Publications by authors named "Haley B Naik"

46 Publications

Importance of Standardized Nomenclature to Advance Hidradenitis Suppurativa Research and Clinical Care.

Authors:
Haley B Naik

JAMA Dermatol 2021 Mar 10. Epub 2021 Mar 10.

Department of Dermatology, University of California, San Francisco.

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http://dx.doi.org/10.1001/jamadermatol.2020.5466DOI Listing
March 2021

Hidradenitis Suppurativa in the Pediatric Population: An International, Multicenter, Retrospective, Cross-sectional Study of 481 Pediatric Patients.

JAMA Dermatol 2021 Feb 24. Epub 2021 Feb 24.

Section of Dermatology, Division of Pediatric Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Canada.

Importance: Hidradenitis suppurativa (HS) in pediatric patients has been understudied. Increased awareness and recognition of HS prevalence in children demand efforts to better understand this condition.

Objective: To describe the demographics, clinical features, treatment, associated comorbidities, and outcomes in a large cohort of pediatric patients with HS.

Design, Setting, And Participants: International, multicenter, retrospective medical record review of pediatric patients (aged 1-18 years) with a clinical diagnosis of HS carried out in 10 dermatology clinics across the US, Canada, Israel, Australia, and Italy from January 1996 to January 2017.

Main Outcomes And Measures: Patient demographics, clinical features, severity, associated comorbidities, and treatments in pediatric patients with HS.

Results: This cross-sectional study included 481 patients diagnosed with HS. Overall, 386 (80%) were girls. The mean (SD) age of disease onset was 12.5 (2.9) years, and the mean (SD) age at diagnosis was 14.4 (3.5) years. Family history of HS was present in 111 of 271 (41%) patients. First signs/symptoms reported at disease onset were cyst/abscess in 229 of 481 (48%), pain/tenderness in 118 of 481 (25%), and papules/pustules in 117 of 481 (24%). At initial dermatologic assessment, 233 of 481 (48%) patients already had evidence of skin scarring. Disease severity (Hurley staging) was documented in 288 of 481 (60%) patients (47% stage 1, 45% stage 2 and 8% stage 3). Comorbid conditions were reported in 406 of 481 (85%) patients, the most common being obesity (263/406 [65%]) and acne vulgaris (118/406 [29%]). Complications occurred in 378 of 481 (79%) patients, the most common of which were scars or contractures (301/378 [80%]).

Conclusions And Relevance: The findings of this study indicate that there is a gap in recognizing and diagnosing pediatric HS. Pediatric patients with HS are likely to present with other comorbidities. Prospective observational and interventional studies are needed to better understand clinical course and optimal treatments for pediatric HS.
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http://dx.doi.org/10.1001/jamadermatol.2020.5435DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7905696PMC
February 2021

Comorbidity screening in hidradenitis suppurativa: Evidence-based recommendations from the US and Canadian Hidradenitis Suppurativa Foundations.

J Am Acad Dermatol 2021 Jan 23. Epub 2021 Jan 23.

Department of Dermatology, University of California, San Francisco, California.

Background: Hidradenitis suppurativa (HS) is associated with comorbidities that contribute to poor health, impaired life quality, and mortality risk.

Objective: To provide evidence-based screening recommendations for comorbidities linked to HS.

Methods: Systematic reviews were performed to summarize evidence on the prevalence and incidence of 30 comorbidities in patients with HS relative to the general population. The screening recommendation for each comorbidity was informed by the consistency and quality of existing studies, disease prevalence, and magnitude of association, as well as benefits, harms, and feasibility of screening. The level of evidence and strength of corresponding screening recommendation were graded by using the Strength of Recommendation Taxonomy (SORT) criteria.

