Vulvar and perineal verrucous changes complicating hidradenitis suppurativa after wide excision: a c...

مرکز و کتابخانه مطالعات اسلامی به زبان های اروپایی

منو

" Vulvar and perineal verrucous changes complicating hidradenitis suppurativa after wide excision: a case and literature review "
Ward, Rachael A; Udechukwu, Nneka S; Selim, Maria A; Jaleel, Tarannum

Document Type	:	AL
Record Number	:	923241
Doc. No	:	LA3d37n310
Language of Document	:	English
Main Entry	:	Ward, Rachael A; Udechukwu, Nneka S; Selim, Maria A; Jaleel, Tarannum
Title & Author	:	Vulvar and perineal verrucous changes complicating hidradenitis suppurativa after wide excision: a case and literature review [Article]\ Ward, Rachael A; Udechukwu, Nneka S; Selim, Maria A; Jaleel, Tarannum
Title of Periodical	:	Dermatology Online Journal
Volume/ Issue Number	:	26/7
Date	:	2020
Abstract	:	Poorly controlled and long-standing hidradenitis suppurativa (HS) increases the risk of squamous cell carcinoma (SCC). We report a 54-year-old woman with an over 20-year history of HS, who had previously undergone wide perineal excision with secondary intention healing and presented with a painful verrucous vulvar plaque and proximal non-healing perineal wound. The patient had four perineal scouting biopsies performed and excisional biopsy with no evidence of high-grade dysplasia or carcinoma on histology. Chromogenic in situ hybridization was negative for HPV 16 and 18 mRNA; the patient's HIV and HSV PCR were also negative. Our patient was treated with interferon alfa-2b with notable clinical improvement. There is currently no standardized stepwise approach to monitoring verrucous lesions in HS patients with significant risk factors for SCC. Our report highlights a vigilant approach to monitoring. If scouting biopsies are negative, complete testing for high risk HPV strains (HPV 16 and 18) is warranted. If negative, we recommend follow up every 6 months with no further biopsies except if overt clinical changes are observed. We also recommend treatment of verrucous changes to decrease risk of possible malignant conversion. Interferon alfa-2b was effective in decreasing the verrucous lesion burden in our patient and may be considered.