Mammary Hidradenitis Suppurativa Lesions – A Suggestion for Phenotyping

Background: Hidradenitis suppurativa (HS) is an under-diagnosed chronic inflammatory skin disease of the pilosebaceous unit of apocrine gland-rich parts of the body. The mammary area is the fourth most HS-affected area and, as typical lesions include non-fluctuating nodules, abscesses, and tunnels/sinus tracts, mammary HS is often mistaken for other mammary “boils”, such as sub-areolar and granulomatous non-lactating breast abscesses. Our objective was to present a spectrum of mammary HS lesions, explore a possible classification, and expose mammary HS as a possible differential diagnosis to non-lactational breast abscesses. Methods: A cross-sectional study on current and newly-referred patients treated for HS affecting the mammary area. Anamnestic information, subjective outcome measures, and lesion counts including anatomical location were collected. Patients with similar morphologies were grouped, and characteristics for the groups were investigated. Limitations: We were not aware of the number of morphologies we would find, and as a result the study did not have sufficient power to show significant differences after correction for multiple testing. Results: We found three morphologically different subtypes of mammary HS; the Sternal, the Frictional, and the Nodule types. These groups differed in anatomical lesion characteristics and other patient characteristics. Furthermore, we found a fourth Mixed type – a combination of the other three. Conclusion: Differential diagnosis between mammary HS and sub-areolar or granulomatous non-fluctuating non-lactating breast abscess is most easily performed by assessing the precise anatomical location of the lesion and determining if the mammary lesion is the only lesion present or if similar lesions exist in other HS-specific ar

Concomitant Hidradenitis Suppurativa and Eruptive Xanthomas Presenting with Phimosis – The Importance of Timely Diagnosis

A 49-year-old man diagnosed with metabolic syndrome (MetS) was referred to us for treatment of xanthoma elements. Physical examination revealed widespread confluent yellow firm papules on his fingers, toes, arms, legs, and back. The diagnosis of eruptive xanthoma (EX) was clinically confirmed. During the examination of scar tissues, tombstone comedones and an inflammatory nodule was noted on his abdominal folds and right groin. These are diagnostic signs of hidradenitis suppurativa (HS), a condition the patient had reportedly suffered for 15 years without being diagnosed. The patient’s HS nodule was treated with intralesional triamcinolone injection, and prophylactic resorcinol was initiated, and he was referred to endocrinologists for xanthoma management. Three weeks later he returned due to newly developed lesions on his preputium, which caused a painful phimosis. Both HS and EX are correlated with MetS and causes increased all-cause cardiovascular mortality. As the average diagnostic delay of HS is 7.2 years, it is likely that timely diagnosis of HS would have identified the patient as being at risk of developing MetS. With proper preventive measures, the resulting EX lesions and increase in cardiac mortality could have been avoide

Concomitant Hidradenitis Suppurativa and Eruptive Xanthomas Presenting with Phimosis – The Importance of Timely Diagnosis

A 49-year-old man diagnosed with metabolic syndrome (MetS) was referred to us for treatment of xanthoma elements. Physical examination revealed widespread confluent yellow firm papules on his fingers, toes, arms, legs, and back. The diagnosis of eruptive xanthoma (EX) was clinically confirmed. During the examination of scar tissues, tombstone comedones and an inflammatory nodule was noted on his abdominal folds and right groin. These are diagnostic signs of hidradenitis suppurativa (HS), a condition the patient had reportedly suffered for 15 years without being diagnosed. The patient’s HS nodule was treated with intralesional triamcinolone injection, and prophylactic resorcinol was initiated, and he was referred to endocrinologists for xanthoma management. Three weeks later he returned due to newly developed lesions on his preputium, which caused a painful phimosis. Both HS and EX are correlated with MetS and causes increased all-cause cardiovascular mortality. As the average diagnostic delay of HS is 7.2 years, it is likely that timely diagnosis of HS would have identified the patient as being at risk of developing MetS. With proper preventive measures, the resulting EX lesions and increase in cardiac mortality could have been avoide

Association mapping in Scandinavian winter wheat for yield, plant height and traits important for second-generation bioethanol production

A collection of 100 wheat varieties representing more than 100 years of wheat-breeding history in Scandinavia was established in order to identify marker-trait associations for plant height, grain yield and biomass potential for bioethanol production. The field-grown material showed variations in plant height from 54 to 122 cm and in grain yield from 2 to 6.61 t ha-1. The release of monomeric sugars was determined by high-throughput enzymatic treatment of ligno-cellulosic material and varied between 0.169 and 0.312 g/g dm for glucose and 0.146 and 0.283 g/g dm for xylose. As expected, plant height and grain yield showed to be highly influenced by genetic factors with repeatability (R) equal to 0.75 and 0.53 respectively, while this was reduced for glucose and xylose (R=0.09 for both) . The study of trait correlations showed how old, low-yielding, tall varieties released higher amounts of monomeric sugars after straw enzymatic hydrolysis, showing reduced recalcitrance to bioconversion compared to modern varieties. 93 lines from the collection were genotyped with the DArTseq® genotypic platform and 5525 markers were used for genome-wide association mapping. Six QTLs for grain yield, plant height and glucose released from straw were mapped. One QTL for plant height was previously reported, while the remaining QTLs constituted new genomic regions linked to trait variation. This paper is one of the first studies in wheat to identify QTLs that are important for bioethanol production based on a genome-wide association approach