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Photodiagnosis Photodyn Ther 2022 Jun 24:102986. Epub 2022 Jun 24.

Department of Dermatologic Surgery, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, Jiangsu 210042, China.

We report the case of a 20-year-old man with acne conglobata (AC) who was treated with 5-aminolevulinic acid photodynamic therapy (ALA-PDT) sequentially to deroofing, and finally used fractional carbon dioxide laser for aesthetic requirements, achieving satisfying results. AC is a severe form of acne vulgaris that can lead to significant scarring and has serious negative effects on a patient's psychological well-being and quality of life. Some cases are likely resistant to currently available treatments. Read More

Pediatr Dermatol 2022 May 18. Epub 2022 May 18.

Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital San Diego, San Diego, California, USA.

Background: Acne vulgaris varies in clinical severity, from minimal comedonal disease to severe hemorrhagic and ulcerative lesions with scarring. While a family history confers a higher risk for developing acne, the correlation between heritability and clinical severity remains unclear.

Objective: To examine the natural history and heritability of severe acne with scarring in patients undergoing isotretinoin therapy. Read More

Photodiagnosis Photodyn Ther 2022 Apr 29;39:102891. Epub 2022 Apr 29.

Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai 200092, PR China. Electronic address:

The follicular occlusion tetrad is a complex dermatologic syndrome which can concomitant with other diseases. The case reported a young male patient suffer from follicular occlusion tetrad (acne conglobata, hidradenitis suppurativa, dissecting cellulitis of the scalp, and pilonidal sinuses) concomitant with pachyonychia congenital type Ⅱ (thickened nails, palmoplantar keratoderma, multiple cysts) and ankylosing spondylitis (lumbago, human leukocyte antigen-B27 positive). The genetic analysis showed the KRT17 gene mutation on exon 1 (c. Read More

Int J Dermatol 2022 Apr 29. Epub 2022 Apr 29.

Department of Dermatology, Sutter Medical Foundation, Sacramento, CA, USA.

Background: Like other chronic, inflammatory skin disorders, hidradenitis suppurativa (HS) is increasingly recognized to be associated with various medical disorders.

Objective: Using the Rochester Epidemiology Project (REP), we sought to conduct the first American population-based study examining the association between HS and various comorbid conditions.

Methods: From the REP database, we identified patients diagnosed with HS from 2003 through 2018 who were residents of Olmsted County, Minnesota, USA, along with age- and gender-matched controls. Read More

Clin Rheumatol 2022 Apr 23. Epub 2022 Apr 23.

Division of Rheumatology, Department of Medicine, and Division of Dermatology, Keck School of Medicine, University of Southern California and Los Angeles County, Los Angeles, CA, USA.

Dissecting cellulitis of the scalp (DCS) is a rare, primary neutrophilic cicatricial alopecia of unknown etiology. The disease follows a chronic, relapsing, and remitting course which may ultimately lead to scar formation and alopecia. The association of seronegative peripheral and/or axial spondyloarthritis in patients with hidradenitis suppurativa (HS) and acne conglobata (AC) is well established. Read More

Clin Cosmet Investig Dermatol 2022 30;15:541-546. Epub 2022 Mar 30.

Department of Plastic Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People's Republic of China.

Follicular occlusion triad (FOT) is a chronic inflammatory skin disease that comprises hidradenitis suppurativa, acne conglobata, and perifolliculitis capitis abscedens et suffodiens and can seriously affect a patient's quality of life. Currently, there is no consensus on the treatment plan for FOT. There are also only a few reports on the treatment of severe FOT. Read More

Cureus 2022 Mar 2;14(3):e22776. Epub 2022 Mar 2.

Pediatrics Department, Prince Mohammad bin Abdulaziz Hospital, Medina, SAU.

Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is a rare auto-inflammatory condition involving cutaneous and osteoarticular manifestations. This study presents a case where a 16-year-old male with glucose-6-phosphate dehydrogenase (G6PD) deficiency presented with severe nodulocystic acne after three weeks of isotretinoin therapy. In addition to worsening acne, the patient had bone and joint pain with movement restriction. Read More

Pediatr Dermatol 2022 Mar 1. Epub 2022 Mar 1.

Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

We report the case of a 2-year-old boy with mosaic trisomy 13 and immunodeficiency who developed severe hidradenitis suppurativa beginning at the age of 18 months. Unresponsive to standard therapies, he exhibited a partial response to immunoglobulin replacement therapy. Read More

Clin Dermatol 2021 May-Jun;39(3):496-499. Epub 2021 Feb 16.

Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.

Although dissecting cellulitis (DC) and hidradenitis suppurativa (HS) are classified separately, they share many clinical, dermatoscopic, pathogenetic, and histologic aspects, as well as therapeutic options. The association between DC, HS, and acne conglobata represents the follicular occlusion triad or follicular occlusion tetrad, which may include a pilonidal sinus. DC, also known as "folliculitis et perifolliculitis capitis abscendes et suffoidens," is classified as a secondary cicatricial and neutrophilic alopecia. Read More

JAMA Dermatol 2021 Sep;157(9):1095-1101

Department of Dermatology, Penn State Hershey Medical Center, Penn State University, Hershey, Pennsylvania.

