Description
Hidradenitis Suppurativa: Pathophysiology and APTT3X Impact in Care
The pathologic process of hidradenitis suppurativa begins when a defective hair follicle becomes
occluded and ruptures, spilling its contents, including keratin and bacteria, into the surrounding dermis.
A chemotactic inflammatory response by surrounding neutrophils and lymphocytes can lead to abscess
formation and subsequent destruction of the pilosebaceous unit and other adjacent structures. Other
possible contributors to pathology include abnormal antimicrobial peptides, abnormal secretion of
apocrine glands, abnormal invaginations of the epidermis leading to tract formation, and deficient
numbers of sebaceous glands Immunological abnormalities have also been observed.
Elevated levels of inflammatory cytokines
Elevated levels of inflammatory cytokines,
including tumor necrosis factor-alpha and various interleukins, have been detected in the lesions of
hidradenitis suppurativa and provide possible targets for emerging treatments. Bacteria do not appear to
be causative. Aspirate from an unruptured lesion typically yields a sterile culture. However, bacterial
infection and colonization during the process can secondarily worsen hidradenitis suppurativa.
Up to half of the individuals will report a prodromal syndrome involving burning, stinging, pain, pruritus,
warmth, or hyperhidrosis in the area 12 to 48 hours before the appearance of a lesion. Triggers can
include menstruation, weight gain, stress, hormonal changes, excessive heat, and perspiration. On
presentation, individuals are typically well appearing and afebrile unless secondary infection or advanced
disease is present.
Characteristic primary lesions are deep-seated nodules, usually 0.5 to 2 cm, that last from days to
months. They are often mistaken for furuncles or “boils.” However, while a furuncle will respond rapidly
to drainage or antibiotics, the nodules of HS are deep and can rupture and track subcutaneously.
Multiple recurrent nodules in the same area may lead to the formation of intercommunicating sinus
tracts that can ulcerate or drain. Drainage may be purulent and malodorous. Other lesions include open
comedones (described as “tombstone” comedones), often double or multi-headed. In advanced stages,
thick fibrotic scars and plaques can develop, leading to architectural distortion of the area.
The axilla is the most common location for HS lesions. Other common areas are the inguinal, inner
thighs, perianal and perineal, inframammary, buttocks, pubic area, scrotum, vulva, trunk, and, less
commonly, the scalp and retro-auricular areas.
APT T3X
WHY APTT3X for treatment of HS lesions?
The extensive use of APTT3X formulation in Wound care (acute and chronic), Burn care,
Orthopedic/Trauma care and many forms of soft tissue infections provide a strong foundation of
efficacy that will and has translated to the benefit of HS patients incorporating APTT3XTM
formulation into their HS treatment program.
APTT3XTM formulation has key aspects of efficacy that lend itself to managing and stopping
these HS lesions.
The APTT3XTM formulation penetrates deeply into tissues- up to 2.5 cm in 24 hrs. This is
important due to treating these early developing HS lesions during “prodromal
symptoms” experienced by HS patients. Start sooner than later with applications.
Our active ingredient of 3% Tetracycline and the formulation, imparts direct inhibition to
the inflammatory cytokine cascade to mitigate ongoing development and rupture of
lesions due to the localized inflammation.
Cell Differentiation Enhancement
The APTT3X formulation contains our proprietary “Cell Differentiation Enhancement”
technology that provides pathways to optimize the localized healing (regenerative type
responses) of these nodules. As noted in wound care and burn care, we see dramatically
less scarring and fibrosis when the APTT3X formulation is the key component of care.
The APTT3XTM formulation will prevent any bacterial infection from developing and
creating secondary pain, inflammation. The APTT3XTM formulation WILL decrease the
use of oral antibiotics in managing HS lesions, hence removing many side effects patients
experience from long term oral antibiotic usage, in addition to developing resistance.
The APTT3XTM formulation will penetrate through scabs/crusts (eschars) when used to
manage more progressive lesions of HS. This addition of APTT3XTM will decrease the
needs for any form of surgical intervention for HS patients (deroofing procedures and
excisional surgery).
Importantly, there have been no adverse events reported or documented in over 8 years
of use of this topical APTT3XTM formulation.
APTT3X formulation for HS lesion treatments
The APTT3XTM formulation for HS lesion treatments will improve the lives of people suffering
from this debilitating and depressing condition. There is no reason not to integrate this
formulation into your long-term management strategies for Hidradenitis Suppurativa.
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