Hidradenitis Suppurativa: Advances in Diagnosis and Treatment
- PMID: 29183082
- DOI: 10.1001/jama.2017.16691
Hidradenitis Suppurativa: Advances in Diagnosis and Treatment
Abstract
Importance: Hidradenitis suppurativa (HS) is relatively common, with the prevalence of 0.05% to 4.10%, yet many patients receive inadequate treatment.
Objective: To review the diagnosis, epidemiology, and treatment of HS with an emphasis on advances in the last 5 years.
Evidence review: A literature search was conducted using PubMed, MEDLINE (Medical Subject Headings [MeSH]), and EMBASE to include recently published treatment studies (searched from September 1, 2011, to May 1, 2017). Reviews, guidelines, conference abstracts, and studies with less than 10 patients were excluded. Furthermore, internet searches for guidelines on hidradenitis suppurativa using Baidu, Bing, Google, and Qwant browsers were performed.
Findings: The diagnosis of HS is made by lesion morphology (nodules, abscesses, tunnels, and scars), location (axillae, inframammary folds, groin, perigenital, or perineal), and lesion progression (2 recurrences within 6 months or chronic or persistent lesions for ≥3 months). HS is more common than was previously thought based on epidemiological analysis (0.05%-4.10%). Disability from HS can be significant. Patients with HS may have significant comorbidities (eg, obesity, metabolic syndrome, diabetes, and arthritis) and increased all-cause mortality (incidence rate ratio, 1.35 [95% CI, 1.15-1.59]). Antibiotic treatment with combinations of clindamycin and rifampicin, or ertapenem followed by combination rifampicin, moxifloxacin, and metronidazole for 6 months is effective. Adalimumab is effective in a significant proportion of patients and treatment with IL-1 and IL-12 receptor subunit beta 1 (Rb1) antibodies may also be useful. Tissue-sparing surgical techniques and carbon dioxide laser treatments also are available, but the evidence on clinical outcomes with these approaches is limited.
Conclusions and relevance: Hidradenitis suppurativa is more common than previously thought and may be treated by an array of pharmacological and surgical techniques. Hidradenitis suppurativa should be considered in the differential diagnosis of nodular lesions or sinus tracts present in the axillae, groin, perineal, and mammillary fold regions.
Comment in
-
Diagnosis and Treatment of Hidradenitis Suppurativa.JAMA. 2018 Apr 17;319(15):1617-1618. doi: 10.1001/jama.2018.0814. JAMA. 2018. PMID: 29677295 No abstract available.
-
Diagnosis and Treatment of Hidradenitis Suppurativa.JAMA. 2018 Apr 17;319(15):1618. doi: 10.1001/jama.2018.0818. JAMA. 2018. PMID: 29677296 No abstract available.
Similar articles
-
Two Cases of Hidradenitis Suppurativa Treated with Adalimumab at the Department of Dermatology and Venereology, Clinical Hospital Mostar.Acta Dermatovenerol Croat. 2021 Jul;29(2):108-110. Acta Dermatovenerol Croat. 2021. PMID: 34477078
-
Lymecycline vs. clindamycin plus rifampicin in hidradenitis suppurativa treatment: clinical and ultrasonography evaluation.Clin Exp Dermatol. 2021 Jan;46(1):96-102. doi: 10.1111/ced.14388. Epub 2020 Sep 17. Clin Exp Dermatol. 2021. PMID: 32683727
-
Novel Therapeutic Approaches and Targets for the Treatment of Hidradenitis Suppurativa.Curr Pharm Biotechnol. 2021;22(1):59-72. doi: 10.2174/1389201021666200505100556. Curr Pharm Biotechnol. 2021. PMID: 32368973 Review.
-
Evidence-based approach to the treatment of hidradenitis suppurativa/acne inversa, based on the European guidelines for hidradenitis suppurativa.Rev Endocr Metab Disord. 2016 Sep;17(3):343-351. doi: 10.1007/s11154-016-9328-5. Rev Endocr Metab Disord. 2016. PMID: 26831295 Free PMC article. Review.
-
Hidradenitis suppurativa: A practical review of possible medical treatments based on over 350 hidradenitis patients.Dermatol Online J. 2013 Apr 15;19(4):1. Dermatol Online J. 2013. PMID: 24021361 Review.
Cited by
-
Topical and Systemic Retinoids in the Management of Hidradenitis Suppurativa: A Comprehensive Literature Review.Dermatol Ther (Heidelb). 2024 May;14(5):1079-1091. doi: 10.1007/s13555-024-01169-1. Epub 2024 May 3. Dermatol Ther (Heidelb). 2024. PMID: 38700645 Free PMC article. Review.
-
Interstitial keratitis presenting as the ocular manifestation of undiagnosed hidradenitis suppurativa.Proc (Bayl Univ Med Cent). 2024 Feb 28;37(3):479-481. doi: 10.1080/08998280.2024.2315540. eCollection 2024. Proc (Bayl Univ Med Cent). 2024. PMID: 38628332 Free PMC article.
-
Effectiveness of Surgical Deroofing and Carbon Dioxide Laser in Moderate-to-Severe Hidradenitis Suppurativa Patients.Cureus. 2024 Mar 26;16(3):e56959. doi: 10.7759/cureus.56959. eCollection 2024 Mar. Cureus. 2024. PMID: 38545424 Free PMC article. Review.
-
Diseases categorized as autoinflammatory keratinization diseases (AiKDs), and their pathologies and treatments.Nagoya J Med Sci. 2024 Feb;86(1):1-15. doi: 10.18999/nagjms.86.1.1. Nagoya J Med Sci. 2024. PMID: 38505726 Free PMC article. Review.
-
Reconstruction of Oncologic Axillary Defects.Eplasty. 2024 Jan 19;24:QA3. eCollection 2024. Eplasty. 2024. PMID: 38501142 Free PMC article. No abstract available.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Miscellaneous