title: Remission of refractory pyoderma gangrenosum, severe acne, and hidradenitis suppurativa (PASH) syndrome using targeted antibiotic therapy in 4 patients.
abstract: Pyoderma gangrenosum, severe acne, and suppurative hidradenitis (PASH) syndrome can prove refractory to treatment and is characterized by relapses and recurrences. The combination of antibiotic therapy and surgery can produce success in the management of the syndrome. Acute treatment is required, but maintenance therapy is also necessary to prevent disease relapse. The response to antibiotic therapy is hypothesis generating, raising the issue of a modified host response. To date, anecdotal reports support the use of surgery and medical therapy, but controlled investigations with extended follow-up are necessary to substantiate preliminary data observed with individual cases.
authors.affiliation: INSERM U1151 eq. 11, Université Paris Descartes - Sorbonne Paris Cité, Laboratory of Microbiology, Necker-Enfants Malades Hospital, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Join-Lambert
authors.affiliation: INSERM UMR 1163, Laboratory of Genetic Skin Diseases: from Disease Mechanism to Therapies, Paris Descartes - Sorbonne Paris Cité University, Imagine Institute, Paris, France.
authors.forename: Sabine
authors.initials: S
authors.lastname: Duchatelet
authors.affiliation: Institut Pasteur, Medical Center, Paris, France.
authors.forename: Maïa
authors.initials: M
authors.lastname: Delage
authors.affiliation: INSERM UMR 1163, Laboratory of Genetic Skin Diseases: from Disease Mechanism to Therapies, Paris Descartes - Sorbonne Paris Cité University, Imagine Institute, Paris, France.
authors.forename: Snaigune
authors.initials: S
authors.lastname: Miskinyte
authors.affiliation: Department of Infectious Diseases, Hôpital Necker-Enfants Malades, Paris, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Coignard
authors.affiliation: Institut de Proctologie Léopold Bellan, Hôpital St Joseph, Paris, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Lemarchand
authors.affiliation: Department of Gastroenterology, Centre Hospitalier, Salons de Provence, France.
authors.forename: Murielle
authors.initials: M
authors.lastname: Alemy-Carreau
authors.affiliation: Department of Infectious Diseases, Hôpital Necker-Enfants Malades, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Lortholary
authors.affiliation: INSERM U1151 eq. 11, Université Paris Descartes - Sorbonne Paris Cité, Laboratory of Microbiology, Necker-Enfants Malades Hospital, Paris, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Nassif
authors.affiliation: INSERM UMR 1163, Laboratory of Genetic Skin Diseases: from Disease Mechanism to Therapies, Paris Descartes - Sorbonne Paris Cité University, Imagine Institute, Paris, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Hovnanian
authors.affiliation: Institut Pasteur, Medical Center, Paris, France. Electronic address: anassif@pasteur.fr.
authors.forename: Aude
authors.initials: A
authors.lastname: Nassif
mesh_terms: D000152:Acne Vulgaris / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D016503:Drug Delivery Systems / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D017497:Hidradenitis Suppurativa / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D006801:Humans; D008297:Male; D064307:Microbiota / Q000187:drug effects; D017511:Pyoderma Gangrenosum / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D012494:Sampling Studies; D012720:Severity of Illness Index; D012867:Skin / Q000187:drug effects / Q000382:microbiology; D013577:Syndrome; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: PASH syndrome; acne fulminans; antibiotic therapy; hidradenitis suppurativa; microbiome host disease; pyoderma gangrenosum; remission; severe acne