Current Medical and Surgical Treatment of Hidradenitis Suppurativa—A Comprehensive Review

Ocker, Lennart; Rached, Nessr Abu; Seifert, Caroline; Scheel, Christina; Bechara, Falk G.

doi:10.3390/jcm11237240

Cited by 31 publications

(30 citation statements)

References 224 publications

(248 reference statements)

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“…23 In case of irreversible changes, including extensive scarring, inflammatory tunnels, contractions and chronic inflammatory lesions that do not respond to conservative therapy, a surgical approach should be implemented. 24 Due to its unique nature, surgical treatment of F I G U R E 2 Assessment of differences in closure time between tunnels' localizations with Kruskal-Wallis one-way analysis of variance on ranks (n = 79).…”

Section: Discussionmentioning

confidence: 99%

“…There are currently more than 50 clinical trials on new therapies in HS 23 . In case of irreversible changes, including extensive scarring, inflammatory tunnels, contractions and chronic inflammatory lesions that do not respond to conservative therapy, a surgical approach should be implemented 24 . Due to its unique nature, surgical treatment of HS can be challenging, even for the most experienced plastic surgeons.…”

Section: Discussionmentioning

confidence: 99%

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Deroofing: A safe, effective and well‐tolerated procedure in patients with hidradenitis suppurativa

Krajewski,

Sanz‐Motilva,

Flores Martinez

et al. 2024

Acad Dermatol Venereol

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IntroductionHidradenitis suppurativa (HS) is a recurrent, debilitating, chronic disorder of the pilosebaceous unit. Although advances in HS treatment have been made, more than 45% of patients remain dissatisfied with systemic treatment, and more than one‐third are dissatisfied with surgical procedures.ObjectivesA prospective, observational study on the deroofing procedures in HS with special attention paid to patient satisfaction and complications.MethodsHS lesions were assessed clinically and by the use of ultrasound. Patients reported outcomes, including pain, itch and satisfaction, were measured at 24 h post‐surgery by a numeric rating scale (NRS) ranging from 0 to 10. Additionally, the timeline of objective wound closure reported by patients in (weeks), in addition to the need for any analgesics use, were both evaluated.ResultsThe mean closure time of the post‐deroofing wound was assessed as 4.4 ± 1.9 weeks. A statistically longer time was necessary for complete closure in males than in females (4.9 ± 2.2 weeks and 3.9 ± 1.6 weeks, respectively; p = 0.046). The closure time correlated positively yet weakly with the HS tunnel's width (r = 0.27, p = 0.016) and length (r = 0.228, p = 0.044). Patients assessed mean pain at 24 h post‐op as mild with 0.7 ± 1.2 points according to NRS, with no differences between sexes. Similarly, itch in the first 24 h was assessed as mild with 1.8 ± 1.1 points, without differences between sexes. No pain, itch or adverse events were reported after 1 week following deroofing. Moreover, no cases of wound infection were reported. An overall patient satisfaction was assessed as 9.9 ± 0.4 points (range 9–10 points).ConclusionDeroofing is an easy, effective and safe dermatosurgical procedure that does not require surgical experience or operating theatre. It is associated with no complications and very low post‐op pain and should be part of holistic HS management.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Deroofing: A safe, effective and well‐tolerated procedure in patients with hidradenitis suppurativa

Krajewski,

Sanz‐Motilva,

Flores Martinez

et al. 2024

Acad Dermatol Venereol

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“…In addition, HS is associated with a reduced quality of life of affected patients, which completely impedes normal functioning [ 2 ]. Current therapy for HS includes a variety of local therapies, antiseptic measures, antibiotics, biologics, surgery, and new-small molecule drugs [ 3 , 4 ]. HS is also associated with endocrine abnormalities and comorbidities [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Screening for Diabetes Mellitus in Patients with Hidradenitis Suppurativa—A Monocentric Study in Germany

