Finasteride for the Treatment of Hidradenitis Suppurativa in Children and Adolescents

Randhawa, Harkamal Kaur; Hamilton, J. R.; Pope, Elena

doi:10.1001/jamadermatol.2013.2874

Cited by 65 publications

(56 citation statements)

References 26 publications

(22 reference statements)

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“…Inhibitors of type II 5α-reductase have been also used as a therapeutic option in HS [23,24], especially in refractory cases. Finasteride, a type II 5α-reductase inhibitor, was applied as monotherapy in a pilot study with 7 patients, in a daily dosis of 5 mg. Six out of seven patients showed a clinical improvement and 2 of the 6 a complete clearance of the lesions [25].…”

Section: Hs and Sexual Hormonesmentioning

confidence: 99%

Hidradenitis suppurativa/Acne inversa: an endocrine skin disorder?

Karagiannidis

Nikolakis

Sabat

et al. 2016

Rev Endocr Metab Disord

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Hidradenitis suppurativa / acne inversa (HS) is a chronic inflammatory, debilitating skin disorder with a largely unknown etiology. However, many observations such as the typical onset of the disease after puberty, the female predominance, the pre-menstrual flare ups and the improvement during pregnancy suggest a contribution of endocrinological factors to the emergence of the disease. In addition, the reported efficacy of anti-androgen treatment on HS indicates a possible involvement of androgens in the pathogenesis. Furthermore, the common comorbidity with metabolic syndrome points to possible interactions between endocrinological and metabolic alterations in the development of HS. Taking into account the endocrine functions of the human skin, several studies investigated the effects of hormones and the behavior of the pilosebaceous unit in the skin of patients with HS. In this review we describe the current view on the hormonal dysregulation and metabolic syndrome and their role in HS.

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Section: Hs and Sexual Hormonesmentioning

confidence: 99%

Hidradenitis suppurativa/Acne inversa: an endocrine skin disorder?

Karagiannidis

Nikolakis

Sabat

et al. 2016

Rev Endocr Metab Disord

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“…The four female children were treated with finasteride 1.25-10 mg daily with good effect. However, all received additional treatment with oral contraceptives, antibiotics, or surgery [128,129].…”

Section: Finasteridementioning

confidence: 99%

An Update on Medical Treatment Options for Hidradenitis Suppurativa

Deckers

Prens

2015

Drugs

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Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by recurrent inflammatory nodules mostly located in the armpits and groin. Over the years multiple treatments for HS have been proposed; however, to date a cure is still lacking. In this update we provide an overview of most drug treatments reported on for HS, where possible with their mode of action and side effects. In mild cases, clindamycin lotion or resorcinol cream have proven effective. Tetracyclines are a first-line systemic option in more widespread or severe cases, followed by the combination of clindamycin and rifampicin. However, the recurrence rate is high after discontinuation of clindamycin plus rifampicin combination therapy. Long-term treatment with retinoids, especially acitretin is feasible, although teratogenicity has to be taken into account in females of reproductive age. Multiple antiinflammatory drugs have been suggested for HS, such as dapsone, fumarates or cyclosporine. However, their effectiveness in HS is based on small case series with varying results. If most common treatments have failed, biologics (e.g., infliximab or adalimumab) are the next step. Although not addressed in this review, surgical interventions are often needed to achieve remission. Key PointsHidradenitis suppurativa (HS) is a chronic inflammatory skin disease without a cure.Antibiotics (topical or oral) are often the first treatment option for HS.In cases of more extensive or therapy-resistant HS, biologicals (e.g., infliximab or adalimumab) are a good therapeutic option.

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“…Finasteride, a selective inhibitor of the type II isomer of 5a-reductase, reduces the levels of 5aeDHT. It was used to improve six of seven adults with HS/AI and three children, one with premature adrenarche and one with polycystic ovarian syndrome [14]. …”

Section: Hormonal Factorsmentioning

confidence: 99%

“…Topical clindamycin 1% solution twice a day and oral antibiotics (doxycycline, minocycline, erythromycin, amoxicillin plus clavulanic acid, rifampicin, cephalosporins, and others) have been used, as has dapsone [32]. [14]. Dutasteride, also "off label," has helped clear both males and females in anecdotal personal cases.…”

Section: Antibioticsmentioning

confidence: 99%

Hidradenitis suppurativa

Margesson

Danby

2014

Best Practice & Research Clinical Obstetrics & Gynaecol

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Hidradenitis suppurativa is a chronic relapsing disorder of the folliculopilosebaceous units (FPSUs). Its negative impact on quality of life is extreme, mainly due to the lack of early recognition, accurate diagnosis, and appropriate management. The support structure of the FPSUs is defective. Under the influence of endogenous reproductive hormones, exogenous hormones, androgens and their precursors in dairy products, and other dietary factors, the follicular unit is plugged and distended by retained keratin. Friction, shearing forces, and pressure lead to rupture and leakage of the ductal contents from the weakened FPSU, causing an inflammatory reaction mediated mainly by the innate immune system. Therapy requires patient comprehension and cooperation, counseling, aggressive hormonal and dietary modification, avoidance of the trauma that leads to rupture, active multimodal anti-inflammatory therapy, and early unroofing and debridement. The full therapeutic program is needed to avoid the aggressive surgery required if the condition is not diagnosed early and managed appropriately.

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Finasteride for the Treatment of Hidradenitis Suppurativa in Children and Adolescents

Cited by 65 publications

References 26 publications

Hidradenitis suppurativa/Acne inversa: an endocrine skin disorder?

Hidradenitis suppurativa/Acne inversa: an endocrine skin disorder?

An Update on Medical Treatment Options for Hidradenitis Suppurativa

Hidradenitis suppurativa

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