Trends in the management of hidradenitis suppurativa in the Middle East region: a systematic review

Abstract

Background Hidradenitis suppurativa (HS) is a chronic, painful, and severely debilitating inflammatory disease that affects apocrine gland-bearing skin. There is no universal consensus on the management of hidradenitis suppurativa (HS). Current available guidelines are from western countries, which may be of limited use in other parts of the world. In this study, we aim to identify trends in the management of HS in the Middle East (ME) and its differences with the West. Methods A systematic literature review was performed to identify all studies in HS management performed by experts in the ME from database inception to June 2020 using PubMed, EMBASE, and Cochrane Library databases. Only original articles published in English language were included. Guidelines from western countries were used for comparison.Results Fifty-four eligible studies comprising 7649 HS patients from the ME region and nine guidelines from the West were included. No established guidelines were found for the management of HS in the ME. Sex ratio of HS patients in the ME is different in that men reported to be affected at a higher rate than in the West. Different antibiotic regimens were recommended in the ME, and the experts in the ME tend to be more procedure intensive than experts in the West.Conclusions Establishing a guideline for HS management in the ME is recommended to address unique considerations in the countries in this region.There is no universal consensus on the best management of HS. 4,5 Although several guidelines are available for clinicians, most of these are from experts in western countries. There is a shortage of such guidelines for non-western countries. This shortage is particularly significant given that ethnicity as well as genetic, environmental, and cultural factors can all affect the clinical course of the disease and therapeutic options. As such, we aim to review approaches to HS management in the Middle East (ME) and compare them with those of the West, providing recommendations for HS management in the ME region. MethodsWe conducted a comprehensive literature search for HS management guidelines from database inception (April 1992) to

Reconstruction of the Axillary Region after Excision of Hidradenitis Suppurativa: A Systematic Review

“…HS is a chronic inflammatory disease of the follicular pilo-sebaceous unit. 32 It usually presents with painful nodules, which may be complicated by abscesses, leading to sinus tract formation, scarring, and fibrosis. 16 32 Surgical management demonstrated to significantly improve the quality of life in patients affected by advanced HS.…”

“… 32 It usually presents with painful nodules, which may be complicated by abscesses, leading to sinus tract formation, scarring, and fibrosis. 16 32 Surgical management demonstrated to significantly improve the quality of life in patients affected by advanced HS. 33 However, no actual gold standard reconstructive technique has been indicated after local excision of the HS affecting the axillary area.…”