Dermatology
Inflammatory dermatological systemic diseases
The inflammatory dermatological systemic diseases include plaque psoriasis, psoriatic arthritis and acne inversa. The three diseases are closely related to a pathogenetic, immunological cascade in which the key cytokine TNF is involved.1-2
An overview of dermatological diseases
Acne inversa (AI)
Acne inversa (AI), also known as hidradenitis suppurativa (HS), is a chronic, recurrent, mutilating skin disease of the terminal hair sebum system, which usually occurs after puberty and can develop into a scar. Acne inversa manifests as painful, deeply localized, inflamed skin lesions in areas of skin rich in apocrine glands, most commonly in the axillae and the inguinal and anogenital regions. (Dessauer definition)3,4,5,6
Often, deep-seated lumps, abscesses, fistulas and scarring also develop on skin areas that are exposed to constant friction, such as under the breasts and on the inside of the thighs.4,7
Plaque psoriasis
Plaque psoriasis is the most common form of psoriasis. This chronic inflammatory skin disease is multifactorial, shows a genetic predisposition and often progresses in attacks. Psoriasis manifests itself in around 85 percent of cases with sharply defined, red, raised spots on the skin - mostly on the elbows and knees, in the sacrum and on the scalp. These spots are the size of a coin or a palm, often covered with silvery-white scales and itchy.8
Psoriatic arthritis (PsA)
If, in addition to the symptoms of plaque psoriasis, the joints are also affected by chronic inflammation, it is called psoriatic arthritis. In the rheumatic group it is assigned to the seronegative spondylarthritis. These are a group of heterogeneous diseases with common clinical, radiological, and genetic characteristics, such as frequent involvement of the axial skeleton, lack of evidence of rheumatoid factor and an association with HLA-B27.9
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Sources
1. Nast et al. S3 guideline for the therapy of psoriasis vulgaris Update 2017, guideline register 013-001, current status 10/2017.
2. Guidelines of the German Dermatological Society (DDG): Therapy of hidradenitis suppurativa / acne inversa. AWMF Guideline Register No. 013-012. Status: 12/2012.
3. Kurzen H, Kurokawa I, Jemec GBE, Emtestam L, Sellheyer K, Giamarellos-Bourboulis EJ, Nagy I, Bechara FG, Sartorius K, Lapins J, Krahl D, Altmeyer P, Revuz J, Zouboulis CC. What causes hidradenitis suppurativa? Exp Dermatol 17: 455-72, 2008.
4. Jemec BE, Hidradenitis Suppurativa, NEJM 2012, 366 (2) 158-64.
5. Fimmel S, Zouboulis CC. Dermatoendocrinol 2: 9-16, 2010.
6. Zouboulis CC, Tsatsou F. In: Goldsmith LA et al (Eds.) Fitzpatrick's Dermatology In General Medicine. 8th ed, McGraw Hill, New York Chicago, pp 947-59, 2012.
7. Dufour DN, Emtestam L, Jemec GB. Hidradenitis Suppurativa: A Common and Burdensome, Yet Under-Recognized, Inflammatory Skin Disease. Postgrad Med J. 2014; 90 (1062): 216-21.
8. Patient guideline for the treatment of psoriasis of the skin, Deutscher Psoriasis Bund eV (DPB), 4th edition (2018).
9. German Rheumatism League, https://www.rheuma-liga.de/rheuma/krankheitsbilder/psoriasis-arthritis , as of February 3, 2020.