Background: Hidradenitis suppurativa (HS) is a distressing condition for which no satisfactory treatment is available. Studies on hormonal mechanisms responsible for HS point towards altered end-organ sensitivity, probably related to the enzyme 5a reductase that converts testosterone to dihydrotestosterone. Finasteride, an inhibitor of type II 5a reductase, has been reported to be effective in recalcitrant HS. Aim: To study the effectiveness and tolerability of finasteride in patients with HS in a preliminary trial . Methods: Seven patients (five women and two men) with HS that was not responding well to antibiotics were treated with finasteride at a dose of 5 mg/day as monotherapy. Clinical response was assessed at regular intervals. Patients were followed up for periods varying from 8 months to 2 years. Results: Six patients improved significantly and three of them had complete healing of lesions. Two patients who were followed up for more than 1 year experienced remissions lasting 8-18 months. The drug was generally well tolerated; however, two women complained of breast enlargement. Conclusion: The results of this preliminary study suggest that finasteride is an effective therapeutic option in HS.
The overall visual outcome is good in HZO patients receiving antiviral therapy. Hutchinson's sign and anterior uveitis were found to be strong predictors of visual loss in HZO. Presence of these predictors calls for close monitoring.
Increasing eruption severity is a good predictor of occurrence of ocular complications and subsequent visual loss in HZO. Presence of a severe eruption is an indication for early ophthalmic intervention. Nasociliary nerve and lacrimal nerve involvement are also good predictors of ocular complications.
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