Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Perianal hidradenitis suppurativa, a chronic recurrent inflammatory disease of apocrine glands, adjacent anal canal skin, and soft tissues, is characteristically ignored and misdiagnosed. A retrospective analysis of 43 patients with perianal hidradenitis suppurativa was performed; 40 patients (93 percent) were male and 3 (7 percent) were female, with a median age at presentation of 29 years. Symptoms, including pain, swelling, purulent discharge, and pruritus, had been present for a median of six years. Diagnoses at the time of presentation included pilonidal disease (28 percent), anal fistula (37 percent), and perirectal abscess (16 percent). Associated medical conditions included diabetes (12 percent) and obesity (12 percent), and 70 percent of the patients were smokers. Once the correct diagnosis was established, 72 percent of patients had wide local excision with healing by secondary intention, and 28 percent of patients had incision and drainage or limited local excision. Although 67 percent of the patients had recurrence of disease after initial treatment, wide excision was more successful in preventing recurrence. Skin grafting failed uniformly, and colostomy was rarely necessary. Despite its relatively common occurrence, perianal hidradenitis suppurativa is infrequently diagnosed correctly and recurs in many patients despite appropriate surgical treatment, making the disease a source of frustration for surgeon and patient alike.
 ...
PMID:Perianal hidradenitis suppurativa. The Lahey Clinic experience. 239 Sep 7

Hidradenitis suppurativa of the perineum and buttocks is a devastating disease often causing patients years of pain, discomfort, and eventual social isolation. The chronic form of the disease results from a lack of aggressive surgical intervention when the patient is first seen. It is characterized by a malodorous drainage from multiple sinus tracts encased in marked scarred and fibrotic tissue. In contrast to axillary involvement, the perianal form of hidradenitis suppurativa is associated with an increased frequency of anemia, fistulous communications with bowel and urinary tract, and the development of carcinomas. Several cases illustrating the debilitating nature of the disease and its optimal management are presented. This report illustrates that (1) a well-planned preoperative and postoperative bowel regimen can eliminate the need for a diverting colostomy, even in the most extensive forms of perianal disease, (2) radical excision is expedited and blood loss is minimized by the use of a Shaw hot knife (Oximetrix, Mountain View, CA), (3) the quilted application of meshed split-thickness skin grafts as a primary procedure provides rapid closure of the surgical defect and minimizes patient discomfort, and (4) aggressive surgical intervention in severe cases provides a chance for a rapid recovery from this crippling disease.
 ...
PMID:Surgical management of massive perianal hidradenitis suppurativa. 384 Dec 67

Eight patients, 7 with hidradenitis suppurativa and 1 with chronic recurrent staphylococcal abscess, all of whom failed to respond to antibiotic therapy, conservative therapeutic measures, and surgery, were experimentally placed on Staphage Lysate. Treatment after appropriate skin testing consisted of subcutaneous infections of 0.1 ml and intranasal installation of 0.3 ml of Staphage Lysate. Treatments were weekly for twelve weeks, biweekly for six months, and then monthly. Complications, which occurred early, were minimal and involved rash, vertigo, malaise, chills, nausea, fever, and headache. Six of the 8 patients reported noticeable improvement in odor, consistency, and amount of drainage and considerable decreases in pain. Seven of the 8 patients reported improvement in the ability of lesions to drain spontaneously, and a decrease in the frequency of inflammatory nodules. All 8 patients reported that the inflammatory periods were definitely shorter. Early data suggests that Staphage Lysate is a useful adjuvant in the treatment of hidradenitis suppurativa.
 ...
PMID:A preliminary report on the use of Staphage Lysate for treatment of hidradenitis suppurativa. 724 54

We describe our experience in the use of a Silastic foam dressing in 17 patients undergoing radical excision of hidradenitis suppurativa whose wounds were allowed to heal by granulation. Axillary excisions were carried out in 9 patients and perineal excisions in 8 patients. The technique permits adequate excision of the disease and results in a cosmetically acceptable scar, superior to that obtained by skin grafting and with little limitation of movement. It avoids the pain of conventional management of granulating wounds by gauze packing. It is considered that this method of management is superior in most respects to other techniques used to manage the defect resulting from adequate excision of hidradenitis.
 ...
PMID:The use of silastic foam dressing in the treatment of advanced hidradenitis suppurativa. 738 12

Hidradenitis suppurativa is a chronic skin condition involving the apocrine glandular zones. Affected patients may present with acute abscesses, but the condition often progresses to a chronic state with persistent pain, sepsis, sinus tract and fistula formation, purulent discharge and dermal scarring. Treatment of patients with severe disease can be difficult and may require complex surgical intervention. This review encompasses the pathogenesis, clinical manifestations and management options for patients with hidradenitis suppurativa.
 ...
PMID:Pathogenesis, clinical features and management of hidradenitis suppurativa. 932 35

