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Hidradenitis Suppurativa

القيحي العرقية هو مرض جلدي مزمن يتسم بانسداد بصيلات الشعر والتهاب الغدد العرقية، وعادةً ما تظهر الإصابات في مناطق التماس بين الجلد مثل الإبطين والفخذين وحول الشرج والثديين. أعراضه تشمل كتل مؤلمة وقرح تنفجر وتخرج صديدًا ذو رائحة كريهة، وتبدأ عادةً بعد البلوغ وتستمر لفترات طويلة. العلاج متاح ولكن لا يوجد Cure، ويعتمد على شدة الحالة مما قد يتطلب تدخلات طبية أو جراحة.

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GXHCI180372
What Is Hidradenitis Suppurativa (HS)? Hidradenitis Suppurativa is a chronic skin disease that is characterized by occlusion (blockage) of the hair follicles and subsequent inflammation of the sweat glands.1 The lesions occur most commonly on areas of skin-to-skin contact: Under the arms (axillary area), in the groin, in the region around the anus and on the skin between and under the breasts. In women, groin and breast areas are most commonly affected. Men most often have HS lesions around the anus and under the arms and may also have HS at the back of the neck and behind and around the ears. 2,3
Diagnosis Depends on the FollowingCriteria: 1. Primary lesions presented as deep-seated painful nodules (blind boils), abscesses, sinus tracts or bridged scars. 2. Involvement areas: Axillae, groin, genitals, perineal and perianal region, buttocks, Infra- and Inter-mammary folds. 3. History of recurrent painful or suppurating lesions.3
What arethe Symptoms ofHidradenitis Suppurativa? Hidradenitits Suppurativa (HS) is often mistaken for many other conditions like acne, boils, infected epidermoid cysts, so delayed diagnosis is always common.3
Signs and Symptoms ofHidradenitis Suppurativa Include:  Blackheads: Small pitted areas of skin containing blackheads  Red, tender bumps: These bumps, or lesions, often enlarge, break, open and drain pus. The drainage may have an unpleasant odor. Itching, burning and excessive sweating may accompany the bumps  Painful, pea-sized lumps: These hard lumps, which develop under the skin, may persist for years. Hidradenitis Suppurativa often starts after puberty with a single, painful bump that persists for weeks or months  Leaking bumps or sores: These open wounds heal very slowly, and often lead to scarring and the development of tunnels under the skin2
What is the Cause of Hidradenitis Suppurativa? The cause of Hidradenitis Suppurativa is not yet known. It is clear that some people are more prone than others to develop this disease, also for unknown reasons.1 Hidradenitis Suppurativa develops when hair follicles become blocked and inflamed. It is still unknown why this blockage occurs, but a number of factors including hormones, family history, age and sex may all play a role.2,4
What is the Cause of Hidradenitis Suppurativa? Blockage might occur when sweat is trapped inside sweat gland tubes, which eventually swell up and either burst or become severely inflamed. Additionally as proved by medical research, there is a link between Hidradenitis Suppurativa and both smoking & obesity. Some of these risk factors may actually worsen the symptoms. It is very important to know that Hidradenitis Suppurativa is not contagious, and it is not caused by poor hygiene, poor nutrition, or being overweight.1
What arethe Risk Factorsfor Hidradenitis Suppurativa? AGE:  Hidradenitis Suppurativa commonly occurs in young adults in their early 20’s but it can occur at any age  Prevalence is usually less after the age 554
What arethe Risk Factorsfor Hidradenitis Suppurativa? SEX:  Women are more likely to develop Hidradenitis Suppurativa than men2,4
What arethe Risk Factorsfor Hidradenitis Suppurativa? GENETICS:  Research shows Hidradenitis Suppurativa may run in families  About 1/3 of people diagnosed with Hidradenitis Suppurativa have family member also living with the condition4
What arethe Risk Factorsfor Hidradenitis Suppurativa? HORMONES:  A link with sex hormones is suggested by prevalence peaking during the reproductive years but there is no evidence of a direct link4
Hidradenitis Suppurativa Main Symptoms Painful abscesses formed due to Hidradenitis Suppurativa either go away on their own, or rupture discharging pus with unpleasant smell. In several cases they forms tunnels connect the abscesses under skin. This disease starts at puberty & lasts for years and worsen by time. So early diagnosis and treatment for this disease may help dealing with the symptoms and prevent new lesions to occur.2
What areHidradenitis Suppurativa Stages? A staging system like Hurley's can be used to describe the severity of the disease: HURLEY'S STAGING5 Single or a few isolated boils without sinus tracts or scarring. Recurring boils in multiple areas with scarring & sinus tracts. Widespread boils with multiple interconnected sinus tracts, which may lead to severe scarring and release of unpleasant-smelling pus.5
How Will Hidradenitis Suppurativa Be Diagnosed? The diagnosis is usually made by a doctor examining the area, the symptoms and history.6 There is no specific test on which the diagnosis can be made.4 The condition is often misdiagnosed, closely resembling simple boils, or infected skin cysts; this can result in delayed treatment and progression of the disease with scarring.4,7 Delayed diagnosis and treatment is not uncommon
Can Hidradenitis Suppurativa be treated?  Hidradenitis suppurativa can be treated but not cured.  Treatment works best in inflamed active disease using medical treatments. In case where Hidradenitis has been present for a longer time, resulting in large more extensive lesions or scarring with less inflammation surgery may be required.6
Preparingfor an Appointment  Write down all your signs and symptoms and when they first occurred. Record how long did the first lesion last and if any recurred.  Make a list of all medications. Note the dosage and directions for each medication on your list.  Also write down questions that you want to ask your doctor.2
Lifestyleand Home Remedies The following suggestions may help relieve discomfort & speed healing:  Apply warm compresses: A warm cloth or compress can help reduce swelling2  Keep the affected area clean: Gently wash the affected areas with antibacterial soap 2  Stress management4  Stop smoking4