Rached

Gambichler

Ocker

et al. 2023

IJMS

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Hidradenitis suppurativa (HS) is a chronic skin disease that is often associated with metabolic disorders. Diabetes mellitus (DM) is a frequent comorbidity in HS. There is currently no established screening for DM in HS patients. The aim of our study was to identify high-risk groups of HS patients that develop DM and to assess the frequency of different types of DM present in HS patients. To do so, we conducted a monocentric study in 99 patients with HS. All patients underwent detailed clinical and laboratory assessments, including the determination of glycated hemoglobin. Among the 20.2% of patients that presented with DM, type 2 was by far the most prevalent (19 out of 20 patients). Moreover, male gender, age, BMI, Hurley stage, modified Hidradenitis Suppurativa Score (mHSS), DLQI and hypertension all correlated with the glycated hemoglobin levels in the HS patients. In the multivariable analysis, Hurley stage III, older age, and higher BMI were significantly associated with DM. Specifically, patients at Hurley stage III were at a 5.3-fold increased risk of having DM type II compared to patients at earlier Hurley stages. Since many of the HS patients had not been diagnosed, our study reveals shortcomings in the screening for DM and suggest that this should be routinely performed in HS patients at high risk to avoid secondary complications.

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“…In Hurley stage II and III, surgery to remove draining fistulas and scar tissue is an important option. In recent years, new systemic treatment approaches involving the use of interleukin 17 (IL‐17) inhibitors, IL‐1 inhibitors and JAK/STAT inhibitors have been tested in HS 11 …”

Section: Introductionmentioning

confidence: 99%

“…In recent years, new systemic treatment approaches involving the use of interleukin 17 (IL-17) inhibitors, IL-1 inhibitors and JAK/STAT inhibitors have been tested in HS. 11 Thus, with the anticipated increased use of biologics and targeted therapy, the treatment of HS is becoming more personalized and strategies for stratification as well as treatment monitoring of patients are becoming increasingly urgent. In this context, biomarkers that predict treatment response represent highly desirable tools for the future treatment of HS.…”

mentioning

confidence: 99%

Haptoglobin is an independent marker for disease severity and risk for metabolic complications in hidradenitis suppurativa: A prospective study

Abu Rached,

Gambichler,

Ocker

et al. 2023

Acad Dermatol Venereol

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BackgroundHidradenitis suppurativa (HS) is a chronic inflammatory disease that is highly correlated with obesity. Haptoglobin serum levels have recently been recognized as an important biomarker linking obesity with chronic inflammation.ObjectiveTo compare haptoglobin with previously proposed serum biomarkers for the determination of disease severity in HS patients. For this purpose, disease severity of HS patients was determined by a panel of clinical scores as well as several risk factors, such as weight and smoking habits.MethodsA prospective, diagnostic accuracy study was performed at the International Centre for Hidradenitis suppurativa/Acne inversa Bochum (ICH). The study included a total of 263 patients, including 131 who had a confirmed diagnosis of HS in Hurley I (n=16), II (n=56), and III (n=59) HS, and 132 healthy controls. The main outcome was to identify serological inflammatory markers for HS disease severity [severe (III) vs. moderate/mild (II/I)] as assessed by Hurley classification.ResultsThe serum levels of acute phase proteins haptoglobin and CRP, as well as the number of neutrophils in peripheral blood, number of monocytes, the systemic immune‐inflammation index and the pan‐immune‐inflammatory value correlated with disease severity according to established clinical scores (mHSS, SAHS, Hurley, DLQI). HS patients had significantly higher haptologlobin levels compared to healthy controls. Logistic regression analysis revealed haptoglobin as the only independent marker predicting severe HS.ConclusionIn this prospective study, we discovered that the serum levels of the acute phase protein haptoglobin levels serve as an independent marker of disease severity in HS. While this presents the first study in the context of HS. Thus, the present data not only yield a highly promising serum marker to be further validated.

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Current Medical and Surgical Treatment of Hidradenitis Suppurativa—A Comprehensive Review

Cited by 31 publications

References 224 publications

Deroofing: A safe, effective and well‐tolerated procedure in patients with hidradenitis suppurativa

Deroofing: A safe, effective and well‐tolerated procedure in patients with hidradenitis suppurativa

Screening for Diabetes Mellitus in Patients with Hidradenitis Suppurativa—A Monocentric Study in Germany

Haptoglobin is an independent marker for disease severity and risk for metabolic complications in hidradenitis suppurativa: A prospective study

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