Results: Screening is recommended for the following comorbidities: acne, dissecting cellulitis of the scalp, pilonidal disease, pyoderma gangrenosum, depression, generalized anxiety disorder, suicide, smoking, substance use disorder, polycystic ovary syndrome, obesity, dyslipidemia, diabetes mellitus, metabolic syndrome, hypertension, cardiovascular disease, inflammatory bowel disease, spondyloarthritis, and sexual dysfunction. It is also recommended to screen patients with Down syndrome for HS. The decision to screen for specific comorbidities may vary with patient risk factors. The role of the dermatologist in screening varies according to comorbidity.

Limitations: Screening recommendations represent one component of a comprehensive care strategy.

Conclusions: Dermatologists should support screening efforts to identify comorbid conditions in HS.
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http://dx.doi.org/10.1016/j.jaad.2021.01.059DOI Listing
January 2021

Diagnosis and management of hidradenitis suppurativa in women.

Am J Obstet Gynecol 2021 01 24;224(1):54-61. Epub 2020 Sep 24.

Division of Dermatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA. Electronic address:

Hidradenitis suppurativa is a chronic inflammatory disease that disproportionately affects women of childbearing age. Hidradenitis suppurativa is characterized by painful nodules, abscesses, draining dermal tunnels, and scarring with a predilection for intertriginous sites, such as the axilla, groin, and breast regions. Delay in diagnosis and treatment of hidradenitis suppurativa often results in long-term sequelae leading to significant morbidity, and rarely mortality, in these patients. This clinical opinion suggests that obstetrician-gynecologists are uniquely poised to recognize early signs of hidradenitis suppurativa during routine well-woman examinations and initiate treatment or referral to dermatology. Herein, we provide clinical pearls for obstetrician-gynecologists caring for female patients with hidradenitis suppurativa, including strategies for comprehensive management and recommendations to improve the comfort of patients with hidradenitis suppurativa during examinations.
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http://dx.doi.org/10.1016/j.ajog.2020.09.036DOI Listing
January 2021

Immunopathogenesis of hidradenitis suppurativa and response to anti-TNF-α therapy.

JCI Insight 2020 10 2;5(19). Epub 2020 Oct 2.

Department of Dermatology, University of California at San Francisco (UCSF), San Francisco, California, USA.

Hidradenitis suppurativa (HS) is a highly prevalent, morbid inflammatory skin disease with limited treatment options. The major cell types and inflammatory pathways in skin of patients with HS are poorly understood, and which patients will respond to TNF-α blockade is currently unknown. We discovered that clinically and histologically healthy appearing skin (i.e., nonlesional skin) is dysfunctional in patients with HS with a relative loss of immune regulatory pathways. HS skin lesions were characterized by quantitative and qualitative dysfunction of type 2 conventional dendritic cells, relatively reduced regulatory T cells, an influx of memory B cells, and a plasma cell/plasmablast infiltrate predominantly in end-stage fibrotic skin. At the molecular level, there was a relative bias toward the IL-1 pathway and type 1 T cell responses when compared with both healthy skin and psoriatic patient skin. Anti-TNF-α therapy markedly attenuated B cell activation with minimal effect on other inflammatory pathways. Finally, we identified an immune activation signature in skin before anti-TNF-α treatment that correlated with subsequent lack of response to this modality. Our results reveal the fundamental immunopathogenesis of HS and provide a molecular foundation for future studies focused on stratifying patients based on likelihood of clinical response to TNF-α blockade.
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http://dx.doi.org/10.1172/jci.insight.139932DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7566733PMC
October 2020

Standardizing Hidradenitis Suppurativa Skin Microbiome Research: The Methods Matter.

J Invest Dermatol 2020 09;140(9):1688-1690

Division of Dermatology, Department of Medicine, University of Toronto, Ontario, Canada; Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, Ontario, Canada.