Importance: Up to 50% of patients may have hidradenitis suppurativa (HS) onset between age 10 and 21 years. To our knowledge, little is known about how adolescents with HS utilize health care during their journey to receiving a diagnosis.

Objective: To assess the clinical characteristics and health care utilization patterns of pediatric vs adult patients with HS. Read More

J Dermatol 2021 Apr 19;48(4):431-438. Epub 2021 Feb 19.

Laboratory of Intestinal Mucosa and Skin Immunology, Seoul, Korea.

Inflammatory bowel disease (IBD) presents with various extraintestinal manifestations. As part of them, various skin diseases are suggested to be related to IBD. We aimed to identify the epidemiology and risk of developing skin manifestations in patients with IBD. Read More

Drugs R D 2021 Mar 2;21(1):29-37. Epub 2021 Jan 2.

Department of Dermatology, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA.

Background And Objective: Dissecting cellulitis of the scalp is a primary scarring alopecia. Isotretinoin is commonly referenced in the literature as a treatment for dissecting cellulitis. The objective of this article was to conduct a review and meta-analysis to assess the efficacy of isotretinoin for treating dissecting cellulitis of the scalp. Read More

J Transl Autoimmun 2020 20;3:100071. Epub 2020 Nov 20.

Department of Dermatology, The Saarland University Hospital, 66421, Homburg, Germany.

In the last decade, new scientific findings significantly improved our understanding of the molecular pathogenesis of autoinflammation and have resulted in the identification and definition of several pyoderma gangrenosum-associated autoinflammatory syndromes (PGAAIS) as new and distinct clinical entities. These different clinical entities include PAPA (pyogenic arthritis, pyoderma gangrenosum and acne conglobata), PASH (pyoderma gangrenosum, acne and suppurative hidradenitis), PAPASH (pyoderma gangrenosum, acne, suppurative hidradenitis and pyogenic arthritis), PsAPASH (pyoderma gangrenosum, acne, suppurative hidradenitis and psoriatic arthritis), PASS (pyoderma gangrenosum, acne conglobata, suppurative hidradenitis, and axial spondyloarthritis) and PAC (pyoderma gangrenosum, acne and ulcerative colitis), which can be distinguished by their clinical presentation and the presence or absence of mutations in several genes, such as the genes encoding proline-serine-threonine phosphatase-interacting protein 1 (PSTPIP1), nicastrin (NCSTN), Mediterranean fever (MEFV) and nucleotide-binding oligomerization domain-containing protein (NOD). In this systematic review, we summarize the present knowledge of this rapidly developing hot topic and provide a guide to enable the easy diagnosis of these syndromes in everyday clinical practice. Read More

Dermatol Ther 2021 01 25;34(1):e14553. Epub 2020 Nov 25.

Department of Psychiatry, College of Medicine, Central Michigan University, Saginaw, Michigan, USA.

Dis Mon 2021 Apr 9;67(4):101103. Epub 2020 Oct 9.

Department of Pediatric and Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008-1284, United States.

Acne vulgaris is a chronic, inflammatory, skin condition that involves the pilosebaceous follicles and is influenced by a variety of factors including genetics, androgen-stimulation of sebaceous glands with abnormal keratinization, colonization with Cutibacterium acnes (previously called Propionibacterium acnes), and pathological immune response to inflammation. Acne can occur at all ages and this discussion focuses on the first three decades of life. Conditions that are part of the differential diagnosis and/or are co-morbid with acne vulgaris are also considered. Read More

Plast Reconstr Surg Glob Open 2020 Aug 18;8(8):e3015. Epub 2020 Aug 18.

Division of Plastic and Reconstructive Surgery, Brigham and Women's Hospital, Boston, Mass.

Dissecting cellulitis of the scalp (DCS) is a part of the follicular occlusion tetrad (hidradenitis, acne conglobata, and pilonidal disease). It is a spectrum disorder that can be severe and refractory to medical management. The authors describe 3 such cases successfully treated with surgical resection and reconstruction and present a scoring system for timely referral of such patients to a reconstructive surgical team. Read More

Dermatol Online J 2020 Aug 15;26(8). Epub 2020 Aug 15.

McGovern Medical School at University of Texas Health Houston, Houston, TX.

Multiple prescription medications may cause or aggravate acne. A number of dietary supplements have also been linked to acne, including those containing vitamins B6/B12, iodine, and whey, as well as "muscle building supplements" that may be contaminated with anabolic-androgenic steroids (AAS). Acne linked to dietary supplements generally resolves following supplement discontinuation. Read More

Clin Exp Dermatol 2020 Dec 13;45(8):1109-1110. Epub 2020 Aug 13.

Department of Dermatology, Wrexham Maelor Hospital, Wrexham, UK.

Int J Trichology 2020 Jan-Feb;12(1):35-37. Epub 2020 Apr 9.

