Should Hidradenitis Suppurativa Be Included in Dermatoses Showing Koebnerization? Is It Friction or Fiction?

Dermatology : International Journal for Clinical and Investigative Dermatology
Jurr Boer

Abstract

The etiology of hidradenitis suppurativa (HS) involves genetic and environmental factors. Well-established associated systemic factors are obesity, smoking, inflammation, and bacteria. Whether localized environmental factors such as friction and pressure may also play a causative role is still unclear. To describe the possible Koebner phenomenon (KP) in HS. The case notes on 14 patients with typical HS and additional HS lesions in previously uninvolved skin areas exposed to mechanical stress, e.g., on the abdomen at the level of the waistband, were reviewed with regard to the clinical characteristics of the cohort. All 14 patients (7 females) were obese with a mean BMI of 35.8 (range 30.1-45.0). All patients developed additional ectopic HS lesions at the sites of friction on the convex abdomen. The ectopic lesions were clinically and histopathologically similar to HS. Mechanical stress factors or trauma play a role in obese patients with HS. It is suggested that these new induced lesions fit the concept of the KP. This phenomenon seems to occur in the so-called frictional furunculoid type of HS and may explain the unique distribution at certain localizations on the body of this follicular cutaneous eruption. Removal in an early...Continue Reading

Citations

Nov 28, 2017·Journal of the European Academy of Dermatology and Venereology : JEADV·J Boer
Sep 25, 2017·Journal of the European Academy of Dermatology and Venereology : JEADV·P Theut RiisG B E Jemec
May 21, 2019·The Journal of Dermatological Treatment·Aleksi J HendricksVivian Y Shi
Jun 6, 2019·Anais Brasileiros De Dermatologia·Renata Ferreira MagalhãesAndrea Machado Coelho Ramos
Jul 30, 2019·International Wound Journal·Maria Letizia MusumeciGiuseppe Micali
Sep 11, 2019·Journal of Cutaneous Medicine and Surgery·Arunima SivanandPatrick J Fleming
May 28, 2020·Journal of the European Academy of Dermatology and Venereology : JEADV·T V NguyenG B Jemec
Aug 8, 2020·American Journal of Clinical Dermatology·Øystein GrimstadCarl Swartling
Jun 23, 2020·Case Reports in Obstetrics and Gynecology·K M DarchL J Spelman
Mar 14, 2020·Nature Reviews. Disease Primers·Robert SabatKerstin Wolk
Nov 2, 2019·SAGE Open Medical Case Reports·Afsaneh AlaviChristian Pagnoux
Mar 5, 2021·Curēus·Nikolas Gutierrez, Philip R Cohen
May 22, 2021·Experimental Dermatology·Stephanie L SchellAmanda M Nelson
Jan 7, 2020·Dermatology : International Journal for Clinical and Investigative Dermatology·Farida BenhadouPhilippe Guillem
Jul 14, 2020·Skin Appendage Disorders·Efthimia AgiasofitouGeorge Kontochristopoulos

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