Lifestyleand Home Remedies The following suggestions may help relieve discomfort & speed healing:  Lose weight: Excess weight increases the number of areas where skin rubs together - for example, between skin folds-causing friction, increased perspiration and bacterial growth. Though weight loss won't cure the disease, it may improve the symptoms2  Wear loose-fitting clothes: Loose clothes and underwear can help prevent skin irritation; while tight, synthetic clothes may irritate your ski 2  Consider joining a support group4
Frequently Asked Questions:  Is Hidradenitis Suppurativa contagious? No, Hidradenitis Suppurativa is not contagious and is not transmitted by direct contact.1  If I quit smoking, will it cure my Hidradenitis Suppurativa? Medical research reported a link between Hidradenitis Suppurativa and smoking, but still debates are there on whether smoking can be a cause or no.8  Is there a link between cancer and Hidradenitis Suppurativa? Yes, research showed a 50% increase in the risk of cancer in patients Iiving with HS, as compared to the general population.5
Frequently Asked Questions:  Will losing weight help to reduce the number of Hidradenitis Suppurativa outbreaks? Medical studies reported a relation between obesity and the risk of disease development. Being overweight increases chances of skin friction, sweating and bacterial infections. Losing weight may help improve the condition but won’t cure the disease.2,3  Is Hidradenitis Suppurativa genetic? Did I inherit It from my parents, or can I pass It on to my children? Research had found that there is a genetic predisposition to the Hidradenitis Suppurativa. In fact, 30% of patients have a family history of the condition.4
Frequently Asked Questions:  Is Hidradenitis Suppurativa diagnosed by a blood test? No, Hidradenitis Suppurativa can’t be diagnosed by a blood test.4  Should I wear any particular types of clothing to help manage Hidradenitis Suppurativa? Typically, cotton and loose-fitting clothes are preferable to synthetic, wool or slim garments.2  Can Hidradenitis Suppurativa lead to Depression? The unpleasant smell and pus discharge can cause embarrassment and isolation leading to depression.2
References 1. THE BRITISH ASSOCIATION OF DERMATOLOGISTS, Hidradenitis Suppurativa www.dermnetnz.org/dna.hidsup/hidsup.html BRITISH ASSOCIATION OF DERMATOLOGISTS PATIENT INFORMATION LEAFLET PRODUCED SEPTEMBER 2004 UPDATED MAY 2011, JUNE 2013 REVIEW DATE JUNE 2016 2. Mayo Clinic. Hidradenitis Suppurativa. Available At; http;//www.mayocllnlc.org/ DiseasesConditions/Hidradenitis suppurativa /Basics /Definition /Con-20027334. Accessed May 2015 3. Revuz J. Hidradenitis Suppurativa. J Eur Acad Dermatol Venereal 2009, JEADV 2009, 23, 985-998 4. BMJ Diagnosis and management of hidradenitis suppurativa, Fiona Collier, BMJ 2013:346:f2121 doi:10.1136/bmj. f2121 (Published 23 April 2013) 5. Hidradenitis Suppurativa Gregor B.E. Jemec, M.D., D.M.Sc. The new england journal of medicine, N Engl J Med 2012;366:158-64. Copyright© 2012 Massachusetts Medical Society 6. Zouboulis C et al. European S1 guideline for the treatment of hidradenitis suppurativa/acne inversa. JEADV 2015, 29, 619–644 7. Hidradenitis Suppurativa. Chapter 3; Clinical presentation. Florence Poli, Gregor B. E. Jemec, Jean Revuz. Springer ed. 2016. ISBN: 9782287720635 8. Zouboulis C et al. Hidradenitis Suppurativa/Acne Inversa: Criteria for Diagnosis, Severity Assessment, Classification and Disease Evaluation. Dermatology 2015; 231:184–190 DOI: 10.1159/000431175
GXHCI180372
‫القيحي؟‬ ‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫هو‬ ‫ما‬ ‫القيحي‬ ‫العرقية‬ ‫ّد‬‫د‬‫الغ‬ ‫التهاب‬‫بصيال‬ ‫في‬ ‫بانسداد‬ ‫يتميز‬ ‫مزمن‬ ‫جلدي‬ ‫مرض‬ ‫هو‬‫ت‬ ‫العرقية‬ ‫الغدد‬ ‫في‬ ‫الحق‬ ‫والتهاب‬ ‫الشعر‬.1 ‫الجلد‬ ‫مع‬ ‫الجلد‬ ‫مالمسة‬ ‫مناطق‬ ‫في‬ ‫شيوعا‬ ‫األكثر‬ ‫اإلصابات‬ ‫تحدث‬:‫تحت‬ ‫وهي‬ ‫الذراعين‬(‫اإلبطين‬ ‫منطقة‬)‫وفي‬ ‫الشرج‬ ‫فتحة‬ ‫حول‬ ‫المنطقة‬ ‫وفي‬ ،‫الفخذ‬ ‫أعلى‬ ، ‫هي‬ ‫شيوعا‬ ‫المتأثرة‬ ‫المناطق‬ ‫أكثر‬ ‫تكون‬ ‫المرأة‬ ‫وفي‬ ،‫الثديين‬ ‫وتحت‬ ‫بين‬ ‫الجلد‬ ‫والثدي‬ ‫الفخذ‬ ‫أعلى‬.‫الع‬ ‫ّد‬‫د‬‫الغ‬ ‫التهاب‬ ‫من‬ ‫يعاني‬ ‫ما‬ ‫غالبا‬ ‫فهو‬ ‫للرجل‬ ‫وبالنسبة‬‫رقية‬ ‫الغدد‬ ‫التهاب‬ ‫من‬ ‫أيضا‬ ‫يعاني‬ ‫وقد‬ ‫الذراعين‬ ‫وتحت‬ ‫الشرج‬ ‫فتحة‬ ‫حول‬ ‫القيحي‬ ‫األذنين‬ ‫وحول‬ ‫وخلف‬ ‫الرقبة‬ ‫من‬ ‫الخلفي‬ ‫الجزء‬ ‫في‬ ‫القيحي‬ ‫العرقية‬.2,3
‫التالية‬ ‫التشخيصية‬ ‫المعايير‬ ‫علي‬ ‫التشخيص‬ ‫ويعتمد‬: ١-‫إصابات‬‫محدده‬ ‫بهيئة‬:‫عميقة‬ ‫مؤلمة‬ ‫قدة‬ُ‫ع‬ ‫إما‬(‫دمامل‬ ‫مغلقة‬)‫متصلة‬ ‫وندوب‬ ‫نازفة‬ ‫جيوب‬ ،‫خراريج‬ ‫أو‬. ٢-‫إصابات‬‫محدده‬ ‫بأماكن‬:،‫الفخذ‬ ‫وأعلى‬ ،‫اإلبطين‬ ،‫الشرج‬ ‫بفتحة‬ ‫المحيطة‬ ‫والمنطقة‬ ،‫التناسلية‬ ‫واألعضاء‬ ‫الثديين‬ ‫وبين‬ ‫طيات‬ ‫وتحت‬ ،‫واألرداف‬. ٣-‫إصابات‬‫ومتكرره‬ ‫مزمنه‬.3
‫القيحي؟‬ ‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫أعراض‬ ‫هي‬ ‫ما‬ ‫تشخيص‬ ‫في‬ ‫لبس‬ ‫يحدث‬ ‫ما‬ ‫غالبا‬‫التهاب‬ ‫القيحي‬ ‫العرقية‬ ‫الغدد‬‫الحاالت‬ ‫من‬ ‫عديد‬ ‫مع‬ ،‫والخراريج‬ ،‫الشباب‬ ‫حب‬ ‫مثل‬ ‫األخرى‬ ،‫الدهنية‬ ‫واألكياس‬.....‫التأخير‬ ‫يكون‬ ‫لذلك‬ ‫دائما‬ ‫شائع‬ ‫التشخيص‬ ‫في‬.3
‫يلي‬ ‫ما‬ ‫القيحي‬ ‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫وأعراض‬ ‫عالمات‬ ‫وتشمل‬: ●‫الرؤوس‬‫على‬ ‫تحتوي‬ ‫الجلد‬ ‫في‬ ‫صغيرة‬ ‫حفر‬ ‫مناطق‬ ‫وهم‬ ‫السوداء‬ ‫السوداء‬ ‫الرؤوس‬ ●‫قرح‬‫وقد‬ ‫الصديد‬ ‫ويخرج‬ ‫تنفتح‬ ‫ثم‬ ‫تكبر‬ ‫ما‬ ‫وغالبا‬ ‫ودمامل‬ ‫حمراء‬ ‫رقيقة‬ ،‫بالحرقان‬ ‫وشعور‬ ،‫حكة‬ ‫القرح‬ ‫هذه‬ ‫يصاحب‬ ‫وقد‬ ‫كريهة‬ ‫رائحة‬ ‫للصديد‬ ‫يكون‬ ‫مفرط‬ ‫وتعرق‬ ●‫كتل‬‫تستمر‬ ‫وقد‬ ،‫الجلد‬ ‫تحت‬ ‫تنمو‬ ،‫صلبة‬ ‫ملتهبة‬ ‫كتل‬ ‫وهي‬ ‫مؤلمة‬ ‫لسنوات‬.‫دمل‬ ‫بظهور‬ ‫البلوغ‬ ‫سن‬ ‫بعد‬ ‫القيحي‬ ‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫يبدأ‬ ‫ما‬ ‫وغالبا‬ ‫أشهر‬ ‫أو‬ ‫لألسابيع‬ ‫يستمر‬ ‫مؤلم‬ ‫واحد‬ ●‫قرح‬‫الجلد‬ ‫تحت‬ ‫وبثور‬ ‫ندوب‬ ‫إلى‬ ‫مؤدية‬ ‫إلتئامها‬ ‫يتأخر‬ ‫وعادة‬ ‫مفرزه‬2
‫القيحي؟‬ ‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫سبب‬ ‫هو‬ ‫ما‬ ‫سبب‬‫القيحي‬ ‫العرقية‬ ‫الغدد‬ ‫التهاب‬‫حتى‬ ‫معروف‬ ‫غير‬ ‫من‬ ‫عرضة‬ ‫أكثر‬ ‫الناس‬ ‫بعض‬ ‫أن‬ ‫الواضح‬ ‫ومن‬ ،‫اآلن‬ ‫معروفة‬ ‫غير‬ ‫واألسباب‬ ،‫المرض‬ ‫هذا‬ ‫لتطور‬ ‫غيرهم‬ ‫أيضا‬.1 ‫يتطور‬‫القيحي‬ ‫العرقية‬ ‫ّد‬‫د‬‫الغ‬ ‫التهاب‬‫انسداد‬ ‫يحدث‬ ‫عندما‬ ‫ملتهبة‬ ‫وتصبح‬ ‫الشعر‬ ‫لبصيالت‬.‫هذا‬ ‫حدوث‬ ‫وسبب‬ ‫العوامل‬ ‫من‬ ‫عدد‬ ‫تلعب‬ ‫قد‬ ‫ولكن‬ ،‫معروف‬ ‫غير‬ ‫االنسداد‬ ‫الجنس‬ ‫ونوع‬ ،‫والعمر‬ ،‫العائلي‬ ‫والتاريخ‬ ‫الهرمونات‬ ‫مثل‬ ‫ذلك‬ ‫في‬ ‫دورا‬.2,4 ‫العرق‬ ‫يكون‬ ‫عندما‬ ‫االنسداد‬ ‫هذا‬ ‫يحدث‬ ‫قد‬ ‫أنه‬ ‫عتقد‬ُ‫ي‬‫و‬ ‫ث‬ ‫النهاية‬ ‫في‬ ‫لتتورم‬ ‫العرقية‬ ‫الغدد‬ ‫أنابيب‬ ‫داخل‬ ‫محصورا‬‫م‬ ‫حادا‬ ‫التهابا‬ ‫تسبب‬ ‫أو‬ ‫تنفجر‬.
