Nuestros primeros 600 pacientes con hidradenitis supurativa y qué hemos aprendido de ellos

Abstract

IntroductionHidradenitis suppurativa is a complex and multifactorial disease, and monographic units dedicated to it in our environment have existed since the second decade of this century. Material and methodsA retrospective review of the monographic unit of the Parc Taulí Hospital (Sabadell, Barcelona) is carried out from its creation in 2015 to the present. The unit has treated 600 patients, 100 of them on biological treatment. ResultsThe series comprised 273 women and 327 men. The distribution according to the Hurley scale was Hurley I: 41.2%, II: 32%, and III: 26.8%. Regarding phenotypes, 22% were classified as belonging to the axillomammary phenotype, 27% to the follicular and 21% to the gluteal. In 30% of the patients there was a mixed phenotype. The therapeutic approach of the selected patients was decided by a medical-surgical committee encompassing the services of dermatology, plastic surgery, and general surgery. The most used surgical technique was the «unroofing» of the lesions. Medical treatment was established following current guidelines, and the most widely used antibiotic regimen was the combination of rifampin and clindamycin followed by oral doxycycline. Biologic drug treatment began with adalimumab, followed by infliximab and ustekinumab. Other drugs, such as sulphone and acitretin, have shown utility in the follicular phenotype. DiscusionThe survival of biological treatment was limited, with a mean of 2 years for adalimumab, although a longer follow-up time is required to gain experience in the use of biologicals for the disease.