Systemic Antibiotics in Hidradenitis Suppurativa

AbstractHidradenitis suppurativa is a chronic, debilitating inflammatory disease of apocrine glands characterized with abscesses and nodular lesions. The treatment of Hidradenitis suppurativa consists of topical antibacterial or antiseptic solutions, systemic antibiotics, steroids, hormonal therapy, anti-tumor necrosis factor, and various surgical procedures. In this report, we present a series of 14 cases with severe Hidradenitis suppurativa. Surgical options are reviewed to show the best outcomes in the long term. A total of 14 patients (9 female, 5 male) were treated for advanced cases of Hidradenitis suppurativa. They underwent excision of the affected regions followed by reconstruction. The reconstruction methods consisted of split-thickness skin grafting and various cutaneous and myocutaneous flaps. There was no flap necrosis or dehiscence. One patient developed contracture in the axilla, for which he underwent release surgery. There were recurrences in 4 cases. There was no limitation of the arm movements in cases with flap reconstruction. In the long-term, they were satisfied with the results. In conclusion, incision and drainage should be avoided because it is of limited value. Surgical removal of the involved tissue should be the first treatment of choice. Depending on the defect following excision, local flaps should be preferred over the grafts for recurrence prevention.

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Rapid Response to Certolizumab Pegol in Hidradenitis Suppurativa: A Case Report

Skin Appendage Disorders ◽

10.1159/000511284 ◽

2020 ◽

pp. 1-4

Author(s):

Pelin Esme ◽

Gulsen Akoglu ◽

Ercan Caliskan

Keyword(s):

Hidradenitis Suppurativa ◽

Certolizumab Pegol ◽

Life Quality ◽

Hair Follicles ◽

Tnf Alpha ◽

Therapeutic Approaches ◽

Surgical Experience ◽

Case Presentation ◽

Systemic Antibiotics

Introduction: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease of hair follicles which usually affects patients’ quality of life negatively. Although there are various therapeutic approaches including topical and systemic antibiotics, retinoids, biological agents, and also surgical modalities, there is no curative treatment option and clinical management of HS is still challenging. Case Presentation: Herein, we present a 43 year-old man with HS who had used different treatments in 15 years. The patient showed improvement initially with adalimumab, then exhibited secondary unresponsiveness after 18 months. While worsening of HS was recorded due to increased discharge under secukinumab, no additional benefit was observed with methotrexate. He was not willing to undergo surgical procedures due to previous surgical experience. Finally, certolizumab pegol has been started to patient with similar dosing to psoriasis patients. Sartorius, 10-point visual analogue scale (VAS), and dermatological life quality index (DLQI) scores regressed from 171 to 105, 9/10 to 3/10, and 27 to 19 after 3 months with certolizumab pegol treatment. Discussion/Conclusion: Certolizumab pegol is a humanized antigen-binding fragment of a monoclonal antibody which binds to TNF-alpha. However, certolizumab pegol is only approved for plaque psoriasis in dermatology; it is likely to be a promising effective agent for HS, especially in challenging cases.

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Radiotherapy for Hidradenitis Suppurativa: A Systematic Review

Dermatology ◽

10.1159/000514027 ◽

2021 ◽

pp. 1-8

Author(s):

Alyssa M. Thompson ◽

Justine Seivright ◽

Swetha Atluri ◽

Amanda Ederle ◽

Joanna Jaros ◽

...

Keyword(s):

Systematic Review ◽

Hidradenitis Suppurativa ◽

Lifestyle Modification ◽

Treatment Options ◽

Long Term Effects ◽

Treatment Regimens ◽

Inflammatory Dermatosis ◽

Low Dose Radiotherapy ◽

Management Recommendations ◽

Systemic Antibiotics

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory dermatosis characterized by painful nodules, abscesses, sinus tracts, and scarring mainly in the intertriginous areas. Patients with HS often experience inadequate responses to traditional treatment consisting of lifestyle modification, topical and systemic antibiotics, hormonal modulators, biologics, and procedural modalities. Low-dose radiotherapy has been used in benign cutaneous conditions, including HS; however, there is a paucity of literature summarizing its evidence. Herein, we systematically review the current literature on the efficacy of radiotherapy for patients with HS. Summary: This systematic review of the published literature reports the patient demographics, treatment regimens, efficacy, and adverse effects of radiotherapy in the treatment of HS. The historic timeline of these publications highlights the changes in management recommendations, introduction of more standardized outcome measures, and enhancements in treatment options. Radiotherapy appears to be an option for patients with treatment-resistant HS or who are poor surgical candidates. However, there remains a paucity of consensus on proper candidate selection, dosing, efficacy, and safety of the short- and long-term effects of radiotherapy.

