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Hidradenitis Suppurativa as a Systemic Disease: Association With Metabolic Syndrome
La hidradenitis supurativa como enfermedad sistémica: asociación a síndrome metabólico
A. Martorell
Servicio de Dermatología, Hospital de Manises, Valencia, España
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Martorell" "autores" => array:1 [ 0 => array:3 [ "nombre" => "A." "apellidos" => "Martorell" "email" => array:1 [ 0 => "antmarto@hotmail.com" ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Dermatología, Hospital de Manises, Valencia, España" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "La hidradenitis supurativa como enfermedad sistémica: asociación a síndrome metabólico" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Dermatologic treatment of hidradenitis suppurativa (HS) has become challenging in recent years both because of the complexity of the disease itself and because a multidisciplinary focus is often needed to manage the full range of its debilitating and progressive effects.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The systematic review and meta-analysis by Rodriguez-Zuñiga et al<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> in this issue found that HS is associated with metabolic syndrome (MS) in up to 9.64% of cases. Risk for MS is 2-fold higher in HS than in both adults and children without the disease. The HS–MS association leads to a greater chance of comorbidity and complications for the patient, and the concomitant conditions that develop have implications for the therapeutic management of HS.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">It has been suggested that the HS-MS association is due to chronic systemic and cutaneous inflammation and that the higher levels of such cytokines as interleukin (IL) 17, IL-1b, IL-10, tumor necrosis factor, and IL-23 will lead to insulin resistance, which will in turn lead to endothelial damage and cardiovascular disease.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">In fact, the association of both HS and MS with hypertension, diabetes, dyslipidemia, and obesity is significantly stronger in patients receiving specialist care than in those treated elsewhere. The likely explanation for this observation is that tertiary care hospitals treat more aggressive forms of HS and that these forms correlate positively with higher rates of MS.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Screening for the various conditions that make up MS should therefore be a key step in achieving integrated management of HS.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0030" class="elsevierStylePara elsevierViewall">A. Martorell declares that he has been a consultant for several pharmaceutical laboratories, including Pfizer, AbbVie, Novartis, Jansen Cilag, Lilly, Leo Pharma, Merk Sharp and Dohme, Isdin, Viñas, Celgene, Pierre Fabre, and UCB.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of Interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Martorell A. La hidradenitis supurativa como enfermedad sistémica: asociación a síndrome metabólico. Actas Dermosifiliogr. 2019;110:259.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "European S1 guideline for the treatment of hidradenitis suppurativa/acne inversa" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.C. Zouboulis" 1 => "N. Desai" 2 => "L. Emtestam" 3 => "R.E. Hunger" 4 => "D. Ioannides" 5 => "I. Juhász" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/jdv.12966" "Revista" => array:6 [ "tituloSerie" => "J Eur Acad Dermatol Venereol." "fecha" => "2015" "volumen" => "29" "paginaInicial" => "619" "paginaFinal" => "644" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25640693" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Asociación entre la hidradenitis supurativa y el síndrome metabólcio: Revisión sistemática y metaanálisis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.J.M. Rodríguez-Zuñiga" 1 => "H.A. García-Perdomo" 2 => "A.C. Ortega-Loayza" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ad.2018.10.020" "Revista" => array:2 [ "tituloSerie" => "Actas Dermofiliogr." 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"fecha" => "2018" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Patients with hidradenitis suppurativa carry a higher systemic inflammatory load than other dermatological patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "P.T. Riis" 1 => "K. Soeby" 2 => "D.M. Saunte" 3 => "G.B. Jemec" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00403-015-1596-5" "Revista" => array:6 [ "tituloSerie" => "Arch Dermatol Res." 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