Combination of ankylosing spondylitis with combined autoinflammatory skin lesions (clinical observation and literature review)

We present a clinical case of combination of axial spondyloarthritis (axSpA) and chronic recurrent skin lesions in the form of acne conglobata, hidradenitis suppurativa (HS) with fistulous tracts formation. During the diagnostic search, the following diseases were considered: HS, SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, osteitis), PASS syndrome (pyoderma gangrenosum, acne, ankylosing spondylitis, HS). The choice of therapy in this patient and the possibility of using biologic disease-modifying antirheumatic drugs for axSpa and concomitant autoinflammatory skin process are discussed.

CONCEPTUAL AND AYURVEDIC MANAGEMENT APPROACH IN YUVANPIDIKA W.S.R. TO ACNE VULGARIS

Acne vulgaris is one of the most prevalent skin disorders found in adolescent age group around the world and manifest itself as comedones (comedonal acne), papulopustular (papulopustular acne) or nodules and cysts (nodulo cystic acne and acne conglobata) pitted depressed or hypertrophic scars may follow all types but especially nodulocystic acne and Acne conglobata. It can be correlated with Yuvanpidika in Ayurveda. It is also called as Tarunyapitika&Mukhdushika. No description of the disease is present in Ayurvedic text CharakSamhita but Acharya Sushrut in SushrutSamhita has described the disease under Ká¹£hudraRoga chapter.In Ayurveda vitiation of Vata, Kapha and Rakta are etiological factor that give rise to Yuvanpidika.And form Shalmali thorns like lesion over face. Although described in short, symptoms resemble very closely with the modern Acne vulgaris description. Regarding the treatment, Abhyanga, Vaman, Nasya, Raktamoká¹£an are indicated for the management of the disease. Various Lepan drugs are also mentioned in different Ayurvedic texts for treatment.

Which Factors Determine Affected Sites in Hidradenitis Suppurativa?

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. We also revealed unexpected correlations between some sites and other comorbidities such as inflammatory diseases, acne conglobata, or dissecting folliculitis of the scalp. Conclusion: Such correlations are crucial to unravel a disease as variable as HS and identify pathophysiological mechanisms to enable the provision of personalized management.

A Review of Treatments for Dissecting Cellulitis of the Scalp

Dissecting cellulitis of the scalp (DCS) is a rare and chronic skin disorder that presents with suppurative nodules on the scalp with associated scarring alopecia. The pathogenesis of the disease involves inflammation and destruction of the hair follicle. This makes it clinically and pathologically similar to acne conglobata and hidradenitis suppurativa, which can also occur concomitantly. Many therapies exist to treat DCS, but its refractory nature makes treatment difficult and combination therapies are often needed. The aim of this review is to evaluate the evidence-based medical and surgical treatments for this disease so that clinicians can choose the best treatments according to the disease stage and severity. Knowledge of the clinical endpoints of each treatment modality is important for managing patient expectations and setting treatment goals. There is no standardized method for measurement of clinical improvement in DCS, and each individual treatment can improve one or more aspect of disease activity (such as inflammation or scarring). Topical and oral medications will be reviewed in addition to surgical and laser treatments.