Combined fractional carbon dioxide laser and long‐pulsed neodymium : yttrium‐aluminium‐garnet (1064 nm) laser in treatment of hidradenitis suppurativa; a prospective randomized intra‐individual controlled study

Azim, Amira A. Abdel; Salem, Rania T.; Abdelghani, Rania

doi:10.1111/ijd.14075

Cited by 28 publications

(28 citation statements)

References 58 publications

(67 reference statements)

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“…This outcome is somewhat nebulous and may include aspects of long‐term control (free from flares) as well as constructs such as relapse or recurrence. In contrast to flare, the terms recurrence and relapse were used more frequently in the literature and had a higher proportion of studies with a definition (Table S1; see Supporting Information) . Again, in contrast to flare, recurrence or relapse were more frequently associated with an increase in HS activity after a surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

A narrative review of the definition of ‘flare’ in hidradenitis suppurativa

et al. 2019

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Summary Background Hidradenitis suppurativa (HS) is a chronic, inflammatory condition that can have periodic worsening or flares. Measurement of flare is important because it can inform treatment efficacy; however, it is unclear how HS flare should be defined. Objectives This study reviewed the literature for definitions of HS flare. Methods The PubMed MEDLINE online database was searched on 10 January 2018 and the search was repeated on 8 December 2018 for new publications. Titles and abstracts were screened for inclusion. Subsequently, full articles were screened for inclusion. Papers were included if the publication was a systematic review, clinical trial, cohort study, case report or series, or cross‐sectional study. Studies were excluded if they were journalistic reviews, did not discuss clinical findings of HS or did not use the words ‘flare’, ‘exacerbation’, ‘relapse’ or ‘recurrence’. Results Two hundred and seventy‐four papers were identified and 154 fulfilled the study criteria. Of these, 27 (17.5%) included the term ‘flare’ and 16 (10.4%) included the term ‘exacerbation’. Two of the 27 papers (7%) defined the term flare and both included patient report of changes in symptoms or signs. One of 16 papers (6%) defined exacerbation, which was taken as one new HS lesion. The terms ‘recurrence’ and ‘relapse’ were more apt to be defined: 13% (13 of 100) and 14% (six of 44), respectively. Conclusions The lack of a specific and measurable definition of HS flare is a barrier to assessment of this important outcome. Once a specific and measurable definition is established, validated and reliable measures of HS flare can be incorporated into future studies. What's already known about this topic? Hidradenitis suppurativa (HS) is a chronic, relapsing inflammatory skin condition. The ability to assess flares is important to people who have HS; however, it is unclear how this is defined. HS flare is one of the core outcomes in the core outcome set for HS clinical trials; however, it is unclear how this should be assessed. What does this study add? This literature review reveals the paucity of measurable definitions associated with the use of the term ‘flare’ in the HS literature. It also highlights the variation and lack of a validated and reliable measure of HS flare.

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Section: Discussionmentioning

confidence: 99%

A narrative review of the definition of ‘flare’ in hidradenitis suppurativa

et al. 2019

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“…Kwon et al 11 found ablative modalities to have superior improvement, less pain, and lower side effects ( P < .05). Robati et al found no significant difference between ablative therapy and nonablative therapy, while Azim et al found statistically significant improvement in combined therapy vs nonablative therapy 4,5 …”

Section: Discussionmentioning

confidence: 99%

Outcomes and adverse effects of ablative vs nonablative lasers for skin resurfacing: A systematic review of 1093 patients

Mirza

Khatri

2020

Dermatologic Therapy

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It is generally believed that ablative laser therapies result in prolonged healing and greater adverse events when compared with nonablative lasers for skin resurfacing. To evaluate the efficacy of ablative laser use for skin resurfacing and adverse events as a consequence of treatment in comparison to other modalities, a PRISMA‐compliant systematic review (Systematic Review Registration Number: 204016) of twelve electronic databases was conducted for the terms “ablative laser” and “skin resurfacing” from March 2002 until July 2020. Studies included meta‐analyses, randomized control trials, cohort studies, and case reports to facilitate evaluation of the data. All articles were evaluated for bias. The search strategy produced 34 studies. Of 1093 patients included in the studies of interest, adverse events were reported in a total of 106 patients (9.7%). Higher rates of adverse events were described in nonablative therapies (12.2% ± 2.19%, 31 events) when compared with ablative therapy (8.28% ± 2.46%, 81 events). 147 patients (13.4%) reported no side effects, 68 (6.22%) reported expected, transient self‐resolving events, and five (0.046%) presented with hypertrophic scarring. Excluding transient events, ablative lasers had fewer complications overall when compared with nonablative lasers (2.56% ± 2.19% vs 7.48% ± 3.29%). This systematic review suggests ablative laser use for skin resurfacing is a safe and effective modality to treat a range of pathologies from photodamage and acne scars to hidradenitis suppurativa and posttraumatic scarring from basal cell carcinoma excision. Further studies are needed, but these results suggest that ablative lasers are a superior, safe, and effective modality to treat damaged skin.

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“…An appropriate combination of topical, oral and surgical therapy should be used to treat HS depending on the stage of the disease and other patient characteristics. Surgery, 29,30 photodynamic treatment and LASER surgery 31,32 and adalimumab treatment 33 have been reported in a few patients from Egypt and South Africa. A study on combination of surgery and oral retinoids in management of HS has been reported from India 34 …”

Section: Treatmentmentioning

confidence: 99%

Hidradenitis suppurativa in skin of colour

Zouboulis¹,

Goyal

Byrd

2021

Experimental Dermatology

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Hidradenitis suppurativa/acne inversa (HS) more prevalent and disproportionally affects African American females. Although there are limited studies in HS skin of colour populations in the USA, there is more scarcity of HS skin of colour studies in other countries, which limits the overall understanding of the disease among these patients. Herein, our overview of the 10th European Hidradenitis Suppurativa Foundation (EHSF) e.V. Conference provided a crude example of the limited number of skin of colour physicians, physician scientists and inclusion of skin of colour patients highlighting the need to increase awareness of this important issue. We summarized the epidemiology, pathogenesis, clinical picture and focused on treatment options from southeast Asia and Africa. Our outlined general recommendations for diagnosis will render better clinical care and outcomes for diverse patient populations.

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Combined fractional carbon dioxide laser and long‐pulsed neodymium : yttrium‐aluminium‐garnet (1064 nm) laser in treatment of hidradenitis suppurativa; a prospective randomized intra‐individual controlled study

Cited by 28 publications

References 58 publications

A narrative review of the definition of ‘flare’ in hidradenitis suppurativa

A narrative review of the definition of ‘flare’ in hidradenitis suppurativa

Outcomes and adverse effects of ablative vs nonablative lasers for skin resurfacing: A systematic review of 1093 patients

Hidradenitis suppurativa in skin of colour

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