Abstract:Background
Hidradenitis suppurativa (HS) is a chronic inflammatory disorder that primarily affects women of childbearing age. There is a paucity of data on HS disease activity during menstruation, pregnancy, and menopause and the potential impact of HS on the method of delivery.
Objective
We aimed to characterize the natural history of HS symptoms during menses, pregnancy, and menopause. We also sought to evaluate the potential impact of HS on delivery method and whethe… Show more
“…Clinicians should also consider that women with painful menstrual periods and menstrual migraines may take non-steroidal anti-inflammatory drugs (NSAIDs), a possible trigger factor in HS. So, treating this syndrome with OCPs may remove these symptoms and decrease the menstrual use of NSAIDs and HS exacerbation [ 41 , 42 ].…”
There is a need to establish the role of antiandrogens as an alternative or concomitant therapy for hidradenitis suppurativa (HS). Thus, the objectives of this study are (1) to assess the effectiveness of oral contraceptive pills (OCPs) at week 12 in HS women, and (2) to describe the clinical profile of patients receiving oral contraceptive pills (OCPs). A prospective observational study was designed. This study included 100 participants, 50 women with HS who started OCPs for the first time at our HS Clinic and 50 participants without OCP treatment. The main outcome of interest was the percentage of reduction in total abscess and inflammatory nodule (AN) count at week 12. Thirty-three women received combined OCPs and 17 non-combined OCP. HS patients with OCPs treatment were younger (31.7 vs. 40.9 years, p < 0.001), thinner (28.62 vs. 33.35 kg/m2), and have a higher number of areas affected (2.32 vs. 1.38, p = 0.02) than those without OCPs. After 12-weeks of treatment, it was observed that the percentage of AN reduction was higher in HS women receiving OCP than in patients without OCP (53.9% vs. 38.42%, p = 0.049). It was observed that OCP prescription (β = 3.79, p = 0.034) and concomitant therapy (β = 3.91, p = 0.037) were independently associated with a higher % AN when controlling for disease duration, concomitant therapy, and treatment with/without OCP (R^2 = 0.67). The factors potentially associated with the percentage AN reduction at week 12 in HS women treated with OCPs were disease duration (β = −1.327, p = 0.052), concomitant therapy (β = 11.04, p = 0.079), and HS worsening with the menstrual cycle (β = 10.55, p = 0.087). In conclusion, OCPs might be effective for improving AN count in women with HS. Women whose HS worsens in relation to the menstrual cycle and have a shorter disease may benefit more from the therapeutic effect of OCPs.
“…Clinicians should also consider that women with painful menstrual periods and menstrual migraines may take non-steroidal anti-inflammatory drugs (NSAIDs), a possible trigger factor in HS. So, treating this syndrome with OCPs may remove these symptoms and decrease the menstrual use of NSAIDs and HS exacerbation [ 41 , 42 ].…”
There is a need to establish the role of antiandrogens as an alternative or concomitant therapy for hidradenitis suppurativa (HS). Thus, the objectives of this study are (1) to assess the effectiveness of oral contraceptive pills (OCPs) at week 12 in HS women, and (2) to describe the clinical profile of patients receiving oral contraceptive pills (OCPs). A prospective observational study was designed. This study included 100 participants, 50 women with HS who started OCPs for the first time at our HS Clinic and 50 participants without OCP treatment. The main outcome of interest was the percentage of reduction in total abscess and inflammatory nodule (AN) count at week 12. Thirty-three women received combined OCPs and 17 non-combined OCP. HS patients with OCPs treatment were younger (31.7 vs. 40.9 years, p < 0.001), thinner (28.62 vs. 33.35 kg/m2), and have a higher number of areas affected (2.32 vs. 1.38, p = 0.02) than those without OCPs. After 12-weeks of treatment, it was observed that the percentage of AN reduction was higher in HS women receiving OCP than in patients without OCP (53.9% vs. 38.42%, p = 0.049). It was observed that OCP prescription (β = 3.79, p = 0.034) and concomitant therapy (β = 3.91, p = 0.037) were independently associated with a higher % AN when controlling for disease duration, concomitant therapy, and treatment with/without OCP (R^2 = 0.67). The factors potentially associated with the percentage AN reduction at week 12 in HS women treated with OCPs were disease duration (β = −1.327, p = 0.052), concomitant therapy (β = 11.04, p = 0.079), and HS worsening with the menstrual cycle (β = 10.55, p = 0.087). In conclusion, OCPs might be effective for improving AN count in women with HS. Women whose HS worsens in relation to the menstrual cycle and have a shorter disease may benefit more from the therapeutic effect of OCPs.
“…It has been suggested that pregnant women with HS should also receive appropriate counseling with regard to appropriate weight gain during pregnancy ( Fernandez et al, 2020 ). This is based on the association of increased body mass index with a risk of developing HS, although the exact mechanisms are incompletely understood.…”
Section: Pregnancy and Hidradenitis Suppurativamentioning
confidence: 99%
“…It is also vital that the woman is referred to various appropriate medical and allied health care teams. It has been widely demonstrated that integrated multidisciplinary management of patients with HS improves patient outcomes and satisfaction with care ( Fernandez et al, 2020 ; Touhouche et al, 2020 ). Fig.…”
Section: Pregnancy and Hidradenitis Suppurativamentioning
Hidradenitis suppurativa (HS) is a chronic, inflammatory disease of the skin with a predilection for women. The role of sex hormones, including estrogen and progesterone, is incompletely understood, but alterations in hormone levels may play a role in disease activity for many patients. Specific clinical considerations should be made for women with HS, particularly in the setting of pregnancy, childbirth, breastfeeding, and menopause. Current knowledge gaps regarding HS include the cumulative impact of disease across an individual's lifespan, as well as the mechanistic role of sex hormones in the disease. An improved understanding of the pathophysiologic role of hormones in HS would optimize our ability to use targeted therapies for hormonally driven disease. Psychological and psychosexual support for women with HS is an important facet of any holistic management strategy for the disease. This article integrates up-to-date pathogenic and mechanistic insights with evidence-based clinical management to optimize care for women with HS.
“…This study also showed that HS may affect delivery methods, because physicians reportedly advised patients with severe anogenital HS to have Cesarean sections as opposed to vaginal deliveries (Fernandez et. al, 2020 ). However, more than half of patients who had Cesarean sections reported new HS lesions in the incision scar Collier et al, 2021 .…”
mentioning
confidence: 95%
“…Does hormonal HS warrant consideration as a subtype of HS? Fernandez et al (2020) contributed significantly to this discussion by characterizing HS in female patients in various stages of life. The study revealed that menstruation caused worsening of HS symptoms in 76.7% patients, pregnancy had mixed effects, and menopause typically caused no change or worsening of HS symptoms.…”
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