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Dec 1, 2022

Hidradenitis Suppurativa: a Cochrane systematic review

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that affects apocrine gland-bearing skin in the axillae, groin, and under the breasts. It is characterised by persistent or recurrent boil-like nodules and abscesses that culminate in a purulent discharge, sinuses, and scarring

Hidradenitis suppurativa (HS), also known as acne inversa, is a chronic inflammatory skin disease characterized by painful nodules, sinuses and scarring in flexural locations.It  is a chronic inflammatory skin disease that affects apocrine gland-bearing skin in the axillae, groin, and under the breasts. It is characterized by persistent or recurrent boil- ike nodules and abscesses that culminate in a purulent discharge, sinuses, and scarring. Hidradenitis suppurativa often starts at puberty, is most active between the ages of 20 and 40 years, and in women can resolve at menopause.

It is possible to describes three clinical stages. Stage I: solitary or multiple isolated abscess formation without sinus tracts or scarring. Stage II: Recurrent abscesses, single or multiple widely spaced lesions, with sinus tract formation. Stage III: Diffuse involvement of an area with multiple interconnected sinus tracts and abscesses.

The complications of hidradenitis suppurativa can include the psychological effects and negative impact on quality-of-life, Pyogenic granuloma, Lymphoedema, Squamous cell carcinoma and Anaemia of chronic disease. 

General measures for treating hidradenitis suppurativa include the weight loss. Patien has to stop Smoking. The use of absorbent dressings and analgesics. It is also important the amnagement of anxiety and depression.

Treatment of HS can be challenging and it can be difficult for clinicians to make evidence-based decisions in partnership with patients- In 2011 a Cochrane review team was assembled to undertake a review of all medical and surgical interventions for HS

The research identified 12 trials for inclusion in the review, in which a total of 615 adults with HS participated. The 12 trials investigated 15 different interventions and most were relatively small, with a median number of participants of 27.

The study was divided into topical therapy, systemic therapy, surgical treatment and other therapies. Antitumour necrosis factor-a therapies were investigated in four studies. More than 50 interventions have been used to treat hidradenitis suppurativa. (HS), and so therapy decisions can be challenging.


Authors: J.R. Ingram, P.N. Woo, S.L. Chua, A.D. Ormerod, N. Desai, A.C. Kai, K. Hood, T. Burton, F. Kerdel, S.E. Garner, and V. Piguet

Interventions for hidradenitis suppurativa: a Cochrane systematic review incorporating GRADE assessment of evidence quality. Br J Dermatol. 2016 May; 174(5): 970–978

Source: www.ncbi.nlm.nih.gov/pmc/articles/PMC5021164/