Photodynamic therapy with intralesional methylene blue and a 635 nm light-emitting diode lamp in hidradenitis suppurativa: a retrospective follow-up study in 7 patients and a review of the literature

Abstract

Hidradenitis suppurativa is a chronic inflammatory skin disease which has an estimated prevalence of 1%. It is characterized by the formation of recurrent painful suppurative nodules and abscesses in the flexural areas of the body. It is believed that its pathogenesis involves an aberrant, genetically-determined activation of innate immunity against the bacterial commensal flora of intertriginous areas. It has been found that the formation of antibiotic-resistant bacterial biofilms is a common finding in hidradenitis lesions. Photodynamic therapy with different compounds and light sources has demonstrated its efficacy in a number of infectious diseases such as nail mycosis and chronic periodontitis. We retrospectively report our experience in the treatment of hidradenitis with photodynamic therapy using intralesional methylene blue and a 635 nm light-emitting diode lamp in 7 patients. Two patients received one session whereas 5 patients received two sessions. At one month follow-up good response was achieved in 6 patients. After 6 months, 5 patients (71%) maintained remission of the disease in the treated area. In view of the results and literature review, we regard methylene blue as an ideal photosensitizer for photodynamic therapy in this disease.

Photodynamic Therapy and Skin Appendage Disorders: A Review

“…Uncertain results have been obtained with intralesional PDT [74][75] . Agut-Busquet et al [76] recently reported a retrospective experience in the treatment of HS with PDT using intralesional methylene blue and a 635-nm light-emitting diode lamp in 7 patients. At 1 month follow-up, good response was achieved in 6 patients.…”

Intralesional Diode Laser 1064 nm for the Treatment of Hidradenitis Suppurativa: A Report of Twenty Patients

“…After six months, five patients (71%) maintained remission of the disease in the treated area. Photodynamic therapy has been used for its ability to reduce bacterial biofilms, which is a common finding in hidradenitis lesions [ 16 ].…”

Vulvar hidradenitis suppurativa: Clinical cross‐sectional study of 25 patients

“…Other frequent therapies were topical antibiotics (48%), intralesional steroids (40%) and photodynamic therapy (PDT) with intralesional methylene blue and 635 nm light-emitting diode lamp (28%) as previously described. 12 Surgical treatment was carried out in 20% of the patients with VHS and biologic therapy (adalimumab, infliximab and ustekinumab) was prescribed in 16% of them. All cases improved in quality of life and pain control.…”