Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory disorder of the apocrine glands characterized by recurrent episodes. Although several therapies exist, none is completely curative. Several immunosuppressives have been studied with encouraging results and targeted approaches. In this review, we highlight the various immunosuppressives used in this condition along with their salient features to enable physicians to choose the correct therapy for their patients. The search of the peer-reviewed literature included clinical trials, scientific reviews, case series, case reports, and guidelines. The literature was identified from electronic databases (MEDLINE and PubMed) through November 2021; additional articles were included from the references of the identified articles.
Highlights
Hidradenitis suppurativa (HS) is a debilitating and relapsing inflammatory disease of the apocrine sweat glands
Adalimumab, an anti-TNF, is an example of a biologic agent used in the treatment of HS
Acitretin is a systemic retinoid for the treatment of HS
Summary
Hidradenitis suppurativa (HS) is a debilitating and relapsing inflammatory disease of the apocrine sweat glands. Hurley staging is used to grade disease severity, estimate prognosis, and measure therapeutic response. Hurley stage 1 is defined by the presence of isolated abscess (es) without scarring or sinus tract formation. In Hurley stage 2, recurrent abscess formation is associated with sinus tract formation and scarring. Hurley stage 3 indicates widespread involvement with multiple interconnected sinus tracts or abscesses involving an entire area [8]. Several immunosuppressive drugs have been studied because of their targeted mechanisms, with encouraging results [9]. Management is guided by clinical presentation of the disease; oral immunosuppressants are usually indicated in Hurley stages 2 and 3. Surgical de-roofing of the affected area is necessary for symptomatic relief, especially those cases with biofilm formation not responding to medical management. Antibiotic and surgical therapy is beyond the scope of this review
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