Cutaneous dysbiosis is implicated in hidradenitis suppurativa (HS) pathogenesis. Previous studies reveal skin microbiota shifts in HS lesional skin. In their report, Riverain-Gillet et al. (2020) extended these findings and reported skin microbiota shifts in unaffected HS skinfolds as well. Their study suggests that skin microbial shifts may precede clinical lesions and draws attention to study methods important for skin microbiome research.
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http://dx.doi.org/10.1016/j.jid.2020.03.946DOI Listing
September 2020

Remote management of hidradenitis suppurativa in a pandemic era of COVID-19.

Int J Dermatol 2020 Sep 23;59(9):e318-e320. Epub 2020 Jun 23.

Division of Dermatology, Women's College Hospital, Toronto, ON, Canada.

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http://dx.doi.org/10.1111/ijd.15022DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7361922PMC
September 2020

Office-Based Surgical Intervention for Hidradenitis Suppurativa (HS): A Focused Review for Dermatologists.

Dermatol Ther (Heidelb) 2020 Aug 20;10(4):529-549. Epub 2020 May 20.

Department of Dermatology, University of California, San Francisco, CA, USA.

Easily accessible office-based procedures that require minimal resources may facilitate timely surgical management of hidradenitis suppurativa (HS). This review focuses on excision and unroofing as two surgical HS treatments that can be tailored to the outpatient setting. Fifty-five articles were included in our review, representing 3914 patients. The majority were retrospective studies (58%, n = 32), and the studies reported data both across patients and by number of treated lesions. Recurrence rates for unroofing (14.5%) were found to be half that of excision (30%) across patients (p = 0.015) and slightly lower across lesions [20% recurrence vs 26% for excision (p = 0.023)]. Complication rates at the lesion level were also significantly associated with procedure, with rates after excision more than double those after roofing (26% vs. 12%, p < 0.001). The complication rate after combined medical and surgical therapy did not differ between procedures. Studies also suggest that continuing medical therapy in the perioperative period may be associated with improved recurrence rates, although delayed wound healing with biologic therapy has been reported. The existing data are limited by low-quality uncontrolled studies with small sample sizes, variable reporting of outcomes, and lack of uniform definitions for recurrence and remission. Further systematic prospective studies are needed to better compare complication and recurrence rates across these procedures in HS, especially in the context of concomitant medical therapy.
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http://dx.doi.org/10.1007/s13555-020-00391-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7367977PMC
August 2020

Hidradenitis suppurativa: The importance of virtual outpatient care during COVID-19 pandemic.

J Am Acad Dermatol 2020 07 1;83(1):e81-e82. Epub 2020 May 1.

Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Division of Dermatology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. Electronic address:

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http://dx.doi.org/10.1016/j.jaad.2020.04.142DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252061PMC
July 2020

Evaluation of Hidradenitis Suppurativa Disease Course During Pregnancy and Postpartum.

JAMA Dermatol 2020 06;156(6):681-685

Department of Dermatology, University of California, Los Angeles, Santa Monica.

Importance: Hidradenitis suppurativa (HS) disproportionately affects women of childbearing potential. There is a paucity of data regarding the HS disease course during pregnancy and in the postpartum period.

Objective: To explore the HS disease course during pregnancy and in the postpartum period.

Design, Setting, And Participants: A retrospective cohort study was conducted on patients in the Henry Ford Health System, Detroit, Michigan-a large, academic, urban referral center. Women with a diagnosis of HS who became pregnant between January 1, 2008, and December 31, 2018, were included. International Classification of Diseases, Ninth Revision, and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, were used for identification of the diagnosis.

Exposures: Pregnancy in patients with HS.

Main Outcomes And Measures: Hidradenitis suppurativa disease status during pregnancy and the postpartum period.

