Is Mechanical Stress an Important Pathogenic Factor in Hidradenitis Suppurativa?
Synopsis:
In summary, we present a patient with inflammatory lesions, resembling HS, at an ectopic location free of apocrine sweat glands and probably induced by a leg prosthesis. We argue that predilection sites of HS are not characterized by the presence of apocrine sweat glands but instead by mechanical friction and a warm humid, occlusive microclimate favorable to bacteria.
Hidradenitis suppurativa (HS) is a chronic of recurrent, inflammatory, follicular disease that usually presents after puberty with painful deep-seated, inflamed lesions in the inverse skin areas of the body. It has been hypothesized that mechanical pressure or friction is a risk factor for HS. We describe the case of a man with a lower leg amputation who presented HS-like lesions on his leg stump after wearing a leg prosthesis. Although pilonidal sinus-like disease could not be excluded, we diagnosed him with HS-like lesions, induced by prosthesis-related friction. We argue that this case supports the concept that mechanical friction and a warm humid microclimate by occlusion contribute to HS development.
Research Synopsis:
https://pubmed.ncbi.nlm.nih.gov/22379963
Full Research Circulation:
https://onlinelibrary.wiley.com/doi/full/10.1111/j.1600-0625.2012.01443.x