Emerging medical treatments for hidradenitis suppurativa

Hidradenitis Suppurativa: Where We Are and Where We Are Going

“…Adalimumab (ADA), an anti-TNFα-antibody, is the only EMA-and FDA-approved therapy for the moderation of to severe HS at the moment [107]. As numerous clinical trials evaluating biologics and other modern immunotherapies are being conducted, it should only be a matter of time until the therapeutic landscape of HS is expanded and patient-centered precision medicine becomes reality [1,108]. Despite these already achieved and coming-up advances, structural alterations of HS-affected skin and subcutaneous tissue presenting with fistulas, sinus tracts, or large scarred areas should primarily be targeted by radical surgical excision [63,109].…”

Pediatric hidradenitis suppurativa

“…Limitations in applying these guidelines to pediatric patients is reflective of the quality and availability of existing published data. Topical and systemic antibiotics, anti‐androgenic agents, corticosteroids, TNF‐alpha blockers, and surgery all remain options for the treatment of HS in adolescent patients 6,37–39 . Currently, adalimumab is the only medication shown in patients <18 years old to be effective in phase 3 clinical trials and is Food and Drug Administration (FDA) approved to treat moderate to severe HS for patients 12 years old and older 40,41 .…”

Hidradenitis suppurativa: Basic considerations for its approach: A narrative review

“…The management of the HS will be carried out depending on the Hurley classification ( Table 4 ) ; Thus, for stage I, topical clindamycin 1% can be used, it has been shown to reduce pustules but has no effect on inflammatory nodules or abscesses [ 28 ], so the mainstay is management with systemic antibiotics with tetracyclines, being of choice doxycycline at a dose of 100 mg every 12 h. Topical clindamycin (0.1%) twice daily was found to be as effective as oral tetracyclines (500 mg) for stage I lesions [ 4 ]. In the second line for stage I but first line for stage II, rifampicin associated with clindamycin, both at doses of 300 mg twice a day for 10 days, with a response range of 71–85% but with the risk of infection by Clostridium difficile [ [31] , [32] , [33] , [34] ]. As a third line, mainly as rescue therapy for patients with Hurley stage III, ertapenem 1 g a day for 6 weeks, with a highly effective but a high level of relapses after it discontinuation.…”

“…Dapsone is considered relatively ineffective because the response is approximately 38% and it is not effective in Hurley stage 3, the dose used was 50 mg per day at the beginning with a progressive increase until 200 mg per day for at least 3 months. It is important to note that improvement with antibiotic management has also been associated with its anti-inflammatory properties, as seen in tetracyclines that suppress lymphocytes, neutrophils, and histiocytes [ [31] , [32] , [33] , [34] ].…”