eISSN: 2299-0046
ISSN: 1642-395X
Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii
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vol. 36
Letter to the Editor

Acute form of acne inversa in an 18-week pregnant patient: a case study

Katarzyna Plagens-Rotman
Renata Przybylska
Katarzyna Gerke
Krystyna Jaracz
Justyna Serafinowska
Anna Sadowska-Przytocka
Zygmunt Adamski
Magdalena Czarnecka-Operacz

Adv Dermatol Allergol 2019; XXXVI (2): 242-246
Online publish date: 2019/05/14
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Acne inversa (hidradenitis suppurativa/acne inversa – HS/AL) is an acute chronic inflammatory disease occurring in the area of skin folds in the form of painful nodules with the tendency to form fistulae and scarring [1, 2]. Changes cover gluteal and genital areas, groins, inguinal fossa and hairy skin on the head [2–4].
The prevalence rate of HS in Europe ranges between 1% and 4% and the disease is more common among post-pubescent men. Among children acne inverse is extremely rare, diagnosed before the age of 11 [5].
The aim of the study was to present a clinical case and methods of treatment of HS based on the case of an 18-week pregnant woman with an exacerbation of HS treated in 2017 at the Department and Clinic of Dermatology at the University of Medical Sciences in Poznan.
A 30-year-old pregnant woman was admitted to the Dermatology Clinic for treatment of HS. Skin lesions in the form of extensive abscesses and fistulae occur in both groin areas (Figure 1). The disease exacerbation had started at the beginning of the pregnancy. In the past, treatment with isotretinoin and surgical treatment were applied. On admission, the patient was in the 18th week of pregnancy. According to the opinion of the gynaecologist established 2 weeks before hospitalisation, the pregnancy was going well.
The lab tests results had revealed:
leucocytosis (10.02.2017 – 12.26 × 103/µl; 1.03.2017 – 9.40 × 103/µl);
neutrocytosis (10.02.2017 – 9.02 × 103/µl; 1.03.2017 – 6.56 × 103/µl);
reduced haemoglobin levels (10.02.216 – 8.6 g/dl; 1.03.2017 – 8.5 g/dl);
high platelet count (10.02.2017 – 563 × 103/µl; 1.03.2017 – 502 × 103/µl); elevated erythrocyte sedimentation rate (ESR) (10.02.2017 – 109 mm/h; 1.03.2017 – 110 mm/h);
Increased concentration of C-reactive protein (CRP) (10.02.2017 – 85.2 mg/l; 1.03.2017 – 23.8 mg/l);
Increased concentration of AST (10.02.2017 – 41 U/I; 1.03.2017 – 21 U/I).
The patient was consulted gynaecologically. FHR (+), foetal movements (+), no signs of placenta abruption. Standard amount of the amniotic fluid. Vulva with scarring from the basic condition, hyperaemia mucosae. In internal examination: vaginal area formed, cervix smooth, uterine fundus 2 cm below the navel. Correct muscle tension. Recommendations: continued treatment of vaginal mycosis – one Clotrimazole pill inserted in the vagina in the evening. No contraindications to...

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