue usually stays in situ. We have tried to establish a modified method of deroofing in which meticulous removal of the fibrotic tissue results in a low recurrence rate in moderate to severe HS patients. PATIENTS AND METHODS: An open prospective study consisted of 96 deroofed lesions in 52 consecutive patients with moderate to severe HS. Patients were followed up for a minimum of 28 months. RESULTS: Recurrence occurred after a median time of 2.3 months in 14 % of locations. Recurrences according to location were as follows: 6 % in the axillary region and 25 % in the inguinal region. Postoperative bleeding was the only considerable complication and occurred in 7 % of treated locations. Seven patients were lost to follow-up. CONCLUSION: Modified deroofing followed by meticulous sinus tract removal is a surgical approach suitable for patients with moderate disease, especially in the axillary region. This results in a low recurrence rate and the same healing period as that of the standard deroofing procedure.

• Klíčová slova
• deroofing, hidradenitis suppurativa, surgery, treatment,
• MeSH
• axila MeSH
• chirurgie operační škodlivé účinky   metody   MeSH
• debridement škodlivé účinky   metody   MeSH
• dospělí MeSH
• hidradenitis suppurativa patologie   chirurgie   MeSH
• hojení ran fyziologie   MeSH
• inguinální kanál MeSH
• lidé MeSH
• pooperační komplikace epidemiologie   MeSH
• pooperační krvácení epidemiologie   MeSH
• prospektivní studie MeSH
• recidiva MeSH
• stupeň závažnosti nemoci MeSH
• subjekt ztracen ze sledování MeSH
• vizuální analogová stupnice MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

• MeSH
• adalimumab terapeutické užití   MeSH
• hidradenitis suppurativa * farmakoterapie   MeSH
• hormony kůry nadledvin terapeutické užití   MeSH
• lidé MeSH
• recidiva MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• dopisy MeSH
• Názvy látek
• adalimumab MeSH
• hormony kůry nadledvin MeSH

• MeSH
• hidradenitis suppurativa * farmakoterapie   MeSH
• lidé MeSH
• monoklonální protilátky terapeutické užití   MeSH
• TNF-alfa MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• dopisy MeSH
• práce podpořená grantem MeSH
• Názvy látek
• monoklonální protilátky MeSH
• risankizumab MeSH Prohlížeč
• TNF-alfa MeSH

BACKGROUND: Hidradenitis suppurativa is a chronic suppurative condition featuring inflammatory nodules, fistulas and scars. It occurs predominantly in the axillae and groin. The disease is poorly responsive to any treatment and is connected with significant morbidity. Systemic therapy, including oral antibiotics, retinoids and antiandrogens, usually has only limited effect. Surgical treatment of affected areas is necessary in advanced stages. OBJECTIVES: Several reports support the beneficial effect of tumor necrosis factor-α (TNF-α) antagonists for the treatment of severe hidradenitis suppurativa. By contrast with data on infliximab and etanercept, data describing the potential positive influence of adalimumab on disease outcome are limited and refer to only small cohorts of patients. METHODS: Eight patients with severe, recalcitrant hidradenitis were treated for 1 year with adalimumab in a standard regimen and were subsequently followed for 1 year. RESULTS: All patients improved within 4-6 weeks and laboratory parameters of C-reactive protein (CRP) and leukocyte count reduced significantly during treatment. Three patients demonstrated long-lasting improvement and five showed recurrences several months after discontinuation of the therapy. The average recurrence-free interval was 9.5 months. CONCLUSIONS: Adalimumab is suitable for the long-term treatment of hidradenitis suppurativa and presents a further conservative treatment approach.

• MeSH
• adalimumab MeSH
• antiflogistika aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• C-reaktivní protein metabolismus   MeSH
• dospělí MeSH
• hidradenitis suppurativa farmakoterapie   patologie   MeSH
• humanizované monoklonální protilátky MeSH
• kouření MeSH
• lidé středního věku MeSH
• lidé MeSH
• monoklonální protilátky aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• následné studie MeSH
• obezita MeSH
• recidiva MeSH
• TNF-alfa antagonisté a inhibitory   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH
• Názvy látek
• adalimumab MeSH
• antiflogistika MeSH
• C-reaktivní protein MeSH
• humanizované monoklonální protilátky MeSH
• monoklonální protilátky MeSH
• TNF-alfa MeSH