In order to examine whether anti-androgen therapy was effective in hidradenitis suppurativa (HS), ethinyloestradiol 50 micrograms/cyproterone acetate 50 mg in a reverse sequential regimen was compared with ethinyloestradiol 50 micrograms/norgestrel 500 micrograms (Eugynon 50) in 24 female patients. Both treatments produced substantial improvement in disease activity. Seven patients cleared and have remained free of disease for 18 months, five patients improved, four remained unchanged, while two deteriorated. Cyproterone acetate was not clinically significantly more effective than E50, and both gave a similar reduction in free androgen index. Anti-androgen therapy appears to be beneficial in the treatment of hidradenitis suppurativa.

Forty two women with hidradenitis suppurative were assessed clinically and biochemically for evidence of androgen excess. Thirteen had irregular menses; 22 of 36 experienced exacerbation of hidradenitis suppurative premenstrually; 19 had or had had acne vulgaris; and seven were hirsute. Comedones (blackheads) were found in apocrine sites in 37, but also in retroauricular sites in 18 and were considered to be an important physical sign for early diagnosis. Eight had evidence of pilonidal (postanal) sinus. The patients had a higher concentration of total testosterone (p<001) and free androgen index (testosterone to sex hormone binding globulin concentrations) (p<0-01) than normal controls.Patients with hidradenitis suppurative appear to have endocrine abnormalities sufficient to suggest an androgenic basis for the disease.

In order to examine whether anti-androgen therapy was effective in hidradenitis suppurativa (HS), ethinyloestradiol 50 /fg/cyproterone acetate 50 mg in a reverse sequential regimen was compared with ethinyloestradiol 50

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