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The experience of follicular occlusion syndrome treatment with tumor necrosis factor inhibitors

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1. Title Title of document The experience of follicular occlusion syndrome treatment with tumor necrosis factor inhibitors
2. Creator Author's name, affiliation, country Natalya P. Teplyuk; The First Sechenov Moscow State Medical University (Sechenov University)
; Russian Federation
2. Creator Author's name, affiliation, country Svetlana A. Konchina; The First Sechenov Moscow State Medical University (Sechenov University); Russian Federation
2. Creator Author's name, affiliation, country Anna S. Pirogova; The First Sechenov Moscow State Medical University (Sechenov University); Russian Federation
3. Subject Discipline(s)
3. Subject Keyword(s) acne inversa; hidradenitis suppurativa; acne conglobata; dissecting cellulitis of the scalp; perifolliculitis capitis abscedens et suffodiens; follicular occlusion syndrome; adalimumab
4. Description Abstract

Follicular occlusion syndrome consists of several conditions that share similar pathophysiology involving infundibular follicular occlusion and secondary inflammatory cascade. This syndrome includes hidradenitis suppurativa, dissecting cellulitis of the scalp, acne conglobata and pilonidal sinus. They can develop independently or as a component of a syndrome in different combinations.

We are the first to present a clinical case of follicular occlusion tetrad and intermediate therapy outcome with tumor necrosis factor inhibitors. We also provide a full and updated review of the literature on the etiology and pathogenesis, diagnosis and treatment of similar syndromic conditions.

Currently, there is no reliable algorithm of treatment for patients with follicular occlusion syndrome, which underlines the importance of further studies. The presented clinical case confirms the need for timely administration of genetically-engineered biological drugs to patients with diseases of the follicular occlusion group (before sinus tract formation).

5. Publisher Organizing agency, location Eco-Vector
6. Contributor Sponsor(s)
7. Date (DD-MM-YYYY) 21.05.2023
8. Type Status & genre Peer-reviewed Article
8. Type Type Research Article
9. Format File format
10. Identifier Uniform Resource Identifier https://rjsvd.com/1560-9588/article/view/133626
10. Identifier Digital Object Identifier (DOI) 10.17816/dv133626
10. Identifier Digital Object Identifier (DOI) (PDF (Rus)) 10.17816/dv133626-118230
11. Source Title; vol., no. (year) Russian Journal of Skin and Venereal Diseases; Vol 26, No 2 (2023)
12. Language English=en ru
13. Relation Supp. Files Fig. 1. The lesions are located on the scalp, we can see an inflammatory node on the vertex of the scalp with developing scarring alopecia. Cutaneous clefts are visible and more easy to recognize on trichoscopy. (697KB) doi: 10.17816/dv133626-166438
Fig. 2. Note the posterior ear lesions which is an area of occlusion, that can explain why hidradenitis suppurativa manifests there typically. (886KB) doi: 10.17816/dv133626-166439
Fig. 3. Bilateral hidradenitis suppurativa of the armpits, multiple scars on the chest and face as an outcome of acne conglobata. (304KB) doi: 10.17816/dv133626-166444
Fig. 4. Improvement of the skin process in the right inguinal region and scrotum in 29 weeks: incomplete resolution of the lesions, decrease in the severity of inflammatory process, persistence of sinus tracts. Hurley stage III. (2MB) doi: 10.17816/dv133626-166440
Fig. 5. Improvement of the skin process in the inguinal region and scrotum in 29 weeks: no decrease in the number of fistulas with almost complete reduction of inflammatory nodules. Hurley stage II–III. (181KB) doi: 10.17816/dv133626-166441
Fig. 6. Improvement of the skin process in the genital area and pubic region in 29 weeks: partial response of scrotal and penile lymphedema. Note the multiple double-ended pseudocomedones, which are pathognomonic for hidradenitis suppurativa. Hurley stage II–III. (206KB) doi: 10.17816/dv133626-166442
Fig. 7. Improvement of the skin process in the right axillary region in 29 weeks: cessation of discharge in draining sinuses, formation of circinate atrophic scars and scars with chords and double-ended pseudocomedones as an outcome of inflammatory lesions evolution. Hurley stage III. (1MB) doi: 10.17816/dv133626-166443
14. Coverage Geo-spatial location, chronological period, research sample (gender, age, etc.)
15. Rights Copyright and permissions Copyright (c) 2023 Eco-Vector
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