Results: A total of 127 women with HS were included in this study and accounted for 202 pregnancies. Of the 202 pregnancies, 171 were in black women, 25 in white women, 3 in women of other race/ethnicity, and 3 had unreported data. Mean (SD) age at HS onset was 19.3 (5.6) years; at time of HS diagnosis, 24.4 (5.3) years; and at time of pregnancy, 25.9 (5.0) years. The disease worsened during pregnancy in 70 pregnancies (61.9%), did not change in 34 pregnancies (30.1%), and improved in 9 pregnancies (8.0%). Hidradenitis suppurativa exacerbated in the postpartum period after 82 of 124 pregnancies (66.1%). Dermatologists were involved in managing HS in 28 pregnancies (14.4%) and for a higher proportion of patients with more severe Hurley stage as compared with cases of mild disease (stage 3: 7 of 18 [38.9%] vs stage 1: 10 of 100 [10.0%] or stage 2: 11 of 67 [16.4%]; P = .004). In addition, HS medical treatment was administered during 77 pregnancies (38.1%), while HS procedural treatment was administered during 34 pregnancies (16.8%). A significantly higher proportion of patients whose care was managed by dermatologists vs those without dermatologist involvement received any HS medication (22 [78.6%] vs 53 [31.7%], P < .001) or any HS procedure (14 [50%] vs 19 [11.4%], P < .001) during pregnancy.

Conclusions And Relevance: Despite a high rate of HS exacerbation during pregnancy and postpartum, this cohort study found that most of the patients did not receive HS-directed medical treatment or care from a dermatologist during pregnancy. Close monitoring and improved collaborative care between dermatology and obstetrics-gynecology services is warranted.
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http://dx.doi.org/10.1001/jamadermatol.2020.0777DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7191431PMC
June 2020

Comprehensive approach to managing hidradenitis suppurativa patients.

Int J Dermatol 2020 Jun 6;59(6):744-747. Epub 2020 Apr 6.

Department of Dermatology, University of California, San Francisco, CA, USA.

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http://dx.doi.org/10.1111/ijd.14870DOI Listing
June 2020

Creation of a Registry to Address Knowledge Gaps in Hidradenitis Suppurativa and Pregnancy-Reply.

JAMA Dermatol 2020 03;156(3):354

The Rockefeller University, New York, New York.

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http://dx.doi.org/10.1001/jamadermatol.2019.3652DOI Listing
March 2020

Skin Microbiota Perturbations Are Distinct and Disease Severity-Dependent in Hidradenitis Suppurativa.

J Invest Dermatol 2020 04 17;140(4):922-925.e3. Epub 2019 Sep 17.

Cutaneous Microbiome and Inflammation Section, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland.

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http://dx.doi.org/10.1016/j.jid.2019.08.445DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7075718PMC
April 2020

Gender Equity Improving among Award Winners and Leaders at the Society for Investigative Dermatology.

J Invest Dermatol 2019 10 22;139(10):2215-2217. Epub 2019 Aug 22.

Department of Dermatology, Stanford University, Stanford, California. Electronic address:

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http://dx.doi.org/10.1016/j.jid.2019.06.123DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6952212PMC
October 2019

A Call to Accelerate Hidradenitis Suppurativa Research and Improve Care-Moving Beyond Burden.

JAMA Dermatol 2019 Jul 10. Epub 2019 Jul 10.

The Rockefeller University, New York, New York.

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http://dx.doi.org/10.1001/jamadermatol.2019.1105DOI Listing
July 2019

The associations of depression and coping methods on health-related quality of life for those with hidradenitis suppurativa.

J Am Acad Dermatol 2019 Apr;80(4):1137-1139

Department of Dermatology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania. Electronic address:

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http://dx.doi.org/10.1016/j.jaad.2018.09.045DOI Listing
April 2019

North American clinical management guidelines for hidradenitis suppurativa: A publication from the United States and Canadian Hidradenitis Suppurativa Foundations: Part I: Diagnosis, evaluation, and the use of complementary and procedural management.

J Am Acad Dermatol 2019 Jul 11;81(1):76-90. Epub 2019 Mar 11.

Centre de Recherche Dermatologique du Quebec Metropolitain, Quebec City, Quebec, Canada.