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Comparison of the efficacy between systemic antibiotics and systemic retinoids in hidradenitis suppurativa

Journal of the American Academy of Dermatology ◽

10.1016/j.jaad.2018.05.365 ◽

2018 ◽

Vol 79 (3) ◽

pp. AB83

Keyword(s):

Hidradenitis Suppurativa ◽

Systemic Antibiotics

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Silver-coated textiles in hidradenitis suppurativa: A case report

SAGE Open Medical Case Reports ◽

10.1177/2050313x19845212 ◽

2019 ◽

Vol 7 ◽

pp. 2050313X1984521

Author(s):

Meggie Morand ◽

Afshin Hatami

Keyword(s):

Antimicrobial Activity ◽

Atopic Dermatitis ◽

Hidradenitis Suppurativa ◽

Skin Diseases ◽

Apocrine Gland ◽

Bacterial Proliferation ◽

Functional Textiles ◽

Systemic Antibiotics ◽

Pathologic Processes

Hidradenitis suppurativa is a chronic and debilitating skin disease of apocrine gland–bearing areas. The mainstay of treatment usually includes topical and systemic antibiotics. These agents can be used as monotherapy or combination therapy. The therapeutic role of functional textiles with antimicrobial activity has been recently emerging in the treatment of other skin diseases such as atopic dermatitis and epidermolysis bullosa. The pathologic processes involved in the development of atopic dermatitis and hidradenitis suppurativa are still incompletely understood, but these two diseases share some similarities including bacterial proliferation and chronic inflammation. We report the case of a 14-year-old boy with hidradenitis suppurativa that has been successfully treated with silver-coated textiles. To the best of our knowledge, this article is the first to report the benefits of silver-coated textiles in the treatment of hidradenitis suppurativa.

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Analysis of effectiveness, costs, quality of life, adherence and safety of the use of adalimumab in adults diagnosed with moderate to severe hidradenitis suppurativa: systematic review protocol

10.37766/inplasy2021.10.0010 ◽

2021 ◽

Author(s):

Nila Albuquerque ◽

◽

Franklin Regis ◽

Lucas Machado

Keyword(s):

Quality Of Life ◽

Hidradenitis Suppurativa ◽

Self Esteem ◽

Systemic Antibiotic Therapy ◽

Disease Condition ◽

Review Protocol ◽

Review Question ◽

Life Improvement ◽

Systemic Antibiotics

Review question / Objective: What evidence is available in longitudinal studies on the use of adalimumab for the treatment of moderate to severe hidradenitis suppurativa in adults with a diagnosis of moderate to severe hidradenitis suppurativa in which systemic antibiotic therapy has been shown to be ineffective and/or in situations where they present intolerance or contraindication to systemic antibiotics, compared to the application of usual care without the use of adalimumab, regarding the reduction in the total count of abscesses and nodules, decreased sensation of pain, therapeutic adherence, increased levels of self-esteem and quality of life, improvement in inflammatory nodules, abscesses and fistulas costs and expenses associated with the treatment of the disease? Condition being studied: Moderate to severe hidradenitis suppurativa.

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Hidradenitis Suppurativa in Kuala Lumpur, Malaysia: A 7-Year Retrospective Review

Dermatology Research and Practice ◽

10.1155/2018/2017959 ◽

2018 ◽

Vol 2018 ◽

pp. 1-9 ◽

Cited By ~ 2

Author(s):

Moonyza Akmal Ahmad Kamil ◽

Azura Mohd Affandi

Keyword(s):

Retrospective Review ◽

Hidradenitis Suppurativa ◽

Clinical Characteristics ◽

Surgical Intervention ◽

Skin Condition ◽

Treatment Modalities ◽

Kuala Lumpur ◽

Delay In Diagnosis ◽

Males And Females ◽

Systemic Antibiotics

Introduction. Hidradenitis Suppurativa (HS) is a chronic inflammatory skin condition characterized by inflamed nodules, abscesses, sinus tracts, and scarring, which can occur in any skin containing folliculopilosebaceous units. We aim to identify the demographic and clinical characteristics and treatment modalities in patients with HS. Methods. A retrospective analysis involving records of patients diagnosed with HS in Hospital Kuala Lumpur from July 2009 to June 2016. Results. Sixty-two patients were identified, with equal cases involving males and females. Majority of patients were Malays (41.9%), followed by Indians (35.5%), Chinese (17.7%), and other ethnicities (4.8%). Median age at diagnosis was 25 (IQR: 14) years. There is a delay in diagnosis with a median of 24 (IQR: 52) months. Most of the patients had lesions on the axilla (85.5%), followed by groin (33.9%) and gluteal region (29%). Gluteal lesions were more common in males. Nodules (67.7%), sinuses (56.5%), and abscesses (33.9%) were the main clinical features, with 43.5% classified under Hurley stage 2. There was no difference in terms of symptoms and types of lesions among different ethnicities and genders. Majority received systemic antibiotics, more than half had retinoid, and third of the patients had surgical intervention. Conclusions. A prompt recognition of HS is imperative, to screen for comorbidities and to initiate early treatment to reduce physical and psychological complications.

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