‫القيحي؟‬ ‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫سبب‬ ‫هو‬ ‫ما‬ ‫بين‬ ‫صلة‬ ‫وجود‬ ‫الطبية‬ ‫البحوث‬ ‫أثبتت‬ ،‫ذلك‬ ‫إلى‬ ‫وباإلضافة‬ ‫القيحي‬ ‫العرقية‬ ‫الغدد‬ ‫التهاب‬‫من‬ ‫وكل‬‫التدخين‬‫والسمنة‬.‫قد‬ ‫األعراض‬ ‫تفاقم‬ ‫إلى‬ ‫هذه‬ ‫الخطر‬ ‫عوامل‬ ‫بعض‬ ‫تؤدي‬. ‫أن‬ ‫نعرف‬ ‫أن‬ ‫جدا‬ ‫المهم‬ ‫ومن‬‫ليس‬ ‫القيحي‬ ‫العرقية‬ ‫ّد‬‫د‬‫الغ‬ ‫التهاب‬ ‫معديا‬‫زيادة‬ ‫أو‬ ،‫التغذية‬ ‫لسوء‬ ‫أو‬ ،‫النظافة‬ ‫قلة‬ ‫عن‬ ‫ناتجا‬ ‫وليس‬ ، ‫الوزن‬.1
‫القيحي؟‬ ‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫في‬ ‫الخطر‬ ‫عوامل‬ ‫هي‬ ‫ما‬ ‫العمر‬ ●‫الذين‬ ‫الصغار‬ ‫البالغين‬ ‫في‬ ‫القيحي‬ ‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫يحدث‬ ‫أى‬ ‫في‬ ‫يحدث‬ ‫أن‬ ‫يمكن‬ ‫ولكنه‬ ،‫العشرينات‬ ‫أوائل‬ ‫في‬ ‫أعمارهم‬ ‫تكون‬ ‫عمر‬ ●‫ينخفض‬‫سن‬ ‫بعد‬ ‫عادة‬ ‫االنتشار‬ ‫معدل‬55‫سنة‬4
‫القيحي؟‬ ‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫في‬ ‫الخطر‬ ‫عوامل‬ ‫هي‬ ‫ما‬ ‫الجنس‬ ‫نوع‬ ●‫المرأة‬‫بالمرض‬ ‫لإلصابة‬ ‫عرضة‬ ‫أكثر‬ ‫الرجل‬ ‫من‬2,4
‫القيحي؟‬ ‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫في‬ ‫الخطر‬ ‫عوامل‬ ‫هي‬ ‫ما‬ ‫الوراثية‬ ‫العوامل‬ ●‫تبين‬‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫أن‬ ‫األبحاث‬ ‫وراثيا‬ ‫العائالت‬ ‫في‬ ‫ينتقل‬ ‫قد‬ ‫القيحي‬ ●‫تم‬ ‫الذين‬ ‫األشخاص‬ ‫ثلث‬ ‫حوالي‬ ‫القي‬ ‫العرقية‬ ‫الغدد‬ ‫بالتهاب‬ ‫كمصابين‬ ‫تشخيصهم‬‫حي‬ ‫الحالة‬ ‫من‬ ‫يعاني‬ ‫العائلة‬ ‫أفراد‬ ‫أحد‬ ‫أيضا‬ ‫لديهم‬4
‫القيحي؟‬ ‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫في‬ ‫الخطر‬ ‫عوامل‬ ‫هي‬ ‫ما‬ ‫الهرمونات‬ ●‫خالل‬ ‫المرض‬ ‫انتشار‬ ‫ذروة‬ ‫تشير‬ ‫الجنسية‬ ‫بالهرمونات‬ ‫صلته‬ ‫إلى‬ ‫اإلنجاب‬ ‫سنوات‬ ‫مباشرة‬ ‫صلة‬ ‫وجود‬ ‫على‬ ‫دليل‬ ‫يوجد‬ ‫ال‬ ‫ولكن‬4
‫المرض‬ ‫أعراض‬ ‫أهم‬ ‫رائحة‬ ‫ذات‬ ‫صديد‬ ‫لتسرب‬ ‫تنكسر‬ ‫قد‬ ‫مؤلمة‬ ‫تكتالت‬ ‫تتكون‬ ‫كريهة‬.‫تحت‬ ‫الكتل‬ ‫هذه‬ ‫تربط‬ ‫إنفاق‬ ‫تتكون‬ ‫كثيرة‬ ‫حاالت‬ ‫وفى‬ ‫الجلد‬. ‫ويزداد‬ ‫لألعوام‬ ‫مستمرا‬ ‫ويبقى‬ ‫البلوغ‬ ‫عند‬ ‫المرض‬ ‫هذا‬ ‫يبدأ‬ ‫الوقت‬ ‫مع‬ ‫سوءا‬. ‫في‬ ‫يساعد‬ ‫قد‬ ‫المرض‬ ‫لهذا‬ ‫المبكر‬ ‫والعالج‬ ‫التشخيص‬ ‫فإن‬ ‫لذا‬ ‫التكون‬ ‫من‬ ‫جديده‬ ‫قرح‬ ‫ومنع‬ ‫األعراض‬ ‫مع‬ ‫التعامل‬.2
‫القيحي؟‬ ‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫مراحل‬ ‫هي‬ ‫ما‬ ‫هارلي‬ ‫مؤشر‬ ‫مثل‬ ‫المقاييس‬ ‫لبعض‬ ‫وفقا‬ ‫القيحي‬ ‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫شدة‬ ‫تصنيف‬ ‫يتم‬: ‫هارلي‬ ‫مراحل‬5 ‫نطاق‬ ‫على‬ ‫خراريج‬ ‫حدوث‬ ‫قنوات‬ ‫وجود‬ ‫مع‬ ‫واسع‬ ‫تؤدى‬ ‫قد‬ ،‫مترابطة‬ ‫عديدة‬ ‫صديد‬ ‫إطالق‬ ‫إلى‬.5 ‫من‬ ‫قليلة‬ ‫أعداد‬ ‫أو‬ ‫خراج‬ ‫أو‬ ‫دمامل‬ ‫أو‬ ‫تجاويف‬ ‫بدون‬ ‫المعزولة‬ ‫الخراريج‬ ‫قنوات‬. ‫فى‬ ‫متكررة‬ ‫خراريج‬ ‫وجود‬ ‫مع‬ ‫متعددة‬ ‫مناطق‬ ‫وقنوات‬ ‫وتجاويف‬ ‫ندوب‬.
‫القيحي؟‬ ‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫تشخيص‬ ‫يمكن‬ ‫كيف‬ ‫عادة‬‫ما‬‫جرى‬ُ‫ي‬‫التشخيص‬‫من‬‫بل‬ِ‫ق‬‫طبيب‬،‫حيث‬‫يقوم‬‫بفحص‬‫المنط‬‫قة‬ ‫واألعراض‬‫والتاريخ‬‫الم‬‫رضي‬.6 ‫ال‬‫يوجد‬‫اختبار‬‫محدد‬‫يمكن‬‫إجراء‬‫التشخيص‬‫على‬‫أساسه‬. ‫غالبا‬‫ما‬‫شخص‬ُ‫ي‬‫هذا‬‫المرض‬‫بشكل‬‫خاطئ‬،‫حيث‬‫يشبه‬‫كثيرا‬‫الدم‬‫امل‬‫البسيطة‬ ‫أو‬‫تكيسات‬‫الجلد‬‫صابة‬ُ‫م‬‫ال‬‫بعدوى‬.4 ‫قد‬‫يؤدي‬‫ذلك‬‫األمر‬‫إلى‬‫تأخر‬‫العالج‬‫وتطور‬‫المرض‬‫مع‬‫ظهور‬‫ندبات‬7,8.
