AI Article Synopsis
- Hidradenitis suppurativa (HS) and Crohn's disease (CD) share some pathogenic similarities, but recent studies reveal significant differences in their clinical and immunological profiles.
- Next-generation sequencing shows HS tunnels are primarily associated with bacteria like Porphyromonas and Prevotella, while no specific bacteria have been linked to cutaneous CD.
- Imaging techniques, like ultrasound for HS and MRI for CD, highlight distinct structural features, underscoring the need for accurate differentiation to improve treatment strategies for these challenging conditions.
Article Abstract
Hidradenitis suppurativa (HS) tunnels and Crohn's disease (CD) fistulas are a challenge to treat. Although pathogenic similarities have been described between HS and CD, recent studies indicate that clinical, microbiological, immunological and imaging characteristics differ between these diseases. This review highlights the differences between HS tunnels and CD fistulas. Next-generation sequencing studies demonstrate a microbiome in HS tunnels dominated by Porphyromonas spp., Prevotella spp. whereas no specific bacteria have been associated with cutaneous CD. Immunologically, TNF has been found upregulated in HS tunnels along with various interleukins (IL-8, IL-16, IL-1α and IL-1β). In CD fistulas, Th1, Th17, IL-17, IFN-ɤ, TNF and IL-23 are increased. US imaging is an important tool in HS. US of HS tunnels depict hypoechoic band-like structure across skin layers in the dermis and/or hypodermis connected to the base of a widened hair follicle. In CD, MR imaging of simple perianal fistulas illustrates a linear, non-branching inflammatory tract relating to an internal opening in the anus or low rectum and an external opening to the skin surface. An increased awareness of the immediate potential differences between HS tunnels and CD fistulas may optimize treatment regimens of these intractable skin manifestations.
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| http://dx.doi.org/10.1111/exd.14036 | DOI Listing |
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