Hidradenitis suppurativa is a chronic inflammatory disorder affecting hair follicles, with profoundly negative impact on patient quality of life. Evidence informing ideal evaluation and management of patients with hidradenitis suppurativa is still sparse in many areas, but it has grown substantially in the last decade. Part I of this evidence-based guideline is presented to support health care practitioners as they select optimal management strategies, including diagnostic testing, comorbidity screening, and both complementary and procedural treatment options. Recommendations and evidence grading based on the evidence available at the time of the review are provided.
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http://dx.doi.org/10.1016/j.jaad.2019.02.067DOI Listing
July 2019

North American clinical management guidelines for hidradenitis suppurativa: A publication from the United States and Canadian Hidradenitis Suppurativa Foundations: Part II: Topical, intralesional, and systemic medical management.

J Am Acad Dermatol 2019 Jul 11;81(1):91-101. Epub 2019 Mar 11.

Centre de Recherche Dermatologique du Quebec Metropolitain, Quebec City, Quebec, Canada.

Hidradenitis suppurativa is a severe and debilitating dermatologic disease. Clinical management is challenging and consists of both medical and surgical approaches, which must often be combined for best outcomes. Therapeutic approaches have evolved rapidly in the last decade and include the use of topical therapies, systemic antibiotics, hormonal therapies, and a wide range of immunomodulating medications. An evidence-based guideline is presented to support health care practitioners as they select optimal medical management strategies and is reviewed in this second part of the management guidelines. A therapeutic algorithm informed by the evidence available at the time of the review is provided.
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http://dx.doi.org/10.1016/j.jaad.2019.02.068DOI Listing
July 2019

Gender Equity in Clinical Dermatology-Reason for Optimism.

JAMA Dermatol 2019 03;155(3):284-286

Program for Clinical Research, Department of Dermatology, University of California, San Francisco, San Francisco.

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http://dx.doi.org/10.1001/jamadermatol.2018.5283DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6682421PMC
March 2019

The TNFRSF members CD27 and OX40 coordinately limit T17 differentiation in regulatory T cells.

Sci Immunol 2018 12;3(30)

Department of Dermatology, University of California, San Francisco, CA 94143, USA.

Regulatory T cells (T) are closely related to T17 cells and use aspects of the T17-differentiation program for optimal immune regulation. In several chronic inflammatory human diseases, T express IL-17A, suggesting that dysregulation of T17-associated pathways in T may result in either loss of suppressive function and/or conversion into pathogenic cells. The pathways that regulate the T17 program in T are poorly understood. We have identified two TNF receptor superfamily (TNFRSF) members, CD27 and OX40, that are preferentially expressed by skin-resident T Both CD27 and OX40 signaling suppressed the expression of T17-associated genes from T in a cell-intrinsic manner in vitro and in vivo. However, only OX40 played a nonredundant role in promoting T accumulation. T that lacked both CD27 and OX40 were defective in controlling skin inflammation and expressed high levels of IL-17A, as well as the master T17 transcription factor, RORγt. Last, we found that CD27 expression was inversely correlated with T IL-17 production in skin of patients with psoriasis and hidradenitis suppurativa. Together, our results suggest that TNFRSF members play both redundant and distinct roles in regulating T plasticity in tissues.
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http://dx.doi.org/10.1126/sciimmunol.aau2042DOI Listing
December 2018

Proceeding report of the Second Symposium on Hidradenitis Suppurativa Advances (SHSA) 2017.

Exp Dermatol 2019 01;28(1):94-103

The Rockefeller University, New York City, New York.