‫القيحي؟‬ ‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫عالج‬ ‫يمكن‬ ‫هل‬ ●‫يمكن‬‫عالج‬‫التهاب‬‫الغدد‬‫العرقية‬‫القيحي‬‫ولكن‬‫ال‬‫يمكن‬‫شف‬‫اؤه‬ ‫بشكل‬‫نهائي‬. ●‫يعمل‬‫العالج‬‫بأفضل‬‫فاعلية‬‫في‬‫األمراض‬‫االلتهابية‬‫النش‬‫طة‬ ‫باستخدام‬‫العالجات‬‫الطبية‬.‫في‬‫حال‬‫اإلصابة‬‫بالتهاب‬‫الغدد‬‫العرقي‬‫ة‬ ‫القيحي‬‫لمدة‬‫أطول‬‫من‬‫المعتاد‬–‫األمر‬‫الذي‬‫ينتج‬‫عنه‬‫حدوث‬‫إصابات‬ ‫أو‬‫ندبات‬‫واسعة‬‫االنتشار‬‫مصحوبة‬‫بالتهابات‬‫أقل‬-‫قد‬‫ب‬َّ‫يتطل‬‫األمر‬ ‫إجراء‬‫جراحة‬.6
‫للموعد‬ ‫التحضير‬ ●‫مرة‬ ‫ألول‬ ‫حدثت‬ ‫ومتى‬ ‫واألعراض‬ ‫العالمات‬ ‫جميع‬ ‫أكتب‬. ‫تكررت‬ ‫قد‬ ‫كانت‬ ‫إذا‬ ‫وما‬ ‫اإلصابات‬ ‫هذه‬ ‫استمرار‬ ‫مدة‬ ‫ل‬ّ‫ج‬‫وس‬. ●‫تتناولها‬ ‫التي‬ ‫األدوية‬ ‫جميع‬ ‫قائمة‬ ‫في‬ ‫أدرج‬.‫الجرعات‬ ‫ل‬ّ‫ج‬‫وس‬ ‫قائمتك‬ ‫في‬ ‫المدرجة‬ ‫األدوية‬ ‫من‬ ‫واحد‬ ‫لكل‬. ●‫طبيبك‬ ‫على‬ ‫تطرحها‬ ‫أن‬ ‫تود‬ ‫التي‬ ‫األسئلة‬ ‫أيضا‬ ‫أكتب‬.2
‫المنزلية‬ ‫والعالجات‬ ‫الحياة‬ ‫نمط‬ ‫وسرعة‬ ‫الراحة‬ ‫عدم‬ ‫تخفيف‬ ‫في‬ ‫التالية‬ ‫االقتراحات‬ ‫تساعد‬ ‫قد‬ ‫االلتئام‬: ●‫الدافئة‬ ‫الكمادات‬ ‫استخدام‬:‫دافئة‬ ‫كمادة‬ ‫أو‬ ‫منشفة‬ ‫تساعد‬ ‫أن‬ ‫يمكن‬ 2‫التورم‬ ‫تقليل‬ ‫في‬ ●‫نظيفة‬ ‫المصابة‬ ‫المنطقة‬ ‫على‬ ‫الحفاظ‬:‫المناطق‬ ‫غسل‬ 2‫للبكتريا‬ ‫مضاد‬ ‫بصابون‬ ‫بلطف‬ ‫المصابة‬ 4 ●‫االتوتر‬ ‫ادارة‬ 4 ●‫التدخين‬ ‫عن‬ ‫التوقف‬
‫المنزلية‬ ‫والعالجات‬ ‫الحياة‬ ‫نمط‬ ‫وسرعة‬ ‫الراحة‬ ‫عدم‬ ‫تخفيف‬ ‫في‬ ‫التالية‬ ‫االقتراحات‬ ‫تساعد‬ ‫قد‬ ‫االلتئام‬: ●‫الوزن‬ ‫فقدان‬:‫يحتك‬ ‫التي‬ ‫المناطق‬ ‫عدد‬ ‫من‬ ‫الزائد‬ ‫الوزن‬ ‫يزيد‬ ‫البعض‬ ‫بعضه‬ ‫مع‬ ‫الجلد‬ ‫فيه‬–‫طيات‬ ‫بين‬ ،‫المثال‬ ‫سبيل‬ ‫وعلى‬ ‫البكتريا‬ ‫ونمو‬ ،‫العرق‬ ‫وزيادة‬ ‫االحتكاك‬ ‫يسبب‬ ‫مما‬ ،‫الجلد‬.‫على‬ ‫يحسن‬ ‫قد‬ ‫فإنه‬ ،‫المرض‬ ‫هذا‬ ‫يعالج‬ ‫ال‬ ‫الوزن‬ ‫فقدان‬ ‫أن‬ ‫من‬ ‫الرغم‬ ‫من‬‫األعراض‬2 ●‫فضفاضة‬ ‫مالبس‬ ‫ارتداء‬:‫المالبس‬ ‫تساعد‬ ‫أن‬ ‫يمكن‬ ‫الضيقة‬ ‫المالبس‬ ‫أن‬ ‫حين‬ ‫في‬ ،‫الجلد‬ ‫تهيج‬ ‫منع‬ ‫في‬ ‫الفضفاضة‬ 2‫جلدك‬ ‫تهيج‬ ‫قد‬ ‫واالصطناعية‬ 4 ●‫دعم‬ ‫مجموعة‬ ‫إلى‬ ‫االنضمام‬ ‫في‬ ‫فكر‬
‫المتداولة‬ ‫األسئلة‬ ‫معدي؟‬ ‫القيحي‬ ‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫هل‬ ‫معديا‬ ‫ليس‬ ‫القيحي‬ ‫العرقية‬ ‫الغدد‬ ‫فالتهاب‬ ،‫ال‬.‫باللمس‬ ‫ينتقل‬ ‫وال‬.1 ‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫من‬ ‫الشفاء‬ ‫إلى‬ ‫هذا‬ ‫يؤدى‬ ‫فهل‬ ،‫التدخين‬ ‫عن‬ ‫أقلعت‬ ‫إذا‬ ‫منه؟‬ ‫أعانى‬ ‫الذى‬ ‫القيحي‬ ،‫والتدخين‬ ‫القيحي‬ ‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫بين‬ ‫صلة‬ ‫الطبية‬ ‫البحوث‬ ‫أوجدت‬ ‫الغدد‬ ‫التهاب‬ ‫بمرض‬ ‫لإلصابة‬ ‫يؤدى‬ ‫التدخين‬ ‫كان‬ ‫إذا‬ ‫ما‬ ‫حول‬ ‫جدل‬ ‫وهناك‬ 6 ‫القيحي‬ ‫العرقية‬. ‫القيحي؟‬ ‫العرقية‬ ‫الغدد‬ ‫والتهاب‬ ‫السرطان‬ ‫بين‬ ‫عالقة‬ ‫هناك‬ ‫هل‬ ‫بنسبة‬ ‫زيادة‬ ‫هناك‬ ‫أن‬ ‫األبحاث‬ ‫تشير‬ ،‫نعم‬50‫بالسرطان‬ ‫اإلصابة‬ ‫خطر‬ ‫في‬ ٪ ‫مع‬ ‫بالمقارنة‬ ،‫القيحي‬ ‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫من‬ ‫يعانون‬ ‫الذين‬ ‫المرضى‬ ‫في‬ ‫األفراد‬‫العاديين‬.5
‫المتداولة‬ ‫األسئلة‬ ‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫تفشي‬ ‫حاالت‬ ‫عدد‬ ‫تقليل‬ ‫على‬ ‫الوزن‬ ‫فقدان‬ ‫يساعد‬ ‫هل‬ ‫القيحي؟‬ ‫لهذا‬ ‫خطر‬ ‫عوامل‬ ‫هي‬ ‫والسمنة‬ ‫الوزن‬ ‫في‬ ‫الزيادة‬ ‫أن‬ ‫إلى‬ ‫الدراسات‬ ‫تشير‬ ‫المرض‬.‫إلى‬ ‫ويؤدي‬ ‫الجلد‬ ‫ثنايا‬ ‫بين‬ ‫ما‬ ‫الجسم‬ ‫احتكاك‬ ‫يسبب‬ ‫الزائد‬ ‫الوزن‬ ‫البكتيريا‬ ‫ونمو‬ ‫العرق‬ ‫إفراز‬.‫من‬ ‫يحسن‬ ‫ولكنه‬ ‫يعالج‬ ‫لن‬ ‫الوزن‬ ‫إنقاص‬ ‫المرض‬ ‫أعراض‬.2,3 ‫هل‬ ‫أو‬ ،‫والدي‬ ‫من‬ ‫ورثته‬ ‫وهل‬ ‫وراثي؟‬ ‫القيحي‬ ‫العرقية‬ ‫ّد‬‫د‬‫الغ‬ ‫التهاب‬ ‫هل‬ ‫أوالدي؟‬ ‫إلی‬ ‫نقله‬ ‫يمكنني‬ ‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫لمرض‬ ‫وراثي‬ ‫استعداد‬ ‫هناك‬ ‫أن‬ ‫األبحاث‬ ‫وجدت‬ ‫القيحي‬.‫فإن‬ ،‫الواقع‬ ‫وفي‬30‫للحالة‬ ‫عائلي‬ ‫تاريخ‬ ‫لديهم‬ ‫المرضى‬ ‫من‬ ٪.4
‫المتداولة‬ ‫األسئلة‬ ‫الدم؟‬ ‫عينات‬ ‫من‬ ‫القيحي‬ ‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫تشخيص‬ ‫يمكن‬ ‫هل‬ ‫ال‬.‫طريق‬ ‫عن‬ ‫القيحي‬ ‫العرقية‬ ‫ّد‬‫د‬‫الغ‬ ‫التهاب‬ ‫لتشخيص‬ ‫اختبار‬ ‫يوجد‬ ‫ال‬ ‫الدم‬ ‫عينات‬.4 ‫هل‬‫مع‬ ‫التعامل‬ ‫في‬ ‫للمساعدة‬ ‫المالبس‬ ‫من‬ ‫معينة‬ ‫أنواع‬ ‫أرتدى‬ ‫أن‬ ‫يجب‬ ‫القيحي؟‬ ‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫االصطناعي‬ ‫المالبس‬ ‫عن‬ ‫مفضلة‬ ‫والفضفاضة‬ ‫القطنية‬ ‫المالبس‬ ‫تكون‬ ‫عادة‬‫ة‬ ‫الضيقة‬ ‫أو‬ ‫الصوفية‬ ‫أو‬.2 ‫اإلكتئاب؟‬ ‫إلى‬ ‫يؤدى‬ ‫المرض‬ ‫هذا‬ ‫هل‬ ‫اإلختالط‬ ‫عن‬ ‫واإلنعزال‬ ‫اإلحراج‬ ‫تسبب‬ ‫قد‬ ‫واإلفرازات‬ ‫الكريهة‬ ‫الرائحة‬ ‫اإلكتئاب‬ ‫إلى‬ ‫مؤدية‬.2

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Hidradenitis Suppurativa

  • 1.
  • 2.
    What Is HidradenitisSuppurativa (HS)? Hidradenitis Suppurativa is a chronic skin disease that is characterized by occlusion (blockage) of the hair follicles and subsequent inflammation of the sweat glands.1 The lesions occur most commonly on areas of skin-to-skin contact: Under the arms (axillary area), in the groin, in the region around the anus and on the skin between and under the breasts. In women, groin and breast areas are most commonly affected. Men most often have HS lesions around the anus and under the arms and may also have HS at the back of the neck and behind and around the ears. 2,3
  • 3.
