Medikamentöse Therapie der Acne inversa

Abstract

Acne inversa is a chronic inflammatory destructive skin disease that affects about 1% of the population. The therapy should be personalized and consists of surgical and conservative procedures. Antibiotics are administered either topically or systemically. Combination therapy with clindamycin and rifampicin for 10-12 weeks can be very effective. Furthermore, TNF-α inhibitors show adequate efficacy and can be recommended. Adalimumab is the only approved drug product for systemic treatment of acne inversa. The efficacy of retinoids is controversial. Isotretinoin cannot be recommended for the treatment of acne inversa; however, acitretin has been proven to be more effective. Immune-modulating substances, like dapsone, cyclosporine A, methotrexate, colchicine, or corticosteroids, can be considered; however, the study data are insufficient for recommendation. Hormonal therapies can influence the course of the disease. Antiseptics are applied independent of the stage of disease. Patients should be informed about triggering factors.

Plant Antimicrobial Peptides as Potential Tool for Topic Treatment of Hidradenitis Suppurativa

“…Once antibiotics were not successful to treat HS, biological drugs (based on antibodies targeting inflammatory cytokines) came as a potential alternative solution, including, for instance, Adalimumab and Infliximab. Adalimumab is the first fully human recombinant IgG monoclonal antibody that binds soluble and transmembrane TNF-α ( Schneider-Burrus et al, 2018 ; Magalhães et al, 2019 ). It was approved by the European Medicine Agency and US Food and Drug Administration (FDA) as the first medicine for the treatment of moderate to severe HS patients, which failed in antibiotic (systemic) therapy ( Schneider-Burrus et al, 2018 ).…”

“…Adalimumab is the first fully human recombinant IgG monoclonal antibody that binds soluble and transmembrane TNF-α ( Schneider-Burrus et al, 2018 ; Magalhães et al, 2019 ). It was approved by the European Medicine Agency and US Food and Drug Administration (FDA) as the first medicine for the treatment of moderate to severe HS patients, which failed in antibiotic (systemic) therapy ( Schneider-Burrus et al, 2018 ).…”

Hidradenitis suppurativa/Acne inversa in der Genitoanalregion

“…Aufgrund des sehr heterogenen klinischen Bildes und Therapieansprechens stellt sich im klinischen Alltag weiterhin die Frage nach der richtigen Indikation für eine konservative Therapie, einen chirurgischen Eingriff oder deren Kombination. Für einen Überblick zu den medikamentösen Therapien verweisen wir auf eine Übersichtsarbeit von Schneider-Burrus et al [32]. Zu den operativen Behandlungsoptionen mit Einordnung der Verfahren anhand der Studienlage verweisen wir auf eine rezente Übersichtsarbeit der Autoren [34].…”