Specialists explain the route of the patient in accordance with the clinical diagnosis of the nurse and the treatment most adequately for each patient.
Dr. Gabriel Arias, resident of the Department of Dermatology of the Department of Medical Sciences and Dr. Adriana Figueroa, resident of the Department of Dermatology of Medical Sciences. Photo: Advocates for doctors in the Journal of Medicine and Salud Pública.
Durante the symposium of suppurative hydradenitis led by Revista Medicina y Salud Pública, la Dra. Adriana Figueroa, fellow of the Department of Dermatology of the Department of Medical Sciences, exposing the passages to follow in order to diagnose the condition, or the egg, as Dr. Gabriel Arias, explaining in detail the unnecessary treatments for patients, allowing the import of maneuver to be conditioned, which is 3 months more common in women than men.
De acuerdo con la Dra. Adriana Figueroa, hydradenitis is a systemic, chronic and inflammatory condition of the pelvis, which is characterized by inverted acne. “For the system we want to determine that all parts of the body are affected and that it is of long duration” indicative.
Although it does not have a specific cause, the specialists evidence that it originates in the follicle, a structure of the pelvis where the veil is cut, all obstructed, accumulating accumulation of fluid to cause the formation of inflammatory bacteria, generating in the zone.
“It is the correct treatment, which is what is being propagated and the condition of progress; even if you can create meaningful scars or channels of drinking” affirmation Figueroa, además, emphasis that the nurse could not propagate in the area.
Prevalence and incidence
The condition can affect a variety of people, usually from adolescence, there is a high risk in patients with family history and is more common in African American, British and Hispanic people. However, for the specialist, hydradenitis is associated with the use of cigarettes, “it is estimated that 3 out of 4 people with HS have smokers and a 15% smoker at the moment”.
However, the relationship with depression and obesity, that 75% of patients present is conditioned. “Even if the person is not overwhelmed, the risk of losing control of the air conditioner and the risk of losing a nurse” is very important.
Ó How to diagnose?
According to Figueroa, the diagnosis is clinical, although it can not be determined whether tracheal blood vessels are present in a patient or have hydradenitis, a diagnostic and nosotros nosableable with advanced condition “.
Pese a ello, explicitly the passages that can be added to the diagnostic. The first to present the medicines to a patient who presents related symptoms is responding to four interrogating:
Is it more of an inflammatory lesion?
¿Is the course chronic, with new and recurring lesions?
¿Las lesiones son bilaterales?
¿Are the lesions mainly located in the line of the lesion?
If all of these answers are affirmative, they want to determine that the patient receiving HS, if not one or more of them, can perform a culture of parasites, bacteria, and other microbes. If there is evidence, culturing with a specific specimen is infertility, whether it is sterile cultivation or with more speciation, news that revises the patient’s history and gastrointestinal symptoms; posterior to ello, if there are no relational conditions, you can go to HS.
The affirmation specialist who classifies dermatologists as a nurse at Hurley Stadium, from one level to another. In stage 1 (leve), there are inflamed lesions, without embargo, no scarring is present, no tunnel formation is allowed in the pelvis, and there is space between a lesion and another.
“In stage 2 (moderate), there are no nodules and recurrent abscesses, there is scarring and there is news of fistula formation; it is important to recognize that the affected area is not complete, due to the pain in the patient” affirmation.
In stage 3 there is a diffuse body involvement of the area, the abscesses aborting all the area, generating an affection in the anatomical structure of which is part of the body.
Frente a ello, la Dra. Acute acne as hydradenitis is not a sexually transmitted disease, it is not contagious, it is not present due to the lack of hygiene in patients and it does not have a condition to de-escalate the condition.
By other means, Dr. Gabriel Arias, a fellow in the Department of Dermatology at the Medical Science Review, emphasizes the importance of changing the quality of each patient or the symptoms that are present in the patient, or depending on the condition of the condition, determining the treatment.
“It treats as if it were infertility, and it is with the dermatologist that it goes to the HS diagnostic; even though there are treatments that are designed to reduce the rash, the herpes, the pain and the avoidance of conditioning” aggregate.
How are you treated?
One of the recommendations that the specialist gives to his patients is that he uses antiseptic jabs, which helps to remove bacterial cargo and inflammation. There are courses of short courses of oral steroids, such as prednisone, which accuse, “can be used in short courses before an agonizing phase, but not before a prolonged phase”. Además, results in the lack of zinc supplements, which contribute to the city or the inflammatory environment characteristic of the condition.
As HS is classified by stages, the treatments are tampered with. Arias says that “in stage 1 the systemic treatments are used before they can be profound and are of the lesion type”, algunos son: oral antibiotics (tetracyclines, clindamycin + rifampin), hormonal therapy (spironolactone, metformin) isotretinoin).
For stage 2, add additive antibiotics (moxifloxacin, metronidazole), biologics (adalimumab, infliximab), excisions, and treatments. In stage 3 intravenous antibiotics (ertapenem), biologics (anakinra, ustekinumab) and excision.
Respectfully, the specialist affirms that “it is an inflammatory disease, but at the same time, our meta can be screened to prevent the patient from having any surgical procedures”, considering that the surgical function works as an adjunctive therapy medically, it is decided that the patient is not responding to or that evidence of an extrinsic structural disorder is present, because “surgery should not replace the treatment and should not treat inflammation”.
Recommendations for patients
Finally, the specialists recommend a multidisciplinary treatment for the condition of the condition in the patients. La Dra. Figueroa afirma que “la clave para poder vivir con la HS es tener an tratamiento adequate junto a un solido sistema de apoyo” y el Dr. Arias, inviting the population to listen to the medical centers, “all patients with the following suppurative hydradenitis should be evaluated and evaluated with a definitive diagnosis. “In the clinics of the medical school we have always been”.
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