The 2nd Annual Symposium on Hidradenitis Suppurativa Advances (SHSA) took place on 03-05 November 2017 in Detroit, Michigan, USA. This symposium was a joint meeting of the Hidradenitis Suppurativa Foundation (HSF Inc.) founded in the USA, and the Canadian Hidradenitis Suppurativa Foundation (CHSF). This was the second annual meeting of the SHSA with experts from different disciplines arriving from North America, Europe and Australia, in a joint aim to discuss most recent innovations, practical challenges and potential solutions to issues related in the management and care of Hidradenitis Suppurativa patients. The last session involved clinicians, patients and their families in an effort to educate them more about the disease.
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http://dx.doi.org/10.1111/exd.13849DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6600821PMC
January 2019

Perspective From the 5th International Pemphigus and Pemphigoid Foundation Scientific Conference.

Front Med (Lausanne) 2018 8;5:306. Epub 2018 Nov 8.

Department of Dermatology, University of Pennsylvania, Philadelphia, PA, United States.

The 5th Scientific Conference of the International Pemphigus and Pemphigoid Foundation (IPPF), "Pemphigus and Pemphigoid: A New Era of Clinical and Translational Science" was held in Orlando, Florida, on May 15-16, 2018. Scientific sessions covered recent, ongoing, and future clinical trials in pemphigus and bullous pemphigoid, disease activity and quality of life instruments, and the IPPF Natural History Study. Furthermore, the meeting provided an opportunity to hear firsthand from patients, investigators, and industry about their experience enrolling for clinical trials.
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http://dx.doi.org/10.3389/fmed.2018.00306DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6236000PMC
November 2018

Are Bacteria Infectious Pathogens in Hidradenitis Suppurativa? Debate at the Symposium for Hidradenitis Suppurativa Advances Meeting, November 2017.

J Invest Dermatol 2019 01 8;139(1):13-16. Epub 2018 Nov 8.

The Rockefeller University, New York, New York, USA.

In November 2017, a formal debate on the role of bacteria in the pathogenesis of hidradenitis suppurativa (HS) was held at the 2nd Symposium on Hidradenitis Suppurativa Advances (SHSA) in Detroit, Michigan. In this report, we present both sides of the argument as debated at the SHSA meeting and then discuss the potential role of bacteria as classic infectious pathogens versus an alternative pathogenic role as activators of dysregulated commensal bacterial-host interactions. Although there was consensus that bacteria play a role in pathogenesis and thus are pathogenic, there was a compelling discussion about whether bacteria in HS incite an infectious disease as we classically understand it or whether bacteria might play a different role in HS pathogenesis.
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http://dx.doi.org/10.1016/j.jid.2018.09.036DOI Listing
January 2019

The effect of antimicrobial washes on antibacterial resistance in hidradenitis suppurativa lesions.

J Am Acad Dermatol 2019 03 4;80(3):821-822. Epub 2018 Nov 4.

Department of Dermatology, Penn State College of Medicine, Hershey, Pennsylvania.

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http://dx.doi.org/10.1016/j.jaad.2018.10.063DOI Listing
March 2019

Concurrent anticytokine biologics for the management of severe hidradenitis suppurativa: are they safe and effective?

Cutis 2018 03;101(3):163;164;176

Department of Dermatology, University of California, San Francisco, USA.

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March 2018

Complications of hidradenitis suppurativa.

Semin Cutan Med Surg 2017 Jun;36(2):79-85

Department of Dermatology, University of California, San Francisco, USA.

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by recurrent painful nodules and abscesses involving intertriginous areas. Repeated episodes of profound inflammation in HS can lead to a number of complications, causing significant morbidity and decreasing quality of life. Complications of HS may affect the skin alone or may have systemic impact. Cutaneous complications of HS include sinus tracts, fistulae, scarring and contractures, squamous cell carcinoma, and lymphedema. Systemic complications of HS include chronic pain, systemic amyloidosis, and possibly anemia. Preventing disease complications by controlling primary disease is a key component of HS management. Clinicians should be prepared to recognize complications early, as prompt management is necessary to minimize negative impacts.
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http://dx.doi.org/10.12788/j.sder.2017.022DOI Listing
June 2017