Abstract:
Genital lymphoedema is a rare but debilitating and disfiguring complication of longstanding hidradenitis suppurativa (HS). Despite the existence of medical and surgical methods that offer varying success rates in a limited number of cases, no data exist about the use of complex decongestive therapy (CDT) in HS-related genital lymphoedema. This case report describes the treatment and outcome of a 56-year-old male patient with severe scrotal lymphoedema due to underlying HS (Hurley stage 3). The patient was unresponsive to various topical and systemic antibiotics and biological agents, including adalimumab and certolizumab pegol. When the patient was assessed, ixekizumab treatment for his HS was planned. He had progressive oedema in the genital area for two years with difficulty in wearing trousers and having sexual intercourse, and painful urination. CDT was recommended for three days a week concurrently with ixekizumab treatment. The patient and his wife were also educated about self-drainage techniques and skincare maintenance. After six sessions of CDT over 14 days, the patient demonstrated a significant reduction in scrotal measurements. He achieved a better scrotal contour, the degree of the buried penis was decreased, and urination was easier and painless. The findings of this case report showed that CDT was an easily applicable, practical and promising method that offered a rapid treatment response for HS-related genital lymphoedema.
摘要:
生殖器淋巴水肿是长期化脓性汗腺炎(HS)的罕见但使人衰弱和毁容的并发症。尽管存在在有限数量的病例中提供不同成功率的医疗和手术方法,没有关于HS相关的生殖器淋巴水肿使用复杂的减充血疗法(CDT)的数据.该病例报告描述了一名56岁男性患者的治疗和结果,该患者因基础HS(Hurley3期)而患有严重的阴囊淋巴水肿。患者对各种局部和全身抗生素和生物制剂无反应,包括阿达木单抗和塞妥珠单抗。对患者进行评估时,已计划对他的HS进行ixekizumab治疗.他在生殖器区域进行性水肿两年,难以穿裤子和性交,和痛苦的排尿。建议CDT每周三天,同时使用ixekizumab治疗。患者和他的妻子还接受了有关自我引流技术和皮肤护理维护的教育。经过14天的六次CDT,患者的阴囊测量值明显减少.他获得了更好的阴囊轮廓,阴茎被埋的程度降低了,排尿更容易和无痛。此病例报告的结果表明,CDT是一种易于应用的,实用和有前途的方法,为HS相关的生殖器淋巴水肿提供了快速的治疗反应。