    Diagnosis Depends onthe FollowingCriteria: 1. Primary lesions presented as deep-seated painful nodules (blind boils), abscesses, sinus tracts or bridged scars. 2. Involvement areas: Axillae, groin, genitals, perineal and perianal region, buttocks, Infra- and Inter-mammary folds. 3. History of recurrent painful or suppurating lesions.3
  • 4.
    What arethe SymptomsofHidradenitis Suppurativa? Hidradenitits Suppurativa (HS) is often mistaken for many other conditions like acne, boils, infected epidermoid cysts, so delayed diagnosis is always common.3
  • 5.
    Signs and SymptomsofHidradenitis Suppurativa Include:  Blackheads: Small pitted areas of skin containing blackheads  Red, tender bumps: These bumps, or lesions, often enlarge, break, open and drain pus. The drainage may have an unpleasant odor. Itching, burning and excessive sweating may accompany the bumps  Painful, pea-sized lumps: These hard lumps, which develop under the skin, may persist for years. Hidradenitis Suppurativa often starts after puberty with a single, painful bump that persists for weeks or months  Leaking bumps or sores: These open wounds heal very slowly, and often lead to scarring and the development of tunnels under the skin2
  • 6.
    What is theCause of Hidradenitis Suppurativa? The cause of Hidradenitis Suppurativa is not yet known. It is clear that some people are more prone than others to develop this disease, also for unknown reasons.1 Hidradenitis Suppurativa develops when hair follicles become blocked and inflamed. It is still unknown why this blockage occurs, but a number of factors including hormones, family history, age and sex may all play a role.2,4
  • 7.
    What is theCause of Hidradenitis Suppurativa? Blockage might occur when sweat is trapped inside sweat gland tubes, which eventually swell up and either burst or become severely inflamed. Additionally as proved by medical research, there is a link between Hidradenitis Suppurativa and both smoking & obesity. Some of these risk factors may actually worsen the symptoms. It is very important to know that Hidradenitis Suppurativa is not contagious, and it is not caused by poor hygiene, poor nutrition, or being overweight.1
  • 8.
    What arethe RiskFactorsfor Hidradenitis Suppurativa? AGE:  Hidradenitis Suppurativa commonly occurs in young adults in their early 20’s but it can occur at any age  Prevalence is usually less after the age 554
  • 9.
    What arethe RiskFactorsfor Hidradenitis Suppurativa? SEX:  Women are more likely to develop Hidradenitis Suppurativa than men2,4
  • 10.
    What arethe RiskFactorsfor Hidradenitis Suppurativa? GENETICS:  Research shows Hidradenitis Suppurativa may run in families  About 1/3 of people diagnosed with Hidradenitis Suppurativa have family member also living with the condition4
  • 11.
    What arethe RiskFactorsfor Hidradenitis Suppurativa? HORMONES:  A link with sex hormones is suggested by prevalence peaking during the reproductive years but there is no evidence of a direct link4
  • 12.
    Hidradenitis Suppurativa MainSymptoms Painful abscesses formed due to Hidradenitis Suppurativa either go away on their own, or rupture discharging pus with unpleasant smell. In several cases they forms tunnels connect the abscesses under skin. This disease starts at puberty & lasts for years and worsen by time. So early diagnosis and treatment for this disease may help dealing with the symptoms and prevent new lesions to occur.2
  • 13.
    What areHidradenitis SuppurativaStages? A staging system like Hurley's can be used to describe the severity of the disease: HURLEY'S STAGING5 Single or a few isolated boils without sinus tracts or scarring. Recurring boils in multiple areas with scarring & sinus tracts. Widespread boils with multiple interconnected sinus tracts, which may lead to severe scarring and release of unpleasant-smelling pus.5
  • 14.
    How Will HidradenitisSuppurativa Be Diagnosed? The diagnosis is usually made by a doctor examining the area, the symptoms and history.6 There is no specific test on which the diagnosis can be made.4 The condition is often misdiagnosed, closely resembling simple boils, or infected skin cysts; this can result in delayed treatment and progression of the disease with scarring.4,7 Delayed diagnosis and treatment is not uncommon
  • 15.
    Can Hidradenitis Suppurativabe treated?  Hidradenitis suppurativa can be treated but not cured.  Treatment works best in inflamed active disease using medical treatments. In case where Hidradenitis has been present for a longer time, resulting in large more extensive lesions or scarring with less inflammation surgery may be required.6
  • 16.
    Preparingfor an Appointment Write down all your signs and symptoms and when they first occurred. Record how long did the first lesion last and if any recurred.  Make a list of all medications. Note the dosage and directions for each medication on your list.  Also write down questions that you want to ask your doctor.2
  • 17.
    Lifestyleand Home Remedies Thefollowing suggestions may help relieve discomfort & speed healing:  Apply warm compresses: A warm cloth or compress can help reduce swelling2  Keep the affected area clean: Gently wash the affected areas with antibacterial soap 2  Stress management4  Stop smoking4
  • 18.
    Lifestyleand Home Remedies Thefollowing suggestions may help relieve discomfort & speed healing:  Lose weight: Excess weight increases the number of areas where skin rubs together - for example, between skin folds-causing friction, increased perspiration and bacterial growth. Though weight loss won't cure the disease, it may improve the symptoms2  Wear loose-fitting clothes: Loose clothes and underwear can help prevent skin irritation; while tight, synthetic clothes may irritate your ski 2  Consider joining a support group4
  • 19.
    Frequently Asked Questions: Is Hidradenitis Suppurativa contagious? No, Hidradenitis Suppurativa is not contagious and is not transmitted by direct contact.1  If I quit smoking, will it cure my Hidradenitis Suppurativa? Medical research reported a link between Hidradenitis Suppurativa and smoking, but still debates are there on whether smoking can be a cause or no.8  Is there a link between cancer and Hidradenitis Suppurativa? Yes, research showed a 50% increase in the risk of cancer in patients Iiving with HS, as compared to the general population.5
  • 20.
    Frequently Asked Questions: Will losing weight help to reduce the number of Hidradenitis Suppurativa outbreaks? Medical studies reported a relation between obesity and the risk of disease development. Being overweight increases chances of skin friction, sweating and bacterial infections. Losing weight may help improve the condition but won’t cure the disease.2,3  Is Hidradenitis Suppurativa genetic? Did I inherit It from my parents, or can I pass It on to my children? Research had found that there is a genetic predisposition to the Hidradenitis Suppurativa. In fact, 30% of patients have a family history of the condition.4
  • 21.
    Frequently Asked Questions: Is Hidradenitis Suppurativa diagnosed by a blood test? No, Hidradenitis Suppurativa can’t be diagnosed by a blood test.4  Should I wear any particular types of clothing to help manage Hidradenitis Suppurativa? Typically, cotton and loose-fitting clothes are preferable to synthetic, wool or slim garments.2  Can Hidradenitis Suppurativa lead to Depression? The unpleasant smell and pus discharge can cause embarrassment and isolation leading to depression.2
  • 22.
    References 1. THE BRITISHASSOCIATION OF DERMATOLOGISTS, Hidradenitis Suppurativa www.dermnetnz.org/dna.hidsup/hidsup.html BRITISH ASSOCIATION OF DERMATOLOGISTS PATIENT INFORMATION LEAFLET PRODUCED SEPTEMBER 2004 UPDATED MAY 2011, JUNE 2013 REVIEW DATE JUNE 2016 2. Mayo Clinic. Hidradenitis Suppurativa. Available At; http;//www.mayocllnlc.org/ DiseasesConditions/Hidradenitis suppurativa /Basics /Definition /Con-20027334. Accessed May 2015 3. Revuz J. Hidradenitis Suppurativa. J Eur Acad Dermatol Venereal 2009, JEADV 2009, 23, 985-998 4. BMJ Diagnosis and management of hidradenitis suppurativa, Fiona Collier, BMJ 2013:346:f2121 doi:10.1136/bmj. f2121 (Published 23 April 2013) 5. Hidradenitis Suppurativa Gregor B.E. Jemec, M.D., D.M.Sc. The new england journal of medicine, N Engl J Med 2012;366:158-64. Copyright© 2012 Massachusetts Medical Society 6. Zouboulis C et al. European S1 guideline for the treatment of hidradenitis suppurativa/acne inversa. JEADV 2015, 29, 619–644 7. Hidradenitis Suppurativa. Chapter 3; Clinical presentation. Florence Poli, Gregor B. E. Jemec, Jean Revuz. Springer ed. 2016. ISBN: 9782287720635 8. Zouboulis C et al. Hidradenitis Suppurativa/Acne Inversa: Criteria for Diagnosis, Severity Assessment, Classification and Disease Evaluation. Dermatology 2015; 231:184–190 DOI: 10.1159/000431175
  • 23.
  • 24.
