215 ACNE INVERSA (HURLEY CLINICAL STAGE II): CASE REPORT ACNE INVERSA (HURLEY - ZAAWANSOWANIE KLINICZNE II’): OPIS PRZYPADKU Anca Chiriac 1 , Liliana Foia 2 , Tudor Pinteala 3 , Anca E. Chiriac 4 1 CMI Dermatology-Iasi,Romania 2 Univ.of Medicine Gr T Popa, Biochemistry Department, Iasi-Romania 3 Imperial College of London, UK 4 Univ.of Medicine Gr T Popa Iasi-Romania Corresponding author: Anca Chiriac, MD PhD ancachiriac@yahoo.com Our Dermatol Online. 2011; 2(4): 215-216 Date of submission: 10.06.2011 / acceptance: 28.07.2011 Conflicts of interest: None Abstract We present a case of acne inversa Hurley clinical stage II, to a 28 year-old patient non-obese, smoker, with a long history of firm nodules, large abscesses and sinous tracts, small scars, distributed in the axillary, groin, perianal and infraumbilical areas, associated with lesions on the face. Any therapeutic schemas ( antibiotics, Isotretinoin orally, Dapsone, UVB,cryotherapy) was unsuccesfully and we sent the patient to Surgery Department for wide excisions. Streszczenie Prezentujemy przypadek trądziku odwróconego w II etapie zaawansowania klinicznego Hurley, u 28-letniego pacjenta bez otylości, palącego papierosy, z dlugą historią guzków, duŜych ropni, przetok, malych blizn, zlokalizowanych w dolach pachowych, w pachwinach, w okolicy odbytu i w obszarach poniŜej pępka, związane ze zmianami na twarzy. Wszelkie schematy terapeutyczne (antybiotyki, izotretynoina doustna, dapson, UVB, krioterapia) byl nieskuteczne, w związku z tym wyslaliśmy pacjenta do Oddzialu Chirurgii celem opracowania chirurgicznego. Key words: acne inversa; Isotretinoin; Dapsone; UVB; surgery Slowa klucze: trądzik odwrócony; Isotretinoina; Dapson, UVB; chirurgia Introduction Hidradenitis suppurativa (from the Greek hidros = sweat and aden = glands) is a chronic follicular occlusive disease involving the intertriginous skin of the axillary, groin, perianal, and inframammary regions. Author Year Name of the disease Velpeau - surgeon from Paris 1839 first description: axillaray, submamary and perianal abcesses Verneuil -Paris 1854 first name: hidrosadenite phlegmoneuse first pathogenic mechanism: inflamation of sweat glands Schiefferdecker 1922 association acne-appocrine sweat glands Pilsburry 1956 acne triad: hidradenitis suppurativa+acne conglobata+perifolliculitis capitis abscendens et suffodiens and the cause: follicular oclusion Plewig-Kligman 1975 acne tetrad: acne triad+pilonidal sinous Plewig-Steger 1989 introduced the term: acne inversa (term accepted today all the world) Recent studies 2000 genetic disease? Table 1. History of the disease Case Report / Opis przypadku © Our Dermatol Online 4.2011