Ultrasound‐guided photodynamic therapy with intralesional methylene blue and a 635 nm light‐emitting diode lamp in hidradenitis suppurativa: A retrospective study of 41 patients

Abstract

Background Photodynamic therapy for hidradenitis suppurativa (HS) is a therapeutic alternative with a good safety profile, but its effectiveness has yet to be demonstrated. Objectives To demonstrate the effectiveness of PDT with intralesional methylene blue in HS lesions. Methods A retrospective cross‐sectional study was performed. Forty‐one patients were treated with intralesional methylene blue and a diode lamp. Follow‐up was carried out at 1 and 6 months after therapy. Efficacy was determined by the diameter reduction of the lesion measured by high‐frequency ultrasound. Results A reduction of ≥75% in the maximum diameter was recorded in 58.5% of the lesions, while 22% showed a reduction between 50% and 75%, and 19.5% showed a reduction of <50%. Recurrence rate was 12.5%. The lesions treated in patients with typical forms of HS (Canoui‐Poitrine phenotype I) had a better therapeutic response. No statistically significant differences were found in terms of lesion location or concomitant treatment. Conclusion This therapy may potentially be a cost‐effective and well‐tolerated local therapy for Hurley I‐II patients with superficial abscesses and fistulas.

Intralesional Treatments in Hidradenitis Suppurativa: A Systematic Review

“…Six case series evaluated the effect of IL light-based therapies on HS lesions, representing 180 patients and 281 lesions (Table 2) [6, 8-10, 17, 19]. Mean age ranged from 27 to 39 years.…”

“…Mean age ranged from 27 to 39 years. In 3 of the studies, there was a female predominance [10, 17, 19]. Patients included were in Hurley stage I [9], I and II [10], or I–III [8, 17, 19]; another one did not specify Hurley stage [6].…”

“…In 3 of the studies, there was a female predominance [10, 17, 19]. Patients included were in Hurley stage I [9], I and II [10], or I–III [8, 17, 19]; another one did not specify Hurley stage [6]. Treated lesions were fistulas [6, 17, 19], nodules [19], and superficial abscesses [17]; in 3 cases, they were not specified [8-10].…”

“…A total of 537 entries were identified from the electronic database search. Once duplicates were eliminated, titles and abstracts reviewed and inclusion and exclusion criteria applied, 15 articles representing 599 patients and 1,032 lesions were eligible for review [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20].…”

“…Patients included were in Hurley stage I [9], I and II [10], or I-III [8,17,19]; another one did not specify Hurley stage [6]. Treated lesions were fistulas [6,17,19], nodules [19], and superficial abscesses [17]; in 3 cases, they were not specified [8][9][10]. The axilla and groin were the most frequent locations.…”