Hidradenitis suppurativa (HS) is a multifactorial disease characterized by the progression of nodules to deep-seated lesions, with subsequent scarring and suppuration. [1][2][3][4] The exact etiology of HS is still unproven.Multiple therapies have been described, including topical, systemic, surgical, and physical treatments. 1,5,6 At present, topical HS therapy include cleansers, keratolytic agents, and antibiotics. 7 Androgens are implicated in skin physiology and may have a role in HS worsening. 8 Consequently, the administration of systemic antiandrogen therapy were described in a small population. 5,8 To the best of our knowledge, this is the first study that describes topical antiandrogen therapy in HS. Here we describe 4 patients that received a commercially available topical finasteride on 2-3 HS affected sites at dosage 50 μl of 2275 mg/ml for each area (Table 1). Patients did not alter their hygiene or antiseptic habits during topical finasteride application.Case 1: A 28-year-old man affected by HS for 12 years, with lesions in axillae, gluteal and inguinal region. He received multiple HS treatments with disease recurrence and discontinuation (Table 1).Recently he experienced frequent inflammatory episodes of three nodules in the left axilla and one nodule in the right axilla. Disease severity 1,9 was: Hurley II, international HS severity (IHS4): 6, dermatology life quality index (DLQI): 16. Daily topical finasteride was introduced on both axillae. Three months later, a significant improvement was observed (IHS4: 2, DLQI: 8, Figure 1A-D).
Background IL-23 inhibitors are the latest class of biologic drugs approved for moderate-to-severe psoriasis. Objectives to investigate real-life safety and efficacy of tildrakizumab. Methods demographic data, medical history, psoriasis disease history, PASI, DLQI, BSA, NAPSI were recorded at weeks 0, 12, 24, 36. Results PASI, BSA, DLQI and NAPSI all decreased rapidly during the 36 week follow-up period. PASI score reduced from 12.28 to 4.65 by week 12, followed by a further decrease to 1.18 at week 36 Multiple logistic regression showed that smoking, BMI ≥30, ≥3 comorbidities, previous systemic traditional or biologic drugs, psoriatic arthritis nor difficult-to-treat areas influenced the reduction of PASI and NAPSI scores during treatment with tildrakizumab ( P > .05). Conclusions we assessed a good performance of tildrakizumab in patients with multiple comorbidities, multi-failure, elderly patients, and in subjects with psoriatic arthritis.
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