Intralesional anti-biofilm therapy for tunnels in patients with hidradenitis suppurativa

Weigelt, Maximillian A.; Lev‐Tov, Hadar

doi:10.23736/s2784-8671.21.06899-1

Cited by 3 publications

(3 citation statements)

References 5 publications

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“…A series of three patients with Hurley stage I and III HS underwent punch incision followed by injection of ABWG into tunnels once daily for 5–7 days [ 61 ]. Two of three patients reported subjective increased speed of healing and decreased pain within 5–6 days.…”

Section: Resultsmentioning

confidence: 99%

Emerging Treatments and the Clinical Trial Landscape for Hidradenitis Suppurativa—Part II: Procedural and Wound Care Therapies

Fragoso,

Masson,

Gillenwater

et al. 2023

Dermatol Ther (Heidelb)

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Procedural treatments are a cornerstone of hidradenitis suppurativa (HS) management. New interventional therapies are being studied as part of the upsurge in HS research and clinical trials. Additionally, draining wounds can impart a significant negative impact on patients’ quality of life, requiring daily dressing changes. However, standardized guidelines on how to best manage HS wounds both day-to-day and post-procedure are lacking. In part II of this emerging therapies review, procedural treatments and wound care dressings and devices that are being investigated for HS management are discussed.

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Section: Resultsmentioning

confidence: 99%

Emerging Treatments and the Clinical Trial Landscape for Hidradenitis Suppurativa—Part II: Procedural and Wound Care Therapies

Fragoso,

Masson,

Gillenwater

et al. 2023

Dermatol Ther (Heidelb)

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“…The efficacy of deroofing may be related to the elimination of biofilms and reversal of the vicious cycle discussed above. Emerging clinical data suggests that topical anti-biofilm therapy that is administered without removing the diseased skin can eliminate isolated tunnels ( 186 ), and new biofilm-eliminating approaches should be considered ( 187 , 188 ). Future metagenomics studies should examine the antimicrobial resistance in HS lesions and tunnels at advanced stages of the disease and characterize the interaction between the microbiome, biofilms, and innate immunity.…”

Section: Discussionmentioning

confidence: 99%

Innate immunity and microbial dysbiosis in hidradenitis suppurativa – vicious cycle of chronic inflammation

et al. 2022

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Hidradenitis Suppurativa (HS) is a chronic multifactorial inflammatory skin disease with incompletely understood mechanisms of disease pathology. HS is characterized by aberrant activation of the innate immune system, resulting in activation of pathways that aim to protect against pathogenic microorganisms, and also contribute to failure to resolve inflammation. Imbalance in innate immunity is evident in deregulation of host antimicrobial peptides (AMPs) and the complement system associated with the microbiome dysbiosis. The pathology is further complicated by ability of pathogens associated with HS to overcome host immune response. Potential roles of major AMPs, cathelicidin, defensins, dermcidin, S100 proteins, RNAse 7 and complement proteins are discussed. Dysregulated expression pattern of innate immunity components in conjunction with bacterial component of the disease warrants consideration of novel treatment approaches targeting both host immunity and pathogenic microbiome in HS.

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“…Interestingly, biofilm formation is an established virulence factor for Porphyromonas spp. [23]; this may explain antibiotic resistance in severe HS stages with tunnel formation and a possible beneficial effect of anti-biofilm therapy [24]. Furthermore, it has been speculated that the biofilm presence may lead to prolonged inflammation and subsequent exacerbation of the disease [21].…”

Section: Microbiomementioning

confidence: 99%

Tunnels in Hidradenitis Suppurativa: Active Inflammatory Entities with Specific Molecular and Genetic Profiles – A Narrative Review

Krajewski¹,

Szepietowski²,

Martorell³

2023

Dermatology

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Background: Hidradenitis suppurativa (HS) is a chronic, inflammatory, debilitating disorder of the pilosebaceous unit. Dermal tunnels, sinus tracts, or fistulas are unique features of HS. One may hypothesize that HS tunnels remain active and may contribute to inflammation and disease severity. Summary: Increased inflammatory infiltrate with an increased number and densities of immune cells was reported in HS tunnels. Moreover, significantly higher levels of IL-36, Il-17A, IL-17C, IL-17F, and CXCL8 mRNA compared to non-tunnel HS skin were found. Furthermore, in the lumen, a proliferative gelatinous mass consisting of inflammatory cells with similar cytokine levels as inflammatory HS lesions was found. It was also proven that HS sinus tracts are often colonized by Porphyromonas spp. and Prevotella spp. with a tendency to biofilm creation. The genetic profile of HS tunnels varies from non-tunnel HS skin, with upregulation of proinflammatory and down-regulation of anti-inflammatory genes. Lastly, treatment with newly developed drugs targeting different subunits of IL-17 seem promising in decreasing dermal tunnel drainage and in the resolution of sinus tracts. Moreover, a higher percentage of patients treated with these drugs achieved HiSCR75 and HiSCR90. Key message: All these data support the hypothesis that dermal tunnels are active, inflammatory entities with different molecular and genetic profiles.

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Intralesional anti-biofilm therapy for tunnels in patients with hidradenitis suppurativa

Cited by 3 publications

References 5 publications

Emerging Treatments and the Clinical Trial Landscape for Hidradenitis Suppurativa—Part II: Procedural and Wound Care Therapies

Emerging Treatments and the Clinical Trial Landscape for Hidradenitis Suppurativa—Part II: Procedural and Wound Care Therapies

Innate immunity and microbial dysbiosis in hidradenitis suppurativa – vicious cycle of chronic inflammation

Tunnels in Hidradenitis Suppurativa: Active Inflammatory Entities with Specific Molecular and Genetic Profiles – A Narrative Review

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