Facial Hidradenitis Suppurativa in a 28-Year-Old Male Responding to Finasteride

Doménech, C.; Matarredona, Jaime; Escribano-Stablé, J.C.; Devesa, José Pedro; Vicente, J.; Jaen, Anouk

doi:10.1159/000339477

Cited by 15 publications

(6 citation statements)

References 26 publications

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“…While antibiotics are widely used to control symptoms in HS, they do not treat the underlying cause of the disease (Yazdanyar and Jemec 2011). Hormonal therapies, including treatment with 5α-reductase inhibitors such as Finasteride reduce disease activity but recurrence of HS is common (Domenech, Matarredona et al 2012, Randhawa, Hamilton et al 2013). Traditional disease modifying anti-rheumatic (DMARD) therapies have been largely ineffective in HS.…”

Section: Introductionmentioning

confidence: 99%

Interferon-gamma (IFN-γ) is Elevated in Wound Exudate from Hidradenitis Suppurativa

Banerjee

McNish

Shanmugam

2016

Immunological Investigations

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Hidradenitis suppurativa (HS) is a chronic recurrent inflammatory disease of apocrine glands which affects 1% to 4% of young adults. The purpose of this study was to investigate inflammatory cytokines in effluent from HS lesions and to identify potential local drivers of inflammation in HS. Wound fluid specimens from HS patients (n=8) and age-matched chronic wound patients (n=8) were selected for analysis. The Hidradenitis Suppurativa Score (HSS) was used to determine extent of HS activity. Cytokine analysis was conducted using Meso Scale Discovery cytokine and proinflammatory panels. Interferon-gamma (IFN-γ) was significantly elevated in the HS effluent compared to chronic wounds (1418 ± 1501 pg/ml compared to 102.5 ± 138 pg/ml, p 0.027). HS effluent also had significantly higher levels of TNF-β (9.24 ± 7.22 pg/ml compared to 1.65 ± 2.14 pg/ml, p 0.03). There was no significant difference in any other cytokines. There was no significant difference in demographics in the HS compared to chronic wound cohorts. Mean HSS in the HS cohort was 68.88 (SD ± 41.45). In this proof of concept pilot study, IFN- γ was significantly elevated in HS effluent. TNF-β/LT-α levels were also elevated in HS, although the levels were more modest. Further studies should focus on molecular drivers of tissue injury in HS, and the relationship between HS effluent cytokine profile and disease activity.

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Section: Introductionmentioning

confidence: 99%

Interferon-gamma (IFN-γ) is Elevated in Wound Exudate from Hidradenitis Suppurativa

Banerjee

McNish

Shanmugam

2016

Immunological Investigations

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“…Furthermore, the female predominance and the fact that the disease often starts many years after puberty are also not consistent with androgen involvement in HS. However, finasteride, another antiandrogen, has shown beneficial effects in several case series . Overall, the impact of androgens remains uncertain and the mechanism of hormonal involvement in HS requires further clarification…”

Section: Pathogenesismentioning

confidence: 99%

“…However, finasteride, another antiandrogen, has shown beneficial effects in several case series. [148][149][150][151] Overall, the impact of androgens remains uncertain and the mechanism of hormonal involvement in HS requires further clarification. 152…”

Section: Hormonal Influencementioning

confidence: 99%

Acne and hidradenitis suppurativa

2018

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Acne and hidradenitis suppurativa (HS) both centre on hair follicles. They often occur together as part of the acne tetrad, but are found in distinct localizations. Acne is primarily defined by the presence of comedones and inflammatory lesions. However, in HS the intertriginous localization and chronicity play equally important roles for the diagnosis to the inflammatory lesions. Genetics, bacteria, environmental factors and innate inflammation have all been found to play a role in acne and/or HS. Surprisingly, there is little overlap between the findings so far. The genetics of acne and HS are distinct, bacteria have not been shown convincingly to play a role in HS, and the important risk factors obesity and smoking in HS cannot be easily translated to acne. The one driving factor central to both diseases is innate inflammation, most strikingly involving interleukin-1. Hence the interleukin-1 family, as already shown in autoinflammatory conditions associated with acne, could represent attractive treatment targets.

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“…Side effects reported in the study were minimal with some swelling and menstrual irregularities. Lastly, Domenech et al reported a case of a 28-year-old man with severe HS treated for one year who developed complete resolution of his symptoms on 5mg/day [30]. The precise means by which finasteride can improve symptoms in HS is unclear; many propose it acts by decreasing local concentrations of dihydrotestosterone at the level of the hair follicle by altering end-organ sensitivity rather than a more systemic effect on circulating androgen.…”

Section: Dermatology Online Journal || Reviewmentioning

confidence: 99%