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Biofilms and Hidradenitis Suppurativa (HS)

Hidradenitis suppurativa (HS) is a disease of the hair follicles characterized by pimple-like bumps on the skin that can grow deep into the skin and are often painful. When they rupture, they leak a foul-smelling pus. Biofilm-driven diseases are characterized by prolonged inflammation, resistance to treatment with antibiotic therapy, and exhibit impaired wound healing. Because HS has many of those characteristics, and the fact that HS lesions contain keratin debris and hair fragments (which provide a vehicle to promote biofilm growth), it has been suggested that biofilms play a role in HS.

A recent study sought to determine and quantify the potential presence of bacterial aggregates in chronic HS lesions. Biopsies were obtained from 42 patients with physician-verified diagnosis of HS, which yielded more than 300 samples for examination. Overall, biofilms (bacterial aggregates) were seen in 67% of the samples of chronic lesions and in 75% of the perilesional samples. In areas such as hair follicles and sinus tracts, large biofilms were often observed.

The authors speculate that deep-seated HS nodules and dilated hair follicles as well as sinus tracts provide ideal conditions for bacterial growth. The authors conclude that biofilms may play a role in chronic lesions in HS; both by promoting chronicity as well as recalcitrance towards antibiotic treatment. Early surgical excision of chronic HS lesions or deroofing, may be helpful in the removal of otherwise intractable biofilms.


Byline: Martha L. Sikes, MS, RPh, PA-C

Posted: May 15, 2017

Source: Wiley Online Library
Adapted from the original article.

[Image: DermNet New Zealand]

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