Abstract
Introduction: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder of the follicular epithelium. The aim of the study was to investigate the effectiveness of colchicine on the clinical outcomes of HS patients, and to evaluate wither colchicine as monotherapy or in combination with doxycycline would provide better outcomes. Methods: A retrospective study was conducted including 44 patients with established HS, divided into three groups. The first group (n = 15 patients) received colchicine as monotherapy, the second group (n = 14 patients) received colchicine and doxycycline 100 mg/d, while the third group (n = 15 patients) received colchicine and doxycycline 40 mg/d. Disease severity during treatment was assessed at baseline and follow-up, using the Hurley Scoring System and the International Hidradenitis Suppurativa Severity Score System (IHS4). All patients were also asked to complete a Dermatology Life Quality Index (DLQI) questionnaire. These scores were compared among the study groups. Results: The DLQI and IHS4 scores significantly improved after treatment with colchicine (p < 0.001) in all groups. All colchicine regimes, including the single colchicine regime, colchicine plus doxycycline 100 mg regime, and colchicine plus doxycycline 40 mg regime, resulted in significant improvements in the DLQI and IHS4 scores (p < 0.001). Clinical improvement based on DLQI and IHS4 scores was similar in all groups. None of the patients had to discontinue the treatment due to adverse events. Discussion: In conclusion, our findings suggest that colchicine may improve clinical severity and quality of life in HS patients, either as monotherapy or in combination with doxycycline, both at antimicrobial (100 mg) and sub-antimicrobial (40 mg) doses.
Highlights
Colchicine is an anti-inflammatory agent that has traditionally been used for the treatment of various dermatological disorders, including chronic urticaria, cutaneous vasculitis, and psoriasis
There are only a few studies focusing on the efficacy of colchicine in Hidradenitis suppurativa (HS) treatment
A prospective Dutch study from van der Zee et al showed no improvement after colchicine treatment, with the patients reporting frequent side effects, such as nausea and diarrhea [1]
Summary
HS has a significant impact on the quality of life of HS patients. A wide variety of medications have been proposed for the treatment of HS, which depends on the morphology, extent, severity, and duration of the disease. Mild HS is usually treated with topical clindamycin, whereas rifampicin combined with oral clindamycin or minocycline are commonly used for stage 1 and 2 HS. Severe cases are treated with cyclosporine, adalimumab, or infliximab and antibiotics. Other HS treatments include oral dapsone, hormone blockers, oral and intralesional prednisone, acitretin, clarithromycin, etc. Despite the broad armamentarium of drug treatment options, HS management, in both children and adults, may be difficult because of its chronic and recurrent nature. A subset of patients is refractory to standard therapeutic options, making HS treatment even more challenging
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