Longitudinal observational study of hidradenitis suppurativa: impact of surgical intervention with adjunctive biologic therapy

Shanmugam, Victoria K.; Mulani, Shaunak; McNish, Sean; Harris, Sarah; Buescher, Teresa M.; Amdur, Richard L.

doi:10.1111/ijd.13798

Cited by 44 publications

(37 citation statements)

References 39 publications

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“…Our case confirms that the treatment approach in patients affected by advanced HS and progressive lymphedema needs to be individualized based on the association of biologic therapy and surgery to restore normal anatomy and function of the organ involved 2 . However, timing needs to be better defined, and clinical trials evaluating effectiveness of biological agents combined with surgery are needed 10 . Early detection of HS-associated lymphedema is crucial, and a multidisciplinary approach is fundamental 2 …”

Section: Discussionsupporting

confidence: 55%

Genital lymphedema associated with hidradenitis suppurativa unresponsive to adalimumab treatment

et al. 2019

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Section: Discussionsupporting

confidence: 55%

Genital lymphedema associated with hidradenitis suppurativa unresponsive to adalimumab treatment

et al. 2019

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“…The majority ( n = 11) of these studies reported on the use of antibiotics and biologic medications, with only two mentioning retinoids [ 47 , 62 ]. Of these, one study discussed post-surgical use of biologics [ 18 ], four studies detailed use of biologics and antibiotics in the weeks or months preceding surgery [ 37 , 39 , 56 , 63 ], three detailed antibiotic and/or biologic use both pre- and post-surgical intervention [ 41 , 46 , 64 ], one detailed intraoperative use of a gentamicin sponge [ 11 ], and two studies did not specify exact timing [ 47 , 54 ]. Prens et al [ 46 ] reported significantly longer healing times with the use of adalimumab (five patients) and infliximab (one patient) started several months before surgery, held for 1–2 weeks perioperatively, and then re-instated postoperatively within 1–2 weeks.…”

Section: Resultsmentioning

confidence: 99%

Office-Based Surgical Intervention for Hidradenitis Suppurativa (HS): A Focused Review for Dermatologists

Saylor

Brownstone

Naik

2020

Dermatol Ther (Heidelb)

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Easily accessible office-based procedures that require minimal resources may facilitate timely surgical management of hidradenitis suppurativa (HS). This review focuses on excision and unroofing as two surgical HS treatments that can be tailored to the outpatient setting. Fiftyfive articles were included in our review, representing 3914 patients. The majority were retrospective studies (58%, n = 32), and the studies reported data both across patients and by number of treated lesions. Recurrence rates for unroofing (14.5%) were found to be half that of excision (30%) across patients (p = 0.015) and slightly lower across lesions [20% recurrence vs 26% for excision (p = 0.023)]. Complication rates at the lesion level were also significantly associated with procedure, with rates after excision more than double those after roofing (26% vs. 12%, p \ 0.001). The complication rate after combined medical and surgical therapy did not differ between procedures. Studies also suggest that continuing medical therapy in the perioperative period may be associated with improved recurrence rates, although delayed wound healing with biologic therapy has been reported. The existing data are limited by lowquality uncontrolled studies with small sample sizes, variable reporting of outcomes, and lack of uniform definitions for recurrence and remission. Further systematic prospective studies are needed to better compare complication and recurrence rates across these procedures in HS, especially in the context of concomitant medical therapy.

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“…Patients who underwent surgery while on a biologic drug had better disease control than those who only had medical treatment in a study with 68 cases of moderate to severe HS. 142…”

Section: Surgical Treatmentmentioning

confidence: 99%

Consensus on the treatment of hidradenitis suppurativa - Brazilian Society of Dermatology

Magalhães

Machado

Duarte³

et al. 2019

An. Bras. Dermatol.

142

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Hidradenitis suppurativa is a chronic immune mediated disease of universal distribution that causes great damage to the quality of life of the affected individual, whose prevalence is estimated at 0.41% in the Brazilian population. The objective of this work was update on physiopathogenesis, diagnosis and classification of hidradenitis suppurativa and to establish therapeutic recommendations in the Brazilian reality. It was organized as a work group composed of eight dermatologists from several institutions of the country with experience in the treatment of hidradenitis suppurativa and carried out review on the topic. Recommendations were elaborated and voted by modified Delphi system and statistical analysis of the results was performed. The Brazilian consensus on the clinical approach of hidradenitis suppurativa had the support of the Brazilian Society of Dermatology.

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Longitudinal observational study of hidradenitis suppurativa: impact of surgical intervention with adjunctive biologic therapy

Abstract: In this diverse cohort of patients with severe HS, biologic therapy was associated with a more rapid decline in disease activity, with the greatest effect in patients who also underwent HS surgery.

Cited by 44 publications

References 39 publications

Genital lymphedema associated with hidradenitis suppurativa unresponsive to adalimumab treatment

Genital lymphedema associated with hidradenitis suppurativa unresponsive to adalimumab treatment

Office-Based Surgical Intervention for Hidradenitis Suppurativa (HS): A Focused Review for Dermatologists

Consensus on the treatment of hidradenitis suppurativa - Brazilian Society of Dermatology

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