Severe perineal hidradenitis suppurativa (HS) and anal fistulas. An underrated association?

Abstract Background Due to its multiple forms of debut hidradenitis suppurativa has classically been a diagnostic challenge as well in the differential diagnosis. Prevalence of perianal fistula in patients with hidradenitis suppurativa ranges form 6,6% to 67%. The aim of the study was to assess bot...

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Autores principales:	Juan Carlos Bernal-Sprekelsen, Laura Gómez Romero, Jorge Tárraga Soriano, José Puche Plà, Guillermo Felipe Valderas Cortés, Antonio Melero Abellán
Formato:	article
Lenguaje:	EN
Publicado:	Shiraz University of Medical Sciences 2020
Materias:	hidradenitis suppurativa anal fistula crohn’s disease diagnosis of hidradenitis suppurativa Medicine R
Acceso en línea:	https://doaj.org/article/33651a20612f4af086611686623ef2db
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spelling	oai:doaj.org-article:33651a20612f4af086611686623ef2db2021-11-14T08:12:11ZSevere perineal hidradenitis suppurativa (HS) and anal fistulas. An underrated association?2783-243010.30476/acrr.2020.46748https://doaj.org/article/33651a20612f4af086611686623ef2db2020-06-01T00:00:00Zhttps://colorectalresearch.sums.ac.ir/article_46748_f06639b2064833ea9dc0cf2ac4bdc7ac.pdfhttps://doaj.org/toc/2783-2430Abstract Background Due to its multiple forms of debut hidradenitis suppurativa has classically been a diagnostic challenge as well in the differential diagnosis. Prevalence of perianal fistula in patients with hidradenitis suppurativa ranges form 6,6% to 67%. The aim of the study was to assess both conditions. Methods A retrospective chart review from 2000 to 2018 using the ICD-9-CM, coded with 705.83. for patients with hidradenitis suppurativa was conducted. Hurley’s three stage classification was applied. Diagnosis and relevant patient characteristics were assessed and the presence of associated perianal fistula. Endoa-nal ultrasound (EAU) was performed in 61% of the patients with perianal hidradenitis and perianal fistu-la, and magnetic resonance imaging (MRI) in 19%. Results Of 143 cases with hidradenitis, sixty two cases (43,4%) presented perianal (perineal/buttocks) location. Of them 93,5% were men. Twenty-one percent were associated with perianal fistulas being 6 of them complex ones associated with Hurley stage II and III. Treatment for the latter included: loose setons in 4 patients with Crohn’s disease and in 2 non Crohn’s disease with complex fistulas, 4 fistulotomies and 2 fistulectomies in low transphincteric fistulas and 1 with incision and drainage. Conclusion Perianal fistula should be treated according to associated diseases and type of fistula. Association of hidradenitis and perianal fistulas may be higher than expected and the relation of severe hidradenitis with complex perianal fistulas should be studied further. Endoanal ultrasound and MRI may be useful tools to assess HS with complex perianal fistulas, but the iconographic patterns of hidradenitis and Crohn’s disease should be kept in mind as both may be associated.Juan Carlos Bernal-SprekelsenLaura Gómez RomeroJorge Tárraga SorianoJosé Puche PlàGuillermo Felipe Valderas CortésAntonio Melero AbellánShiraz University of Medical Sciencesarticlehidradenitis suppurativaanal fistulacrohn’s diseasediagnosis of hidradenitis suppurativaMedicineRENIranian Journal of Colorectal Research, Vol 8, Iss 2, Pp 88-92 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	hidradenitis suppurativa anal fistula crohn’s disease diagnosis of hidradenitis suppurativa Medicine R
spellingShingle	hidradenitis suppurativa anal fistula crohn’s disease diagnosis of hidradenitis suppurativa Medicine R Juan Carlos Bernal-Sprekelsen Laura Gómez Romero Jorge Tárraga Soriano José Puche Plà Guillermo Felipe Valderas Cortés Antonio Melero Abellán Severe perineal hidradenitis suppurativa (HS) and anal fistulas. An underrated association?
description	Abstract Background Due to its multiple forms of debut hidradenitis suppurativa has classically been a diagnostic challenge as well in the differential diagnosis. Prevalence of perianal fistula in patients with hidradenitis suppurativa ranges form 6,6% to 67%. The aim of the study was to assess both conditions. Methods A retrospective chart review from 2000 to 2018 using the ICD-9-CM, coded with 705.83. for patients with hidradenitis suppurativa was conducted. Hurley’s three stage classification was applied. Diagnosis and relevant patient characteristics were assessed and the presence of associated perianal fistula. Endoa-nal ultrasound (EAU) was performed in 61% of the patients with perianal hidradenitis and perianal fistu-la, and magnetic resonance imaging (MRI) in 19%. Results Of 143 cases with hidradenitis, sixty two cases (43,4%) presented perianal (perineal/buttocks) location. Of them 93,5% were men. Twenty-one percent were associated with perianal fistulas being 6 of them complex ones associated with Hurley stage II and III. Treatment for the latter included: loose setons in 4 patients with Crohn’s disease and in 2 non Crohn’s disease with complex fistulas, 4 fistulotomies and 2 fistulectomies in low transphincteric fistulas and 1 with incision and drainage. Conclusion Perianal fistula should be treated according to associated diseases and type of fistula. Association of hidradenitis and perianal fistulas may be higher than expected and the relation of severe hidradenitis with complex perianal fistulas should be studied further. Endoanal ultrasound and MRI may be useful tools to assess HS with complex perianal fistulas, but the iconographic patterns of hidradenitis and Crohn’s disease should be kept in mind as both may be associated.
format	article
author	Juan Carlos Bernal-Sprekelsen Laura Gómez Romero Jorge Tárraga Soriano José Puche Plà Guillermo Felipe Valderas Cortés Antonio Melero Abellán
author_facet	Juan Carlos Bernal-Sprekelsen Laura Gómez Romero Jorge Tárraga Soriano José Puche Plà Guillermo Felipe Valderas Cortés Antonio Melero Abellán
author_sort	Juan Carlos Bernal-Sprekelsen
title	Severe perineal hidradenitis suppurativa (HS) and anal fistulas. An underrated association?
title_short	Severe perineal hidradenitis suppurativa (HS) and anal fistulas. An underrated association?
title_full	Severe perineal hidradenitis suppurativa (HS) and anal fistulas. An underrated association?
title_fullStr	Severe perineal hidradenitis suppurativa (HS) and anal fistulas. An underrated association?
title_full_unstemmed	Severe perineal hidradenitis suppurativa (HS) and anal fistulas. An underrated association?
title_sort	severe perineal hidradenitis suppurativa (hs) and anal fistulas. an underrated association?
publisher	Shiraz University of Medical Sciences
publishDate	2020
url	https://doaj.org/article/33651a20612f4af086611686623ef2db
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Severe perineal hidradenitis suppurativa (HS) and anal fistulas. An underrated association?

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