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Sábado, 1 de febrero 2025, 20:07
Dermatology Department at the General University Hospital Doctor Balmis, led by Dr. José Bañuls, has a dedicated clinic for hidradenitis suppurativa, one of the oldest in Spain. Since its inception in 2014, it has treated nearly 1,000 patients with this complex condition.
Hidradenitis suppurativa is an immune-mediated, chronic, and recurrent dermatological disease affecting 1% of the population. It is more common in women and usually appears after adolescence. It is characterised by the recurrent appearance of nodules, abscesses, and skin fistulas in the armpits, breasts, groin, buttocks, and perineum.
"This condition is associated with diagnostic challenges, as patients are often misdiagnosed with abscesses, boils, fistulas, etc., leading to a delay of around seven years in diagnosis. Additionally, the impact on patients' quality of life is greater than in other dermatological diseases, as it is particularly painful and difficult to manage, and is associated with multiple comorbidities such as metabolic syndrome, fatty liver, and depression," stated Dr. Pascual, head of the dedicated clinic.
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Early treatment of hidradenitis prevents progression to more advanced and complex forms of the disease. "A mixed medical and surgical approach is necessary. Until 2015, no medication was approved for these patients, but fortunately, there are now three biological drugs indicated for this condition, allowing control of inflammatory activity. Subsequently, surgery plays an important role, repairing structural damage, such as skin fistulas and scars, caused by the disease," emphasised Dr. Pascual.
Specifically, the surgery involves removing damaged tissues and functionally reconstructing the affected area. A benefit of this approach by Dermatology is that most interventions are performed with sedation and, therefore, without hospitalisation.
In this regard, the Dermatology Department has extensive experience in this type of surgery, which requires specialised training. Through courses like the one held, the aim is to facilitate its expansion to other hospital centres.
"From the dedicated clinic, we offer comprehensive medical-surgical assistance and coordinate multidisciplinary work, collaborating with various services for managing patients with greater complexity; among them, Plastic Surgery, General Surgery, Urology, Gynaecology, and Emergency, as the latter often refers patients to the specialised Dermatology clinic," remarked the specialist.
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Furthermore, within this multidisciplinary approach, it is noteworthy that the Dermatology clinic involves specialised medical and nursing intervention. The latter receives the patient, determines their level of activity and quality of life impact, and also offers health education for managing comorbidities, following healthy lifestyle habits (such as quitting smoking, which is a significant risk factor), in addition to managing surgical wounds.
"It is noteworthy that we also actively participate in international publications and communications derived from our own studies, conducted through the Alicante Institute for Health and Biomedical Research (ISABIAL). Additionally, we regularly participate in clinical trials, facilitating our patients' access to drugs not yet marketed," added Dr. Pascual.
Similarly, the team maintains an excellent relationship with the Association of Hidradenitis Patients (ASENDHI), which has a national registry, listing the Alicante hospital as a specialised centre for the condition.
From this clinic, the first 'Live Surgery Course on Hidradenitis Suppurativa' has been launched, held this week at the Alicante centre. It is a training that comprised two days, during which a dozen cases of live dermatological surgery were performed.
The training was conducted by the three professionals who perform surgical interventions on these patients, Drs. José Carlos Pascual, José Pedro Devesa, and Jaime Guijarro, and was aimed at dermatologists, as well as other specialists interested in the condition.
Thus, around twenty professionals from different centres in the provinces of Alicante, Murcia, and Albacete had the opportunity to attend these highly challenging interventions from a room adjacent to the operating theatre.
According to Dr. José Carlos Pascual, "the course offers a theoretical first part on the importance of dermatological surgery for treating hidradenitis suppurativa and a second part of live surgery."
"We discuss with attendees the cases we are going to operate on, considering the different surgical options and, after the surgery, we examine how we resolved each case to consolidate the knowledge," concluded Dr. Pascual.
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