    ‫القيحي؟‬ ‫العرقية‬ ‫الغدد‬‫التهاب‬ ‫هو‬ ‫ما‬ ‫القيحي‬ ‫العرقية‬ ‫ّد‬‫د‬‫الغ‬ ‫التهاب‬‫بصيال‬ ‫في‬ ‫بانسداد‬ ‫يتميز‬ ‫مزمن‬ ‫جلدي‬ ‫مرض‬ ‫هو‬‫ت‬ ‫العرقية‬ ‫الغدد‬ ‫في‬ ‫الحق‬ ‫والتهاب‬ ‫الشعر‬.1 ‫الجلد‬ ‫مع‬ ‫الجلد‬ ‫مالمسة‬ ‫مناطق‬ ‫في‬ ‫شيوعا‬ ‫األكثر‬ ‫اإلصابات‬ ‫تحدث‬:‫تحت‬ ‫وهي‬ ‫الذراعين‬(‫اإلبطين‬ ‫منطقة‬)‫وفي‬ ‫الشرج‬ ‫فتحة‬ ‫حول‬ ‫المنطقة‬ ‫وفي‬ ،‫الفخذ‬ ‫أعلى‬ ، ‫هي‬ ‫شيوعا‬ ‫المتأثرة‬ ‫المناطق‬ ‫أكثر‬ ‫تكون‬ ‫المرأة‬ ‫وفي‬ ،‫الثديين‬ ‫وتحت‬ ‫بين‬ ‫الجلد‬ ‫والثدي‬ ‫الفخذ‬ ‫أعلى‬.‫الع‬ ‫ّد‬‫د‬‫الغ‬ ‫التهاب‬ ‫من‬ ‫يعاني‬ ‫ما‬ ‫غالبا‬ ‫فهو‬ ‫للرجل‬ ‫وبالنسبة‬‫رقية‬ ‫الغدد‬ ‫التهاب‬ ‫من‬ ‫أيضا‬ ‫يعاني‬ ‫وقد‬ ‫الذراعين‬ ‫وتحت‬ ‫الشرج‬ ‫فتحة‬ ‫حول‬ ‫القيحي‬ ‫األذنين‬ ‫وحول‬ ‫وخلف‬ ‫الرقبة‬ ‫من‬ ‫الخلفي‬ ‫الجزء‬ ‫في‬ ‫القيحي‬ ‫العرقية‬.2,3
  • 25.
    ‫التالية‬ ‫التشخيصية‬ ‫المعايير‬‫علي‬ ‫التشخيص‬ ‫ويعتمد‬: ١-‫إصابات‬‫محدده‬ ‫بهيئة‬:‫عميقة‬ ‫مؤلمة‬ ‫قدة‬ُ‫ع‬ ‫إما‬(‫دمامل‬ ‫مغلقة‬)‫متصلة‬ ‫وندوب‬ ‫نازفة‬ ‫جيوب‬ ،‫خراريج‬ ‫أو‬. ٢-‫إصابات‬‫محدده‬ ‫بأماكن‬:،‫الفخذ‬ ‫وأعلى‬ ،‫اإلبطين‬ ،‫الشرج‬ ‫بفتحة‬ ‫المحيطة‬ ‫والمنطقة‬ ،‫التناسلية‬ ‫واألعضاء‬ ‫الثديين‬ ‫وبين‬ ‫طيات‬ ‫وتحت‬ ،‫واألرداف‬. ٣-‫إصابات‬‫ومتكرره‬ ‫مزمنه‬.3
  • 26.
    ‫القيحي؟‬ ‫العرقية‬ ‫الغدد‬‫التهاب‬ ‫أعراض‬ ‫هي‬ ‫ما‬ ‫تشخيص‬ ‫في‬ ‫لبس‬ ‫يحدث‬ ‫ما‬ ‫غالبا‬‫التهاب‬ ‫القيحي‬ ‫العرقية‬ ‫الغدد‬‫الحاالت‬ ‫من‬ ‫عديد‬ ‫مع‬ ،‫والخراريج‬ ،‫الشباب‬ ‫حب‬ ‫مثل‬ ‫األخرى‬ ،‫الدهنية‬ ‫واألكياس‬.....‫التأخير‬ ‫يكون‬ ‫لذلك‬ ‫دائما‬ ‫شائع‬ ‫التشخيص‬ ‫في‬.3
  • 27.
    ‫يلي‬ ‫ما‬ ‫القيحي‬‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫وأعراض‬ ‫عالمات‬ ‫وتشمل‬: ●‫الرؤوس‬‫على‬ ‫تحتوي‬ ‫الجلد‬ ‫في‬ ‫صغيرة‬ ‫حفر‬ ‫مناطق‬ ‫وهم‬ ‫السوداء‬ ‫السوداء‬ ‫الرؤوس‬ ●‫قرح‬‫وقد‬ ‫الصديد‬ ‫ويخرج‬ ‫تنفتح‬ ‫ثم‬ ‫تكبر‬ ‫ما‬ ‫وغالبا‬ ‫ودمامل‬ ‫حمراء‬ ‫رقيقة‬ ،‫بالحرقان‬ ‫وشعور‬ ،‫حكة‬ ‫القرح‬ ‫هذه‬ ‫يصاحب‬ ‫وقد‬ ‫كريهة‬ ‫رائحة‬ ‫للصديد‬ ‫يكون‬ ‫مفرط‬ ‫وتعرق‬ ●‫كتل‬‫تستمر‬ ‫وقد‬ ،‫الجلد‬ ‫تحت‬ ‫تنمو‬ ،‫صلبة‬ ‫ملتهبة‬ ‫كتل‬ ‫وهي‬ ‫مؤلمة‬ ‫لسنوات‬.‫دمل‬ ‫بظهور‬ ‫البلوغ‬ ‫سن‬ ‫بعد‬ ‫القيحي‬ ‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫يبدأ‬ ‫ما‬ ‫وغالبا‬ ‫أشهر‬ ‫أو‬ ‫لألسابيع‬ ‫يستمر‬ ‫مؤلم‬ ‫واحد‬ ●‫قرح‬‫الجلد‬ ‫تحت‬ ‫وبثور‬ ‫ندوب‬ ‫إلى‬ ‫مؤدية‬ ‫إلتئامها‬ ‫يتأخر‬ ‫وعادة‬ ‫مفرزه‬2
  • 28.
    ‫القيحي؟‬ ‫العرقية‬ ‫الغدد‬‫التهاب‬ ‫سبب‬ ‫هو‬ ‫ما‬ ‫سبب‬‫القيحي‬ ‫العرقية‬ ‫الغدد‬ ‫التهاب‬‫حتى‬ ‫معروف‬ ‫غير‬ ‫من‬ ‫عرضة‬ ‫أكثر‬ ‫الناس‬ ‫بعض‬ ‫أن‬ ‫الواضح‬ ‫ومن‬ ،‫اآلن‬ ‫معروفة‬ ‫غير‬ ‫واألسباب‬ ،‫المرض‬ ‫هذا‬ ‫لتطور‬ ‫غيرهم‬ ‫أيضا‬.1 ‫يتطور‬‫القيحي‬ ‫العرقية‬ ‫ّد‬‫د‬‫الغ‬ ‫التهاب‬‫انسداد‬ ‫يحدث‬ ‫عندما‬ ‫ملتهبة‬ ‫وتصبح‬ ‫الشعر‬ ‫لبصيالت‬.‫هذا‬ ‫حدوث‬ ‫وسبب‬ ‫العوامل‬ ‫من‬ ‫عدد‬ ‫تلعب‬ ‫قد‬ ‫ولكن‬ ،‫معروف‬ ‫غير‬ ‫االنسداد‬ ‫الجنس‬ ‫ونوع‬ ،‫والعمر‬ ،‫العائلي‬ ‫والتاريخ‬ ‫الهرمونات‬ ‫مثل‬ ‫ذلك‬ ‫في‬ ‫دورا‬.2,4 ‫العرق‬ ‫يكون‬ ‫عندما‬ ‫االنسداد‬ ‫هذا‬ ‫يحدث‬ ‫قد‬ ‫أنه‬ ‫عتقد‬ُ‫ي‬‫و‬ ‫ث‬ ‫النهاية‬ ‫في‬ ‫لتتورم‬ ‫العرقية‬ ‫الغدد‬ ‫أنابيب‬ ‫داخل‬ ‫محصورا‬‫م‬ ‫حادا‬ ‫التهابا‬ ‫تسبب‬ ‫أو‬ ‫تنفجر‬.
  • 29.
    ‫القيحي؟‬ ‫العرقية‬ ‫الغدد‬‫التهاب‬ ‫سبب‬ ‫هو‬ ‫ما‬ ‫بين‬ ‫صلة‬ ‫وجود‬ ‫الطبية‬ ‫البحوث‬ ‫أثبتت‬ ،‫ذلك‬ ‫إلى‬ ‫وباإلضافة‬ ‫القيحي‬ ‫العرقية‬ ‫الغدد‬ ‫التهاب‬‫من‬ ‫وكل‬‫التدخين‬‫والسمنة‬.‫قد‬ ‫األعراض‬ ‫تفاقم‬ ‫إلى‬ ‫هذه‬ ‫الخطر‬ ‫عوامل‬ ‫بعض‬ ‫تؤدي‬. ‫أن‬ ‫نعرف‬ ‫أن‬ ‫جدا‬ ‫المهم‬ ‫ومن‬‫ليس‬ ‫القيحي‬ ‫العرقية‬ ‫ّد‬‫د‬‫الغ‬ ‫التهاب‬ ‫معديا‬‫زيادة‬ ‫أو‬ ،‫التغذية‬ ‫لسوء‬ ‫أو‬ ،‫النظافة‬ ‫قلة‬ ‫عن‬ ‫ناتجا‬ ‫وليس‬ ، ‫الوزن‬.1
  • 30.
