Metformin for the treatment of hidradenitis suppurativa: a little help along the way

Verdolini, Roberto; Clayton, N.; Smith, Ann C.; Alwash, N.; Mannello, B.

doi:10.1111/j.1468-3083.2012.04668.x

Cited by 138 publications

(105 citation statements)

References 53 publications

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“…The other seven patients were unresponsive to the treatment. Only minor gastro-intestinal side effects were reported at the beginning of the treatment [122].…”

Section: Metforminmentioning

confidence: 99%

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An Update on Medical Treatment Options for Hidradenitis Suppurativa

Deckers

Prens

2015

Drugs

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Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by recurrent inflammatory nodules mostly located in the armpits and groin. Over the years multiple treatments for HS have been proposed; however, to date a cure is still lacking. In this update we provide an overview of most drug treatments reported on for HS, where possible with their mode of action and side effects. In mild cases, clindamycin lotion or resorcinol cream have proven effective. Tetracyclines are a first-line systemic option in more widespread or severe cases, followed by the combination of clindamycin and rifampicin. However, the recurrence rate is high after discontinuation of clindamycin plus rifampicin combination therapy. Long-term treatment with retinoids, especially acitretin is feasible, although teratogenicity has to be taken into account in females of reproductive age. Multiple antiinflammatory drugs have been suggested for HS, such as dapsone, fumarates or cyclosporine. However, their effectiveness in HS is based on small case series with varying results. If most common treatments have failed, biologics (e.g., infliximab or adalimumab) are the next step. Although not addressed in this review, surgical interventions are often needed to achieve remission. Key PointsHidradenitis suppurativa (HS) is a chronic inflammatory skin disease without a cure.Antibiotics (topical or oral) are often the first treatment option for HS.In cases of more extensive or therapy-resistant HS, biologicals (e.g., infliximab or adalimumab) are a good therapeutic option.

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“…The other seven patients were unresponsive to the treatment. Only minor gastro-intestinal side effects were reported at the beginning of the treatment [122].…”

Section: Metforminmentioning

confidence: 99%

“…Metformin also has anti-oxidative and anti-androgenic properties and has been shown to inhibit human immortalized keratinocytes in vitro [121,122]. Metformin was initially reported to have an effect on HS after a woman reported worsening of her HS after metformin was stopped [123].…”

Section: Metforminmentioning

confidence: 99%

An Update on Medical Treatment Options for Hidradenitis Suppurativa

Deckers

Prens

2015

Drugs

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“…Az epidemiológiai vizsgálatok fontos eredménye a diabetes gyakori előfordulása HS-ben (közel 20% a várt 1,5%-kal szemben), amely alapján felvetődött az inzulin és az inzulin-szerű növeke-dési faktor és a táplálkozás szerepe a betegségben. Erősítve a PCOS-el és a diabetesszel összefüggő ténye-zők patológiai szerepét, a metformin hatásosságára vonatkozólag 25 betegnél elvégzett klinikai vizsgálat alapján vannak adatok (19).…”

Section: Epidemiológiai Tényezők Patológiai Relevanciávalunclassified

Hidradenitis suppurativa: why isn’t it a form of acne?

Törőcsik¹,

Kinyó²,

Kovács³

et al. 2016

BVSZ

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ÖSSZEFOGLALÁSKey words: acne inversa, acne vulgaris, hidradenitis suppurativa 1. Patogenezis Acne inversa: miért nem acne és nem is hidradenitis?A betegség korábbi nevével, az acne inversával joggal leszámolva, hisz nem ott, nem akkor és nem úgy jelenik meg, mint a serdülőkori acne, sokak számára a jellegzetes lokalizációból adódóan egyértelmű patogenetikai tényező-ként az apokrin mirigyek foglalták el a központi helyet. A tünetek típusos intertriginózus megjelenése kétséget kizá-róan rámutat az adott terület jellegzetességeinek szerepére, melyek nagyban hozzájárulhatnak a betegség kialakulásá-hoz. Számos elmélet született már, részleges magyarázatot adva a hidradenitis suppurativa (HS) patogenezisére, mint például a fokozott mechanikai irritáció szerepe, vagy a terület eltérő higiénés jellemzői, immunológiai sajátossá-gai, melyben a fokozott nedvesség kaphat központi szerepet. Ugyanakkor a szövettani vizsgálatok alapján az apokrin mirigyek csak az előrehaladott formákban voltak érint-ve és akkor is sokkal inkább a végpontjai mint sem aktív szereplői voltak a patológiai folyamatoknak (1).Az utóbbi évek kutatásai a faggyúmirigyek szerepére is ráirányították a figyelmet, melyhez nagyban hozzájárultak azok a szövettani leletek, melyek a faggyúmirigyek elpusztulását már a HS kezdeti stádiumában leírták (2). A szövet-tani minták elemzésének másik szembetűnő lelete az acné-ből jól ismert follicularis hiperkeratinizáció/okklúzió volt, mely a folliculusok kitágulásához majd roncsolódásához vezet, így a baktériumokban gazdag törmelék a dermist infiltrálva annak gyulladását eredményezi felvetve, hogy a baktériumok és a különböző gyulladásos útvonalak éppúgy fontosak lehetnek ebben a betegségben is (1. ábra). A gyulladásban szerepet játszó sejteken az acnéban ismerthez hasonlóan, szintén fokozottan vannak jelen a Toll-like 129

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“…79 In a clinical trial, 18 of 25 (72%) patients who received metformin (500 to 1500 mg daily) had a mean 12.7 reduction in their Sartorius score at 24 weeks while 7 patients had no response. 111 Antiandrogenic therapy can be considered in patients with HS who also have diabetes or women with menstrual abnormalities, signs of hyperandrogenism or polycystic ovary disease. Tacrolimus: In 2 patients with a kidney transplant and comorbid HS, all lesions disappeared after a switch from cyclosporine to tacrolimus while maintaining mycophenolate.…”

Section: -Antiandrogenic Therapymentioning

confidence: 99%

Update on Hidradenitis Suppurativa (Part I): Epidemiology, Pathogenesis, Severity assessment and Comorbidities

Silva

Azevedo

Lisboa

2018

SPDV

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Hidradenitis suppurativa (HS) is as a chronic, inflammatory and recurrent skin disease of the hair follicle. Prevalence of HS is a matter of debate, with estimate rates as low as 0.00033% and as high as 4.1%. HS prevalence appears significantly higher in women and has a mean age of onset in the early 20s. The primary histopathologic event seems to be a follicular hyperkeratosis with plugging, dilatation and rupture of the hair follicle resulting with subsequent inflammation and formation of abscesses and sinus tracts. The cause of this is likely multifactorial, involving genetic factors, cigarette smoking, mechanical stress, obesity, immune aberrant response and hormonal abnormalities. HS, as a chronic inflammatory dermatosis, is associated with a variety of concomitant and secondary diseases such as metabolic syndrome, inflammatory and rheumatologic diseases, depression and malignancy, and, for this reason HS management often requires a multidisciplinary team.

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Metformin for the treatment of hidradenitis suppurativa: a little help along the way

Abstract: Background Despite recent insights into its aetiology, hidradenitis suppurativa (HS) remains an intractable and

Cited by 138 publications

References 53 publications

An Update on Medical Treatment Options for Hidradenitis Suppurativa

An Update on Medical Treatment Options for Hidradenitis Suppurativa

Hidradenitis suppurativa: why isn’t it a form of acne?

Update on Hidradenitis Suppurativa (Part I): Epidemiology, Pathogenesis, Severity assessment and Comorbidities

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