Local, systemic and surgical treatment of hidradenitis suppurativa – literature review

Austėja Šakaityė1, Tadas Raudonis2

1Vilnius University, Faculty of Medicine, Vilnius, Lithuania

2Vilnius University, Centre of Dermatovenereology, Vilnius, Lithuania

Abstract

Introduction. Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder characterised by painful lesions found in areas with apocrine glands. HS is estimated to affect approximately 1% of the general population, with a higher incidence in females. Treatment remains challenging due to limited understanding of its causes, but recent research has paved the way for new therapeutic options.

Aim. Summarize and present information on HS local, systemic, and surgical treatment based on the latest scientific literature.

Methods. The literature review was performed using PubMed, The Wiley Online Library, and ScienceDirect databases. The following keywords and combinations of them were used: hidradenitis suppurativa, anti-bacterial agents, biological therapy, surgical therapy. Only articles written in English were selected.

Results. For mild and localised cases of HS with few lesions, topical clindamycin 1% may be considered. Patients with Hurley stages II/III and multiple ongoing lesions are often treated with systemic clindamycin combined with rifampicin 300 mg twice daily for about 10 weeks. Adalimumab is the preferred option for moderate to severe HS cases when traditional treatments fail, with clinical response rates ranging from 41.8% to 58.9%. Surgical interventions range from minimally invasive techniques like laser treatments, incision and drainage, deroofing, to more extensive procedures like wide local excisions.

Conclusions. Treatment for HS varies based on severity, ranging from local treatments for mild cases to systemic interventions like antibiotics and biological therapy for severe cases. Surgical options are also available. Managing concurrent conditions, weight, and quitting smoking are vital for better outcomes.

Keywords: hidradenitis suppurativa, anti-bacterial agents, biological therapy, surgical therapy.

Full article

https://doi.org/10.53453/ms.2024.5.7