Antibiotic Treatment of Hidradenitis Suppurativa

Bettoli, Vincenzo; Join‐Lambert, Olivier; Nassif, Aude

doi:10.1016/j.det.2015.08.013

Cited by 49 publications

(54 citation statements)

References 14 publications

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“…Antibiotic treatment is frequently used and recommended in the treatment of HS [20,21]. Most relevant data address rifampicin-clindamycin combination therapy, which showed satisfactory results in some HS patients [12,22,23].…”

Section: Discussionmentioning

confidence: 99%

Microbial Profile and Antimicrobial Susceptibility of Bacteria Found in Inflammatory Hidradenitis Suppurativa Lesions

Hessam¹,

Sand²,

Georgas

et al. 2016

Skin Pharmacol Physiol

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Background: The role of bacterial colonization in hidradenitis suppurativa (HS) lesions is poorly understood. To date, data on the related microbial profile and especially on bacterial resistance rates are scarce. Methods: The results of bacterial cultures and susceptibility patterns of the isolated microorganisms obtained from deep portions of HS lesions from patients who underwent surgery at our HS Centre between 2010 and 2015 were retrospectively evaluated. Results: Analyses of 113 bacterial samples from 113 HS patients revealed bacterial growth in 95 samples (84.1%). Polymicrobial growth was found in 51 samples (45.1%). Coagulase-negative staphylococci and Staphylococcus aureus were the most commonly isolated bacteria, followed by Proteus mirabilis and Escherichia coli. Data on susceptibility testing were available for 68 samples, which yielded 129 isolates. The isolated strains were primarily resistant to penicillin G, followed by erythromycin, clindamycin and ampicillin. The highest effectiveness against isolates was observed for fosfomycin, imipenem, fluoroquinolones (moxifloxacin, ciprofloxacin, levofloxacin), and cotrimoxazole. Conclusions: Our findings on bacterial species and their topographical distribution revealed that the microbial flora in HS lesions reflects commensal flora of the skin. Due to the susceptibility rate and immunomodulatory and anti-inflammatory properties, cotrimoxazole may represent an alternative antibiotic agent and should be considered for therapy in HS patients.

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Section: Discussionmentioning

confidence: 99%

Microbial Profile and Antimicrobial Susceptibility of Bacteria Found in Inflammatory Hidradenitis Suppurativa Lesions

Hessam¹,

Sand²,

Georgas

et al. 2016

Skin Pharmacol Physiol

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“…They are lined with squamous epithelia and often filled with a white gelatinous material . The tunnels are generally not expected to respond medical treatment . The intractable nature of the tunnels may be partly attributed to the high presence of bacterial biofilms and partly to the epithelial lining, which may however not be continuous .…”

Section: Introductionmentioning

confidence: 99%

The microbiome of tunnels in hidradenitis suppurativa patients

Ring

Sigsgaard

Thorsen

et al. 2019

Acad Dermatol Venereol

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Background Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease defined by recurrent nodules, tunnels and scarring involving the intertriginous regions. Recent next‐generation sequencing (NGS) studies suggest genera such as Prevotella spp., Peptoniphilus spp. and Porphyromonas spp. are associated with chronic and early HS lesions. However, a systematic investigation of the bacterial microbiome in HS tunnels remains unexplored using NGS. Objective We aimed to investigate the bacterial composition of the luminal white gelatinous material found in HS tunnels using NGS. Methods An exploratory study of patients with diagnosis of HS (n = 32) with tunnels. The tunnels were present either in the groin (n = 17) or in the axilla (n = 15). During deroofing of the tunnels, a sterile E‐swab was taken of the luminal gelatinous material. The samples were investigated using NGS targeting 16S ribosomal RNA. Results The skin microbiome was characterized in 32 HS patients. Overall, five microbiome types were identified: Porphyromonas spp. (type I), Corynebacterium spp., (type II), Staphylococcus spp. (type III), Prevotella spp. (type IV) and Acinetobacter spp (type V). Porphyromonas spp. (type I) and Prevotella spp. (IV) were the most frequent genera found the tunnels. Conclusion This study points to a potential association between the presence of certain anaerobic bacteria (Porphyromonas spp., Prevotella spp.) and HS tunnels. It may be speculated that these two genera are associated with the pathogenesis in HS either as drivers or as biomarkers.

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“…Long-term usage of topical and systemic antibiotics in patients with HS may cause the formation of comorbidity as a result of affecting the microflora in addition to antibiotic resistance (9). Furthermore, unnecessary and long-term usage of antibiotics may induce demodicosis formation by affecting the flora.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, combined treatments specific to the patients may be planned. Long-term usage of topical and systemic antibiotics may cause comorbidity as a result of effects on the microflora in addition to antibiotic (9,10). Consequently, choosing a patient-specific HS treatment is extremely important.…”

Section: Discussionmentioning

confidence: 99%

“…During HS treatment, various systemic antibiotic treatments such as clindamycin, rifampin, moxifloxacin, ceftriaxone, ertapenem, and metronidazole, dapsone, triamcinolone, infliximab, adalimumab, and anakinra may be used. For fibrotic lesions, surgical treatments are recommended, and long-pulsed Neodymium: yttrium-aluminum-garnet laser and carbon dioxide laser are also useful (9,10). Moreover, combined treatments specific to the patients may be planned.…”

Section: Discussionmentioning

confidence: 99%

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Hidradenitis Suppurativa, Metabolic Syndrome, and Demodex spp. Infestation

Ünal

Akçınar

Arduç

2018

TurkiyeParazitolDerg

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Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease. This type of dermatosis with underlying chronic inflammation significantly affects the quality of life and may be accompanied by many comorbidities. In this case, Demodex spp. was associated with treatment-resistant and persistent course of skin diseases. A 46-year-old female patient applied to our clinic with complaints of lesions on the body and hip. Her dermatological examination revealed abscess formation and post-inflammatory pigmentation. Millimetric scar formation and improved folliculitis-like lesions were observed on both glutei. These complaints started 7 years ago and become more intense and severe by time. Owing to the diagnoses of diabetes mellitus, hypertension, and hyperlipidemia, the patient was monitored for metabolic syndrome. In the cultures taken from the lesions, no growth was seen. A standardized skin surface biopsy of the patient demonstrated demodicosis. The patient was treated with oral metronidazole and topical permethrin lotion, whereupon a pronounced recovery was observed in her clinical condition. In the light of this case, we recommend that patients with HS should be checked for the presence of Demodex spp., and if it is detected, an appropriate treatment should be applied. To our knowledge, this is the first case report presenting the relationship between HS and Demodex infestation.

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Antibiotic Treatment of Hidradenitis Suppurativa

Cited by 49 publications

References 14 publications

Microbial Profile and Antimicrobial Susceptibility of Bacteria Found in Inflammatory Hidradenitis Suppurativa Lesions

Microbial Profile and Antimicrobial Susceptibility of Bacteria Found in Inflammatory Hidradenitis Suppurativa Lesions

The microbiome of tunnels in hidradenitis suppurativa patients

Hidradenitis Suppurativa, Metabolic Syndrome, and Demodex spp. Infestation

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