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15.07.2022 | Originalien

Hidradenitis suppurativa

verfasst von: Dr. Antonia Wiala, Theresa Stockinger, Christian Posch, Klemens Rappersberger

Erschienen in: hautnah

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Zusammenfassung

Die Hidradenitis suppurativa (HS, Acne inversa) ist eine chronisch entzündliche Hauterkrankung, gekennzeichnet durch das rezidivierende Auftreten von entzündlichen Knoten, Abszessen und Fisteln in den intertriginösen Arealen. Schmerzen und putride übelriechende Sekretion führen zu massiven Einschränkungen der Lebensqualität. Die follikuläre Okklusion scheint in der multifaktoriellen Pathogenese der Erkrankung eine wichtige Rolle zu spielen. Zudem sind genetische Prädispositionen und zahlreiche Triggerfaktoren wie Übergewicht und Tabakkonsum bekannt. Die Diagnose der HS wird klinisch anhand der charakteristischen Hautveränderungen gestellt. Zur Einteilung der Schweregrade dient unter anderem das Hurley-Staging. Therapeutische Optionen bei milder HS umfassen eine antiseptische sowie antibiotische Lokaltherapie. Bei milder bis moderater Erkrankung kann durch systemische antibiotische Therapien (Kombination Clindamycin-Rifampicin; Tetracycline) eine vorrübergehende Remission erreicht werden. Zur Behandlung der moderaten bis schweren HS ist Adalimumab, ein TNF-α-Antagonist, zugelassen. Operative Techniken spielen eine wichtige Rolle bei der Behandlung von Fistelgängen und Narbensträngen. Mittels En-bloc-Resektion, also der großzügigen Exzision erkrankter Hautareale, kann die Heilung eines umschriebenen Areals erreicht werden. Hauptziel aktueller Therapien bleibt eine verbesserte Lebensqualität.
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Metadaten
Titel
Hidradenitis suppurativa
verfasst von
Dr. Antonia Wiala
Theresa Stockinger
Christian Posch
Klemens Rappersberger
Publikationsdatum
15.07.2022
Verlag
Springer Vienna
Erschienen in
hautnah
Print ISSN: 1866-2250
Elektronische ISSN: 2192-6484
DOI
https://doi.org/10.1007/s12326-022-00518-1