title: Is mechanical stress an important pathogenic factor in hidradenitis suppurativa?
abstract: Hidradenitis suppurativa (HS) is a chronic of recurrent, inflammatory, follicular disease that usually presents after puberty with painful deep-seated, inflamed lesions in the inverse skin areas of the body. It has been hypothesized that mechanical pressure or friction is a risk factor for HS. We describe the case of a man with a lower leg amputation who presented HS-like lesions on his leg stump after wearing a leg prosthesis. Although pilonidal sinus-like disease could not be excluded, we diagnosed him with HS-like lesions, induced by prosthesis-related friction. We argue that this case supports the concept that mechanical friction and a warm humid microclimate by occlusion contribute to HS development.
authors.affiliation: Department of Dermatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: Kim
authors.initials: K
authors.lastname: de Winter
authors.forename: Hessel H
authors.initials: HH
authors.lastname: van der Zee
authors.forename: Errol P
authors.initials: EP
authors.lastname: Prens
mesh_terms: D000328:Adult; D000672:Amputation Stumps; D001186:Artificial Limbs / Q000009:adverse effects*; D017577:Cutaneous Fistula / Q000175:diagnosis / Q000601:surgery; D017497:Hidradenitis Suppurativa / Q000209:etiology*; D006358:Hot Temperature / Q000009:adverse effects; D006801:Humans; D006813:Humidity / Q000009:adverse effects; D007868:Leg Dermatoses / Q000209:etiology*; D008297:Male; D008834:Microclimate; D016459:Prosthesis-Related Infections / Q000150:complications*; D013314:Stress, Mechanical