    ‫القيحي؟‬ ‫العرقية‬ ‫الغدد‬‫التهاب‬ ‫في‬ ‫الخطر‬ ‫عوامل‬ ‫هي‬ ‫ما‬ ‫العمر‬ ●‫الذين‬ ‫الصغار‬ ‫البالغين‬ ‫في‬ ‫القيحي‬ ‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫يحدث‬ ‫أى‬ ‫في‬ ‫يحدث‬ ‫أن‬ ‫يمكن‬ ‫ولكنه‬ ،‫العشرينات‬ ‫أوائل‬ ‫في‬ ‫أعمارهم‬ ‫تكون‬ ‫عمر‬ ●‫ينخفض‬‫سن‬ ‫بعد‬ ‫عادة‬ ‫االنتشار‬ ‫معدل‬55‫سنة‬4
  • 31.
    ‫القيحي؟‬ ‫العرقية‬ ‫الغدد‬‫التهاب‬ ‫في‬ ‫الخطر‬ ‫عوامل‬ ‫هي‬ ‫ما‬ ‫الجنس‬ ‫نوع‬ ●‫المرأة‬‫بالمرض‬ ‫لإلصابة‬ ‫عرضة‬ ‫أكثر‬ ‫الرجل‬ ‫من‬2,4
  • 32.
    ‫القيحي؟‬ ‫العرقية‬ ‫الغدد‬‫التهاب‬ ‫في‬ ‫الخطر‬ ‫عوامل‬ ‫هي‬ ‫ما‬ ‫الوراثية‬ ‫العوامل‬ ●‫تبين‬‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫أن‬ ‫األبحاث‬ ‫وراثيا‬ ‫العائالت‬ ‫في‬ ‫ينتقل‬ ‫قد‬ ‫القيحي‬ ●‫تم‬ ‫الذين‬ ‫األشخاص‬ ‫ثلث‬ ‫حوالي‬ ‫القي‬ ‫العرقية‬ ‫الغدد‬ ‫بالتهاب‬ ‫كمصابين‬ ‫تشخيصهم‬‫حي‬ ‫الحالة‬ ‫من‬ ‫يعاني‬ ‫العائلة‬ ‫أفراد‬ ‫أحد‬ ‫أيضا‬ ‫لديهم‬4
  • 33.
    ‫القيحي؟‬ ‫العرقية‬ ‫الغدد‬‫التهاب‬ ‫في‬ ‫الخطر‬ ‫عوامل‬ ‫هي‬ ‫ما‬ ‫الهرمونات‬ ●‫خالل‬ ‫المرض‬ ‫انتشار‬ ‫ذروة‬ ‫تشير‬ ‫الجنسية‬ ‫بالهرمونات‬ ‫صلته‬ ‫إلى‬ ‫اإلنجاب‬ ‫سنوات‬ ‫مباشرة‬ ‫صلة‬ ‫وجود‬ ‫على‬ ‫دليل‬ ‫يوجد‬ ‫ال‬ ‫ولكن‬4
  • 34.
    ‫المرض‬ ‫أعراض‬ ‫أهم‬ ‫رائحة‬‫ذات‬ ‫صديد‬ ‫لتسرب‬ ‫تنكسر‬ ‫قد‬ ‫مؤلمة‬ ‫تكتالت‬ ‫تتكون‬ ‫كريهة‬.‫تحت‬ ‫الكتل‬ ‫هذه‬ ‫تربط‬ ‫إنفاق‬ ‫تتكون‬ ‫كثيرة‬ ‫حاالت‬ ‫وفى‬ ‫الجلد‬. ‫ويزداد‬ ‫لألعوام‬ ‫مستمرا‬ ‫ويبقى‬ ‫البلوغ‬ ‫عند‬ ‫المرض‬ ‫هذا‬ ‫يبدأ‬ ‫الوقت‬ ‫مع‬ ‫سوءا‬. ‫في‬ ‫يساعد‬ ‫قد‬ ‫المرض‬ ‫لهذا‬ ‫المبكر‬ ‫والعالج‬ ‫التشخيص‬ ‫فإن‬ ‫لذا‬ ‫التكون‬ ‫من‬ ‫جديده‬ ‫قرح‬ ‫ومنع‬ ‫األعراض‬ ‫مع‬ ‫التعامل‬.2
  • 35.
    ‫القيحي؟‬ ‫العرقية‬ ‫الغدد‬‫التهاب‬ ‫مراحل‬ ‫هي‬ ‫ما‬ ‫هارلي‬ ‫مؤشر‬ ‫مثل‬ ‫المقاييس‬ ‫لبعض‬ ‫وفقا‬ ‫القيحي‬ ‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫شدة‬ ‫تصنيف‬ ‫يتم‬: ‫هارلي‬ ‫مراحل‬5 ‫نطاق‬ ‫على‬ ‫خراريج‬ ‫حدوث‬ ‫قنوات‬ ‫وجود‬ ‫مع‬ ‫واسع‬ ‫تؤدى‬ ‫قد‬ ،‫مترابطة‬ ‫عديدة‬ ‫صديد‬ ‫إطالق‬ ‫إلى‬.5 ‫من‬ ‫قليلة‬ ‫أعداد‬ ‫أو‬ ‫خراج‬ ‫أو‬ ‫دمامل‬ ‫أو‬ ‫تجاويف‬ ‫بدون‬ ‫المعزولة‬ ‫الخراريج‬ ‫قنوات‬. ‫فى‬ ‫متكررة‬ ‫خراريج‬ ‫وجود‬ ‫مع‬ ‫متعددة‬ ‫مناطق‬ ‫وقنوات‬ ‫وتجاويف‬ ‫ندوب‬.
  • 36.
    ‫القيحي؟‬ ‫العرقية‬ ‫الغدد‬‫التهاب‬ ‫تشخيص‬ ‫يمكن‬ ‫كيف‬ ‫عادة‬‫ما‬‫جرى‬ُ‫ي‬‫التشخيص‬‫من‬‫بل‬ِ‫ق‬‫طبيب‬،‫حيث‬‫يقوم‬‫بفحص‬‫المنط‬‫قة‬ ‫واألعراض‬‫والتاريخ‬‫الم‬‫رضي‬.6 ‫ال‬‫يوجد‬‫اختبار‬‫محدد‬‫يمكن‬‫إجراء‬‫التشخيص‬‫على‬‫أساسه‬. ‫غالبا‬‫ما‬‫شخص‬ُ‫ي‬‫هذا‬‫المرض‬‫بشكل‬‫خاطئ‬،‫حيث‬‫يشبه‬‫كثيرا‬‫الدم‬‫امل‬‫البسيطة‬ ‫أو‬‫تكيسات‬‫الجلد‬‫صابة‬ُ‫م‬‫ال‬‫بعدوى‬.4 ‫قد‬‫يؤدي‬‫ذلك‬‫األمر‬‫إلى‬‫تأخر‬‫العالج‬‫وتطور‬‫المرض‬‫مع‬‫ظهور‬‫ندبات‬7,8.
  • 37.
    ‫القيحي؟‬ ‫العرقية‬ ‫الغدد‬‫التهاب‬ ‫عالج‬ ‫يمكن‬ ‫هل‬ ●‫يمكن‬‫عالج‬‫التهاب‬‫الغدد‬‫العرقية‬‫القيحي‬‫ولكن‬‫ال‬‫يمكن‬‫شف‬‫اؤه‬ ‫بشكل‬‫نهائي‬. ●‫يعمل‬‫العالج‬‫بأفضل‬‫فاعلية‬‫في‬‫األمراض‬‫االلتهابية‬‫النش‬‫طة‬ ‫باستخدام‬‫العالجات‬‫الطبية‬.‫في‬‫حال‬‫اإلصابة‬‫بالتهاب‬‫الغدد‬‫العرقي‬‫ة‬ ‫القيحي‬‫لمدة‬‫أطول‬‫من‬‫المعتاد‬–‫األمر‬‫الذي‬‫ينتج‬‫عنه‬‫حدوث‬‫إصابات‬ ‫أو‬‫ندبات‬‫واسعة‬‫االنتشار‬‫مصحوبة‬‫بالتهابات‬‫أقل‬-‫قد‬‫ب‬َّ‫يتطل‬‫األمر‬ ‫إجراء‬‫جراحة‬.6
  • 38.
    ‫للموعد‬ ‫التحضير‬ ●‫مرة‬ ‫ألول‬‫حدثت‬ ‫ومتى‬ ‫واألعراض‬ ‫العالمات‬ ‫جميع‬ ‫أكتب‬. ‫تكررت‬ ‫قد‬ ‫كانت‬ ‫إذا‬ ‫وما‬ ‫اإلصابات‬ ‫هذه‬ ‫استمرار‬ ‫مدة‬ ‫ل‬ّ‫ج‬‫وس‬. ●‫تتناولها‬ ‫التي‬ ‫األدوية‬ ‫جميع‬ ‫قائمة‬ ‫في‬ ‫أدرج‬.‫الجرعات‬ ‫ل‬ّ‫ج‬‫وس‬ ‫قائمتك‬ ‫في‬ ‫المدرجة‬ ‫األدوية‬ ‫من‬ ‫واحد‬ ‫لكل‬. ●‫طبيبك‬ ‫على‬ ‫تطرحها‬ ‫أن‬ ‫تود‬ ‫التي‬ ‫األسئلة‬ ‫أيضا‬ ‫أكتب‬.2
  • 39.
