Continuing medical educationHidradenitis suppurativa: Current and emerging treatments
Section snippets
Established therapies
Key points Antibiotics are used to decrease inflammation and to treat secondary infection Systemic tetracyclines, alone or in combination with other agents, are frequently used as first-line treatments Prednisone does not have much benefit alone, but may increase the response to adalimumab Surgery remains an important treatment for HS; wide excision is the only known curative procedure Weight loss and smoking cessation counseling should be recommended for patients with HS
Biologic therapies
Key points Advances in the understanding of HS pathogenesis has guided studies to investigate the therapeutic role of biologics for this disease Tumor necrosis factor–α inhibitors are effective and safe for the treatment of HS; adalimumab is the only therapy for HS approved by the US Food and Drug Administration There are several ongoing clinical trials for newer biologic therapies targeting multiple cytokines It is likely that multiple immunologic pathways are implicated in HS progression, so complete
Other therapies
Key points Ethinyloestradiol, noregestrol, and cyproterone acetate have not been effective for HS treatment, but finasteride might decrease symptoms Systemic retinoids might decrease symptoms in younger patients with HS with acne and lower body weight For mild HS, a combination of antibacterial soap, warm compresses, and sodium dusidate 2% ointment may decrease lesion size and symptoms
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Funding sources: None.
Date of release: May 2020
Expiration date: May 2023
Dr Strober serves as a consultant for AbbVie, Almirall, Amgen, Arena, Aristea, Boehringer Ingelheim, Bristol-Myers-Squibb, Celgene, Dermavant, Dermira, Janssen, Leo, Eli Lilly, Kyowa Hakko Kirin, Meiji Seika Pharma, Novartis, Pfizer, GlaxoSmithKline, UCB Pharma, Sun Pharma, Ortho Dermatologics, Regeneron, Sanofi-Genzyme. Dr Strober is also a speaker for AbbVie, Lilly, Janssen, Ortho Dermatologics. Dr Strober is also a scientific director for Corrona Psoriasis Registry. Dr Strober is also an investigator for Dermavant, AbbVie, Corrona Psoriasis Registry, Dermira. Dr Payette is a consultant for Abbvie Inc, Novartis, and Janssen Global Services.