Background
Hidradenitis suppurativa (HS), or acne inversa, is a chronic inflammatory skin disease
characterized by abscesses, fistulating sinus tracts, and scarring. The exact pathogenesis
of this disease remains unclear. We present our experience with HS and a possible
cause of the disease and offer a surgical and clinical treatment that allows for disease
resolution.
Methods
We studied 12 patients who presented with axillary and perineal fistulas and underwent
surgical excision (repaired by skin grafts or healing by secondary intention) or localized
treatments followed by diet modification. All patients were found to have a specific
immunology IgG reaction to brewer's yeast and wheat and were put on a controlled brewer's
yeast–free diet for 12 months and followed monthly.
Results
The diet demonstrated immediate stabilization of their clinical symptoms, and the
skin lesions regressed over the 12-month treatment period. Similarly, all the patients
demonstrated an immediate recurrence of skin lesions following accidental or voluntary
consumption of beer or other foods containing brewer's yeast or wheat. The patients
also demonstrated a return of their quality of life and activities, including the
reestablishment of sexual activity in the patients with inguinal and perigenital lesions.
Conclusion
The results of the investigation suggested that the patients had severe reactions
to brewer's yeast. Surgery followed by the elimination of the foods containing or
made with the yeast resulted in a rapid stabilization of the dermatologic manifestation
and a slow, but complete, regression of the skin lesions within a year. Despite the
small number of patients in our study, our study could provide the basis for extensive
and multicentric studies in order to better investigate this disabling and rare disease.
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Article info
Publication history
Published online: July 29, 2013
Accepted:
April 11,
2013
Identification
Copyright
© 2013 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
