Clinical discussion of patients with follicular occlusion syndrome and comorbid pathology

Follicular occlusion syndrome includes hidradenitis suppurativa (HS), acne conglobata, perifolliculitis capitis abscedens et suffodiens and pilonidal cyst leading to the formation of painful nodules, abscesses, comedones, fistulous passages and scars. Patients with follicular occlusion syndrome have a number of comorbid conditions including autoinflammatory diseases that may indicate a common etiology of these pathologies and confirm the presence of chronic inflammatory process in HS pathogenesis. Follicular occlusion syndrome is a rather complex disease for treatment and the presence of comorbid conditions imposes certain difficulties in approach to therapy of such patients. We present 3 clinical cases of patients with follicular occlusion syndrome and comorbid autoinflammatory disease: ankylosing spondylitis, Chron’s disease and psoriasis. Patients received therapy: secukinumab (anti-IL-17A) in combination with isotretinoin, ixekizumab (anti-IL-17A). The provided treatment was insufficient to achieve complete remission of follicular occlusion syndrome. The described clinical cases allow to pay attention on the difficulties in managing patients with this syndrome even when using biological therapy or combined treatment, as well as indicate the need for interdisciplinary management of patients with comorbid pathologies.