A 20-year review of the inflammatory bowel disease surgical database of the author was analyzed for Crohn's disease (CD) patients who had a surgical approach to perianal fistula disease (PAD). Of 333 patients with CD operated between July 1977 and February 1997, 51 had procedures for PAD (15.3%), and 7 of these patients had laser ablation of severe, debilitating complex PAD (13.7%). These patients have traditionally been treated by diverting ileostomy or proctectomy with permanent diversion. Others have advocated conservative management with long-term antibiotics, staged operations, and insertion of multiple loose setons to promote drainage. This technique was adapted from the laser procedure now advocated for severe hydradenitis suppurativa. The hand-held CO2 laser was used to unroof all fistulas external to the external sphincter. Fistulas were identified by probing. Infected granulation tissue was removed by laser ablation until normal fat or muscle was revealed. Intersphincteric abscesses were unroofed, and a single seton was placed around the external sphincter for all but submucous fistulas. Patients were usually operated as outpatients with pain control effected with oral and transnasal agents. A laparoscopically performed temporary diverting ileostomy was used in one early patient in the series. Patients were followed, and progress was documented by physical examination and photographs. Quality of life was assessed. All patients improved remarkably from their preoperative state. The 4 patients in the group operated more than 1 year before this review have all demonstrated complete healing. The three more recent patients are in various stages of healing. Continence was preserved in 7 of 7 patients. No patient has required rectal excision. Recurrence thought to be related to associated hydradenitis has occurred in 1 patient. Laser ablation is a valuable technique in the management of patients with severe, debilitating complex PAD complicating CD. It effectively eradicates the septic tracks and pockets while preserving sphincter function. It obviates the need for diversion with or without proctectomy.
 ...
PMID:Laser ablation of complex perianal fistulas preserves continence and is a rectum-sparing alternative in Crohn's disease patients. 965 72

Painful erythematous papules and nodules involving either the palms of the hands, or, more commonly, the soles of the feet, characterize palmoplantar eccrine hidradenitis or palmoplantar hidradenitis (PH). The younger pediatric population is predominately affected. Histologically, the eccrine gland apparatus is the target of inflammatory neutrophilic infiltrates. This entity has been reported under a variety of names, including traumatic plantar urticaria, neutrophilic eccrine hidradenitis, plantar erythema nodosum, and idiopathic recurrent palmoplantar hidradenitis. All are essentially the same process, described in different forms. Despite the growing number of reported cases, the pathogenesis remains obscure. We present four children with PH of the soles of the feet, who shared a common recent history of exposure to cold, damp, footwear. The temporal relationship between exposure to dampness and cold and the appearance of the skin lesions suggest a possible pathogenetic mechanism.
 ...
PMID:Plantar hidradenitis in children induced by exposure to wet footwear. 1088 59

Acne inversa (synonyms are hidradenitis suppurativa, pyodermia fistulans sinifica) is a chronic inflammatory disorder of the terminal hair follicles of the intertrigines. Abscesses and fistules develop mostly in both axillae, in the anogenital region, and under the breasts. The disease is common, but the right diagnosis is often missed. Local incision gives only a short relief of pain. The therapy of choice is wide local excision. We report on 12 patients with acne inversa who were surgically treated from 1991-1999 in our department. Surgical results and patient satisfaction were assessed on an average of 4.2 years. In all, 20 excisions in the axillae and 5 excisions anogenital were done. Seven patients were treated preoperatively with isotretinoin over at least 2 months. All patients could move their limbs without trouble. The cosmetic result was good in nine patients and three expressed dissatisfaction. Nine patients did not develop new lesions in the treated area. Three patients had new inflammations in both treated and previously uninvolved and therefore not resected regions. Wide local excision gives very good functional and cosmetic results. It usually heate long-lasting disease for nearly disabled patients. Isotretinoin reduces the disease activity and allows radical surgical treatment.
 ...
PMID:[Acne inversa (hidradenitis suppurativa): early deetection and curative surgery]. 1113 29

Reflex sympathetic dystrophy (RSD) or complex regional pain syndrome type 1, is characterized by spontaneous pain or allodynia and hyperalgesia disproportionate to the inciting event, multiperipheral nerve involvement, edema, vasomotor or sudomotor change, and possible loss of function. It has been described in relation to various insults, including a number of infectious and inflammatory conditions. We report a case of a patient who developed RSD 1 week after an exacerbation of hidradenitis suppurativa, a rare chronic inflammatory disease of apocrine sweat glands. The patient responded well to a combination of range-of-motion exercises, thermal modalities, and oral steroids. Hidradenitis suppurativa should be considered when searching for an etiology of new onset RSD.
 ...
PMID:Reflex sympathetic dystrophy with hidradenitis suppurativa exacerbation: a case report. 1124 66

Idiopathic palmoplantar eccrine hidradenitis (IPPH) is a recently described disorder characterized by painful erythematous plantar nodules and in three cases, showed a typical neutrophilic infiltrate around and within the eccrine sweat apparatus. Five cases of IPPH on the soles of the feet in healthy children are reported. The disorder presented after intense physical activity in four cases. The course was benign and self-limiting. Complete bed rest for several days without any medical therapy led to alleviation of the pain and disappearance of all the lesions. Conclusion. Idiopathic palmoplantar eccrine hidradenitis may be more common than reported. Paediatricians should be aware of it in order to avoid unnecessary diagnostic tests and treatments.
 ...
PMID:Idiopathic palmoplantar eccrine hidradenitis in children. 1127 82


1 2 3 4 5 6 Next >>