Is PASH Syndrome a Biofilm Disease?: A Case Series and Review of the Literature

Background: When occurring together, pyoderma gangrenosum, severe acne, and hidradenitis suppurativa have been described as PASH syndrome. Due to the chronic autoinflammatory state existing in affected patients, PASH syndrome has been attributed to the dysregulation of wound healing.

Case Study: Two cases are presented that demonstrate the paradigmatic clinical features of PASH syndrome and its potential link as an expanding spectrum of bacterial biofilm disorder. Biofilm is a dynamic, heterogenous species with a continuously evolving morphology. It has been associated with and found in a number of pathologies. These infectious networks can essentially affect every organ system in the human body, including skin. The complex architecture of biofilms presents a major challenge to clinicians due to an intrinsic ability to resist antibiotic therapy.  

Results: As reported herein, based on biofilm's clinical presentation and resistance to proper wound healing, it could serve as the common denominator and may redirect clinicians' treatment pathways in the near future.