Division of Dermatology, Al-Sadr Teaching Hospital, Basra, Iraq.

Acne conglobata (AC) is a rare form of severe and chronic nodulocystic acne. It is characterized by nodulocystic lesions, borrowing, interconnecting abscesses, scars, in addition to grouped comedones. AC usually appears on the trunk and may extend to the buttocks. Read More

Dermatol Online J 2020 Feb 15;26(2). Epub 2020 Feb 15.

Department of Dermatology, University of Illinois at Chicago, Chicago, IL.

Follicular occlusion triad is a symptom complex of three conditions with a similar pathophysiology including hidradenitis suppurativa (HS), dissecting cellulitis of the scalp, and acne conglobata. Although the exact pathogenesis of the triad is unknown, it appears to be related to follicular occlusion in areas with apocrine glands. Wolf isotopic response refers to the occurrence of a new dermatosis at the site of another, unrelated, previously healed dermatosis. Read More

Dermatology 2020 6;236(1):15-20. Epub 2020 Jan 6.

ResoVerneuil, Paris, France,

Background: The factors that determine whether an area of the body will be affected by hidradenitis suppurativa (HS) are unknown.

Methods: To address these factors, we performed multivariate regression analyses in a cohort of 1,138 patients.

Results: We found that the body sites affected occurred in specific combinations that were influenced by sex and body mass index. Read More

Sao Paulo Med J 2019;137(4):363-368. Epub 2019 Oct 31.

MD, PhD. Dermatologist and Associate Professor, Department of Dermatology, Escola Paulista de Medina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.

Background: Acne needs to be treated early to prevent negative psychosocial impacts. In severe or moderate forms, which tend to leave scars, oral isotretinoin is the first-line therapy. However, concern about its adverse events, especially in developed countries, delays effective treatment. Read More

J Eur Acad Dermatol Venereol 2019 Oct;33 Suppl 6:36-39

Dermatology Clinic, University of Catania, Catania, Italy.

The case of a 24-year-old male patient affected by follicular occlusion tetrad (acne conglobata, hidradenitis suppurativa, pilonidal cyst and dissecting cellulitis of the scalp) associated with clinical signs of pachyonychia congenita (PC)-2 (focal palmoplantar keratoderma, plantar pain, onycodystrophy and multiple cysts) is reported. The diagnosis was supported by genetic analysis that showed heterozygous mutation within the exon 1 of KRT17 gene. This case may reflect different expressions of a phenotypic spectrum induced by a common genetic alteration. Read More

Clin Case Rep 2019 Sep 10;7(9):1769-1772. Epub 2019 Aug 10.

FB Dermatology Denmark Limited Aps. Ballerup Denmark.

The Kleresca biophotonic platform utilizing fluorescent light energy (FLE) effectively treated both acne conglobata and hidradenitis suppurativa. FLE decreased the presence of inflammatory nodules, cysts, and associated erythema. It also supported a healing response to improve skin texture. Read More

Ann Dermatol 2019 Aug 1;31(Suppl):S59-S61. Epub 2019 Jul 1.

Department of Dermatology and Venereology, Medical University of Warsaw, Warsaw, Poland.

BMC Dermatol 2019 07 23;19(1):11. Epub 2019 Jul 23.

Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.

Background: Hidradenitis suppurativa is one member of the follicular occlusion triad: acne conglobata, hidradenitis suppurativa, and dissecting cellulitis of the scalp. The presence of acantholysis and desmoglein autoantibodies in hidradenitis suppurativa is rare.

Case Presentation: We report a case of 68-year-old male with a diagnosis of gluteal hidradenitis suppurativa co-presenting pemphigus-like findings including acantholysis and positive desmoglein autoantibodies. Read More

J Dermatol 2019 Sep 4;46(9):802-807. Epub 2019 Jul 4.

Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan.

Perifolliculitis capitis abscedens et suffodiens (PCAS) or dissecting cellulitis is a rare condition presenting deep follicular occlusions, follicular ruptures and follicular infections in the scalp area with unknown etiology, which consequently cause primary neutrophilic cicatricial alopecia by the repeated follicular inflammation. PCAS is categorized as one of the "follicular occlusion tetrad" along with hidradenitis suppurativa, acne conglobata and pilonidal cyst. In the pathogenesis of the follicular occlusion tetrad, the involvement of neutrophils and its activator tumor necrosis factor (TNF) have been discussed. Read More

Br J Hosp Med (Lond) 2019 May;80(5):258-262

Consultant Geriatrician, Proactive Care of Older People undergoing Surgery (POPS), Department of Ageing & Health, Guy's and St Thomas' NHS Foundation Trust, London.

As a consequence of an ageing population greater numbers of elderly patients are presenting for both elective and emergency surgery. These older patients typically present with an increased burden of age-related problems and multimorbidity, which is associated with an increased risk of adverse postoperative outcomes. Traditional preoperative assessment models are adept at discerning patients' suitability for anaesthesia and surgery, but there is minimal focus on improving postoperative outcomes. Read More