    ‫المنزلية‬ ‫والعالجات‬ ‫الحياة‬‫نمط‬ ‫وسرعة‬ ‫الراحة‬ ‫عدم‬ ‫تخفيف‬ ‫في‬ ‫التالية‬ ‫االقتراحات‬ ‫تساعد‬ ‫قد‬ ‫االلتئام‬: ●‫الدافئة‬ ‫الكمادات‬ ‫استخدام‬:‫دافئة‬ ‫كمادة‬ ‫أو‬ ‫منشفة‬ ‫تساعد‬ ‫أن‬ ‫يمكن‬ 2‫التورم‬ ‫تقليل‬ ‫في‬ ●‫نظيفة‬ ‫المصابة‬ ‫المنطقة‬ ‫على‬ ‫الحفاظ‬:‫المناطق‬ ‫غسل‬ 2‫للبكتريا‬ ‫مضاد‬ ‫بصابون‬ ‫بلطف‬ ‫المصابة‬ 4 ●‫االتوتر‬ ‫ادارة‬ 4 ●‫التدخين‬ ‫عن‬ ‫التوقف‬
  • 40.
    ‫المنزلية‬ ‫والعالجات‬ ‫الحياة‬‫نمط‬ ‫وسرعة‬ ‫الراحة‬ ‫عدم‬ ‫تخفيف‬ ‫في‬ ‫التالية‬ ‫االقتراحات‬ ‫تساعد‬ ‫قد‬ ‫االلتئام‬: ●‫الوزن‬ ‫فقدان‬:‫يحتك‬ ‫التي‬ ‫المناطق‬ ‫عدد‬ ‫من‬ ‫الزائد‬ ‫الوزن‬ ‫يزيد‬ ‫البعض‬ ‫بعضه‬ ‫مع‬ ‫الجلد‬ ‫فيه‬–‫طيات‬ ‫بين‬ ،‫المثال‬ ‫سبيل‬ ‫وعلى‬ ‫البكتريا‬ ‫ونمو‬ ،‫العرق‬ ‫وزيادة‬ ‫االحتكاك‬ ‫يسبب‬ ‫مما‬ ،‫الجلد‬.‫على‬ ‫يحسن‬ ‫قد‬ ‫فإنه‬ ،‫المرض‬ ‫هذا‬ ‫يعالج‬ ‫ال‬ ‫الوزن‬ ‫فقدان‬ ‫أن‬ ‫من‬ ‫الرغم‬ ‫من‬‫األعراض‬2 ●‫فضفاضة‬ ‫مالبس‬ ‫ارتداء‬:‫المالبس‬ ‫تساعد‬ ‫أن‬ ‫يمكن‬ ‫الضيقة‬ ‫المالبس‬ ‫أن‬ ‫حين‬ ‫في‬ ،‫الجلد‬ ‫تهيج‬ ‫منع‬ ‫في‬ ‫الفضفاضة‬ 2‫جلدك‬ ‫تهيج‬ ‫قد‬ ‫واالصطناعية‬ 4 ●‫دعم‬ ‫مجموعة‬ ‫إلى‬ ‫االنضمام‬ ‫في‬ ‫فكر‬
  • 41.
    ‫المتداولة‬ ‫األسئلة‬ ‫معدي؟‬ ‫القيحي‬‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫هل‬ ‫معديا‬ ‫ليس‬ ‫القيحي‬ ‫العرقية‬ ‫الغدد‬ ‫فالتهاب‬ ،‫ال‬.‫باللمس‬ ‫ينتقل‬ ‫وال‬.1 ‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫من‬ ‫الشفاء‬ ‫إلى‬ ‫هذا‬ ‫يؤدى‬ ‫فهل‬ ،‫التدخين‬ ‫عن‬ ‫أقلعت‬ ‫إذا‬ ‫منه؟‬ ‫أعانى‬ ‫الذى‬ ‫القيحي‬ ،‫والتدخين‬ ‫القيحي‬ ‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫بين‬ ‫صلة‬ ‫الطبية‬ ‫البحوث‬ ‫أوجدت‬ ‫الغدد‬ ‫التهاب‬ ‫بمرض‬ ‫لإلصابة‬ ‫يؤدى‬ ‫التدخين‬ ‫كان‬ ‫إذا‬ ‫ما‬ ‫حول‬ ‫جدل‬ ‫وهناك‬ 6 ‫القيحي‬ ‫العرقية‬. ‫القيحي؟‬ ‫العرقية‬ ‫الغدد‬ ‫والتهاب‬ ‫السرطان‬ ‫بين‬ ‫عالقة‬ ‫هناك‬ ‫هل‬ ‫بنسبة‬ ‫زيادة‬ ‫هناك‬ ‫أن‬ ‫األبحاث‬ ‫تشير‬ ،‫نعم‬50‫بالسرطان‬ ‫اإلصابة‬ ‫خطر‬ ‫في‬ ٪ ‫مع‬ ‫بالمقارنة‬ ،‫القيحي‬ ‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫من‬ ‫يعانون‬ ‫الذين‬ ‫المرضى‬ ‫في‬ ‫األفراد‬‫العاديين‬.5
  • 42.
    ‫المتداولة‬ ‫األسئلة‬ ‫العرقية‬ ‫الغدد‬‫التهاب‬ ‫تفشي‬ ‫حاالت‬ ‫عدد‬ ‫تقليل‬ ‫على‬ ‫الوزن‬ ‫فقدان‬ ‫يساعد‬ ‫هل‬ ‫القيحي؟‬ ‫لهذا‬ ‫خطر‬ ‫عوامل‬ ‫هي‬ ‫والسمنة‬ ‫الوزن‬ ‫في‬ ‫الزيادة‬ ‫أن‬ ‫إلى‬ ‫الدراسات‬ ‫تشير‬ ‫المرض‬.‫إلى‬ ‫ويؤدي‬ ‫الجلد‬ ‫ثنايا‬ ‫بين‬ ‫ما‬ ‫الجسم‬ ‫احتكاك‬ ‫يسبب‬ ‫الزائد‬ ‫الوزن‬ ‫البكتيريا‬ ‫ونمو‬ ‫العرق‬ ‫إفراز‬.‫من‬ ‫يحسن‬ ‫ولكنه‬ ‫يعالج‬ ‫لن‬ ‫الوزن‬ ‫إنقاص‬ ‫المرض‬ ‫أعراض‬.2,3 ‫هل‬ ‫أو‬ ،‫والدي‬ ‫من‬ ‫ورثته‬ ‫وهل‬ ‫وراثي؟‬ ‫القيحي‬ ‫العرقية‬ ‫ّد‬‫د‬‫الغ‬ ‫التهاب‬ ‫هل‬ ‫أوالدي؟‬ ‫إلی‬ ‫نقله‬ ‫يمكنني‬ ‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫لمرض‬ ‫وراثي‬ ‫استعداد‬ ‫هناك‬ ‫أن‬ ‫األبحاث‬ ‫وجدت‬ ‫القيحي‬.‫فإن‬ ،‫الواقع‬ ‫وفي‬30‫للحالة‬ ‫عائلي‬ ‫تاريخ‬ ‫لديهم‬ ‫المرضى‬ ‫من‬ ٪.4
  • 43.
    ‫المتداولة‬ ‫األسئلة‬ ‫الدم؟‬ ‫عينات‬‫من‬ ‫القيحي‬ ‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫تشخيص‬ ‫يمكن‬ ‫هل‬ ‫ال‬.‫طريق‬ ‫عن‬ ‫القيحي‬ ‫العرقية‬ ‫ّد‬‫د‬‫الغ‬ ‫التهاب‬ ‫لتشخيص‬ ‫اختبار‬ ‫يوجد‬ ‫ال‬ ‫الدم‬ ‫عينات‬.4 ‫هل‬‫مع‬ ‫التعامل‬ ‫في‬ ‫للمساعدة‬ ‫المالبس‬ ‫من‬ ‫معينة‬ ‫أنواع‬ ‫أرتدى‬ ‫أن‬ ‫يجب‬ ‫القيحي؟‬ ‫العرقية‬ ‫الغدد‬ ‫التهاب‬ ‫االصطناعي‬ ‫المالبس‬ ‫عن‬ ‫مفضلة‬ ‫والفضفاضة‬ ‫القطنية‬ ‫المالبس‬ ‫تكون‬ ‫عادة‬‫ة‬ ‫الضيقة‬ ‫أو‬ ‫الصوفية‬ ‫أو‬.2 ‫اإلكتئاب؟‬ ‫إلى‬ ‫يؤدى‬ ‫المرض‬ ‫هذا‬ ‫هل‬ ‫اإلختالط‬ ‫عن‬ ‫واإلنعزال‬ ‫اإلحراج‬ ‫تسبب‬ ‫قد‬ ‫واإلفرازات‬ ‫الكريهة‬ ‫الرائحة‬ ‫اإلكتئاب‬ ‫إلى‬ ‫مؤدية‬.2