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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Dermatologic treatment of hidradenitis suppurativa &#40;HS&#41; 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&#46;<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-Zu&#241;iga et al<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> in this issue found that HS is associated with metabolic syndrome &#40;MS&#41; in up to 9&#46;64&#37; of cases&#46; Risk for MS is 2-fold higher in HS than in both adults and children without the disease&#46; The HS&#8211;MS association leads to a greater chance of comorbidity and complications for the patient&#44; and the concomitant conditions that develop have implications for the therapeutic management of HS&#46;<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 &#40;IL&#41; 17&#44; IL-1b&#44; IL-10&#44; tumor necrosis factor&#44; and IL-23 will lead to insulin resistance&#44; which will in turn lead to endothelial damage and cardiovascular disease&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">In fact&#44; the association of both HS and MS with hypertension&#44; diabetes&#44; dyslipidemia&#44; and obesity is significantly stronger in patients receiving specialist care than in those treated elsewhere&#46; 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&#46;<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&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0030" class="elsevierStylePara elsevierViewall">A&#46; Martorell declares that he has been a consultant for several pharmaceutical laboratories&#44; including Pfizer&#44; AbbVie&#44; Novartis&#44; Jansen Cilag&#44; Lilly&#44; Leo Pharma&#44; Merk Sharp and Dohme&#44; Isdin&#44; Vi&#241;as&#44; Celgene&#44; Pierre Fabre&#44; and UCB&#46;</p></span></span>"
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Commentaries
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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    "titulo" => "Hidradenitis Suppurativa as a Systemic Disease&#58; Association With Metabolic Syndrome"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Dermatologic treatment of hidradenitis suppurativa &#40;HS&#41; 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&#46;<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-Zu&#241;iga et al<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> in this issue found that HS is associated with metabolic syndrome &#40;MS&#41; in up to 9&#46;64&#37; of cases&#46; Risk for MS is 2-fold higher in HS than in both adults and children without the disease&#46; The HS&#8211;MS association leads to a greater chance of comorbidity and complications for the patient&#44; and the concomitant conditions that develop have implications for the therapeutic management of HS&#46;<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 &#40;IL&#41; 17&#44; IL-1b&#44; IL-10&#44; tumor necrosis factor&#44; and IL-23 will lead to insulin resistance&#44; which will in turn lead to endothelial damage and cardiovascular disease&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">In fact&#44; the association of both HS and MS with hypertension&#44; diabetes&#44; dyslipidemia&#44; and obesity is significantly stronger in patients receiving specialist care than in those treated elsewhere&#46; 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&#46;<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&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0030" class="elsevierStylePara elsevierViewall">A&#46; Martorell declares that he has been a consultant for several pharmaceutical laboratories&#44; including Pfizer&#44; AbbVie&#44; Novartis&#44; Jansen Cilag&#44; Lilly&#44; Leo Pharma&#44; Merk Sharp and Dohme&#44; Isdin&#44; Vi&#241;as&#44; Celgene&#44; Pierre Fabre&#44; and UCB&#46;</p></span></span>"
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