2017, Number 3
Surgical treatment in pilonidal fistulas in follicular occlusion syndrome
Language: Spanish
References: 19
Page: 707-719
PDF size: 455.38 Kb.
ABSTRACT
Introduction: follicular occlusive syndrome includes inverse acne, acne conglobata and pilonidal fistula (triad); when it is associated to the dissecting folliculitis of the scalp then it constitutes the tetrad of follicular occlusion. Reverse acne is a suppurative, chronic and invalidating disease. Its clinical features are the presence of comedones with multiple openings that link two or more follicles, abscesses with epithelial communications, and draining sinuses in regions with apocrine glands. The genesis of these affections is basically genetic with dermatological expression.Objective: to describe physically and histopathologically the patients with follicular occlusion syndrome, as well as the results of surgical treatment of pilonidal fistula in this disorder.
Method: the study is on the prevalence of pilonidal fistula in follicular occlusion syndrome in 37 patients with follicular occlusion syndrome. The local excision of the pilonidal and perianal fistulas was performed, this exeresis extended by the subcutaneous cellular tissue until the facia. The area was then repaired with a skin-free graft.
Results: four patients had the pilonidal fistula, with long periods of evolution, who were treated with autograft of skin. Hyperkeratosis, as well as, perifolliculitis were the most relevant histopathological changes.
Conclusion: the pilonidal fistula is difficult for follicular occlusion syndrome management and only the surgical treatment is the most suitable.
REFERENCES
Li CR, Jiang MJ, Shen BD, Xu HX, Wang HS, Yao X, et al. Two novel mutations of the nicastrin gene in Chinese patients with acne inversa. Br J Dermatol. 2011 [citado 15 dic 2014]; 165(2):415–418. Disponible en: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2133.2011.10372.x/abstract;jsessionid=B03644305219D7CF895F44C11172916D.f03t01
Liu Y, Gao M, Lv YM, Yang X, Ren YQ, Jiang T, et al. Confirmation by exome sequencing of the pathogenic role of NCSTN mutations in acne inversa (hidradenitis suppurativa). J Invest Dermatol. 2011[citado 15 dic 2014];131(7):1570–1572. Disponible en: http://www.sciencedirect.com/science/article/pii/S0022202X15353185
Nomura Y, Nomura T, Sakai K, Sasaki K, Ohguchi Y, Mizuno O, et al. A novel splice site mutation in NCSTN underlies a Japanese family with hidradenitis suppurativa.Br J Dermatol. 2013 [citado 15 dic 2014]; 168(1):206–209.Disponible en:http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2133.2012.11174.x/abstract
Von Laffert M, Stadie V, Wohlrab J, Marsch WC. Hidradenitis suppurativa/acne inversa: bilocated epithelial hyperplasia with very different sequelae. Br J Dermatol. 2011 [citado 15 de diciembre 2014]; 164(2):367-71. Disponible en: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2133.2010.10034.x/full
Gao M, Wang PG, Cui Y, Yang S, Zhang YH, Lin D, et al. Inversa Acne (Hidradenitis Suppurativa): A Case Report and Identification of the Locus at Chromosome 1p21.1–1q25.3. J Invest Dermatol. 2006 [citado 15 dic 2014]; 126(6):1302-1306. Disponible en: http://www.sciencedirect.com/science/article/pii/S0022202X15329444
Al-Ali FM, Ratnamala U, Mehta TY, Naveed M, Al-Ali MT, Al-Khaja N, et al. Hidradenitis suppurativa (or Acne inversa) with autosomal dominant inheritance is not linked to chromosome 1p21.1-1q25.3 region. Exp Dermatol. 2010 [citado 15 dic 2014]; 19(9):851–853. Disponible en: http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0625.2010.01088.x/full
Hamosh A, Scott AF, Amberger JS, Bocchini CA, McKusick VA. Online Mendelian Inheritance in Man (OMIM), a knowledgebase of human genes and genetic disorders. Nucleic Acids Res. 2005 [citado 15 dic 2014]; 33(Suppl 1): 514-517. Disponible en: https://academic.oup.com/nar/article/33/suppl_1/D514/2505259/Online-Mendelian-Inheritance-in-Man-OMIM-a
Ingram JR, Piguet V. Phenotypic heterogeneity in hidradenitis suppurativa (acne inversa): classification is an essential step toward personalized therapy. J Invest Dermatol. 2013 [citado 15 dic 2014]; 133(6):1453-1456.Disponible en: http://ac.els-cdn.com/S0022202X15362977/1-s2.0-S0022202X15362977-main.pdf?_tid=258dd4c2-e97a-11e6-9f7e-00000aab0f01&acdnat=1486062330_23cb44c3a7a17fefafd9cc909e034b00
Jain K, Jain VK, Aggarwal K, Bansal A. Late onset isotretinoin resistant acne conglobata in a patient with acromegaly. Indian J Dermatol Venereol Leprol. 2008 [citado 15 dic 2014]; 74(2):139-141. Disponible en: http://www.ijdvl.com/article.asp?issn=0378-6323;year=2008;volume=74;issue=2;spage=139;epage=141;aulast=Jain
Orozco B, Campo ME, Anaya LA, Atuesta J, Ávila JM, Balcázar LF. Guías colombianas para el manejo del acné: una revisión basada en la evidencia por el Grupo Colombiano de Estudio en Acné. Rev Asoc Colombiana Dermatol. 2011 [citado 15 de diciembre 2014]; 19: 129-158. Disponible en: http://docplayer.es/4394597-Guias-colombianas-para-el-manejo-del-acne-una-revision-basada-en-la-evidencia-por-el-grupo-colombiano-de-estudio-en-acne.htm