Special considerations for women with hidradenitis suppurativa

Collier, Erin K.; Shi, Vivian Y.; Parvataneni, Ram; Lowes, Michelle A.; Hsiao, Jennifer L.

doi:10.1016/j.ijwd.2020.02.005

Cited by 20 publications

(25 citation statements)

References 28 publications

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“…Higher BMI in women with fulfilled reproductive desires may be explained by their older age, as BMI is positively correlated with age [ 46 ], and the increasing weight gain between consecutive pregnancies, even in women without pre-existing obesity [ 47 ]. Weight gain is known to contribute to HS pathogenesis [ 48 ], while the effect of pregnancy on HS [ 49 ] as well as the effect of HS on pregnancy are unknown [ 50 , 51 ]. Although a high rate of HS exacerbation during pregnancy and postpartum has been reported, most patients did not receive HS-directed medical treatment or care from a dermatologist during their pregnancy [ 51 ].…”

Section: Discussionmentioning

confidence: 99%

Reproductive Potential and Outcomes in Patients with Hidradenitis Suppurativa: Clinical Profile and Therapeutic Implications

Montero‐Vílchez

Salvador‐Rodríguez

Rodriguez-Tejero

et al. 2021

Life

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There are scarce data available regarding the impact of hidradenitis suppurativa (HS) on fertility, course and outcome of pregnancy and risk associated with treatments. The aims of this study are (1) to describe the clinical profile of HS women of childbearing age with and without accomplished reproductive desires and (2) to describe the prescribed treatments based on the fulfillment of reproductive intentions. We conducted a prospective observational study that included 104 HS women of childbearing age, 50.96% (53/104) with unfulfilled reproductive desires. These women were younger (29.08 vs. 42.06 years, p < 0.001), less frequently married and higher educated than women with fulfilled reproductive desires. Their age of disease onset was lower, but disease duration was shorter, in concordance with a lower International Hidradenitis Suppurativa Severity Score System (IHS4) and lower number of draining tunnels. Combined oral contraceptives were more frequently prescribed in women with unfulfilled reproductive desires (30.19% vs. 9.80%, p = 0.013) while biologics were less used in this group (3.77% vs. 13.73%, p = 0.08). In conclusion, a higher educational level and an earlier disease onset, with potential implications in finding a partner, may make the fulfillment of reproductive desires difficult for patients with HS. This study could help clinicians to achieve a better understanding of the specific characteristics of HS during childbearing age and consider reproductive desires when making treatment decisions.

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Section: Discussionmentioning

confidence: 99%

Reproductive Potential and Outcomes in Patients with Hidradenitis Suppurativa: Clinical Profile and Therapeutic Implications

Montero‐Vílchez

Salvador‐Rodríguez

Rodriguez-Tejero

et al. 2021

Life

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“…Lifestyle modifications such as smoking cessation, weight loss, or modifications in shaving or antiperspirants 20 are not supported by high-quality evidence and can be considered medical and surgical treatment adjuncts. It is unclear whether changes in smoking status influence hidradenitis suppurativa severity, treatment response, or disease duration 5 , 21 – 25 (though smoking cessation is encouraged to improve overall health 26 ).…”

Section: Lifestyle Modificationsmentioning

confidence: 99%

“… 119 Painful axillary lesions making it difficult to lift the infant also interfere with breastfeeding, so proactive management during pregnancy and early counseling is important for supporting mothers planning to breastfeed. 20 Clindamycin and rifampin are compatible with breastfeeding. 120 Cephalexin, amoxicillin with clavulanate, and ertapenem are also compatible, though may cause infant diarrhea.…”

Section: Special Populations: Pediatrics and Pregnantmentioning

confidence: 99%

Clinical Epidemiology and Management of Hidradenitis Suppurativa

Sayed

Hsiao

Okun

2021

Obstetrics &Amp; Gynecology

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has been reviewed by the Editorial Board and by special expert referees. Although it is judged not acceptable for publication in Obstetrics & Gynecology in its present form, we would be willing to give further consideration to a revised version. If you wish to consider revising your manuscript, you will first need to study carefully the enclosed reports submitted by the referees and editors. Each point raised requires a response, by either revising your manuscript or making a clear and convincing argument as to why no revision is needed. To facilitate our review, we prefer that the cover letter include the comments made by the reviewers and the editor followed by your response. The revised manuscript should indicate the position of all changes made. We suggest that you use the "track changes" feature in your word processing software to do so (rather than strikethrough or underline formatting).

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“…Androgens increase the keratinization of the hair follicle, leading to follicular obstruction, favoring the appearance of outbreaks and exacerbations of HS [ 17 ]. Weight gain is also known to contribute to HS pathogenesis [ 18 ], and it has been observed that high levels of testosterone and low levels of sex hormone-binding globulin (SHGB) are associated with high BMI [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

The Role of Oral Contraceptive Pills in Hidradenitis Suppurativa: A Cohort Study

Montero‐Vílchez

Valenzuela-Amigo

Cuenca‐Barrales

et al. 2021

Life

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There is a need to establish the role of antiandrogens as an alternative or concomitant therapy for hidradenitis suppurativa (HS). Thus, the objectives of this study are (1) to assess the effectiveness of oral contraceptive pills (OCPs) at week 12 in HS women, and (2) to describe the clinical profile of patients receiving oral contraceptive pills (OCPs). A prospective observational study was designed. This study included 100 participants, 50 women with HS who started OCPs for the first time at our HS Clinic and 50 participants without OCP treatment. The main outcome of interest was the percentage of reduction in total abscess and inflammatory nodule (AN) count at week 12. Thirty-three women received combined OCPs and 17 non-combined OCP. HS patients with OCPs treatment were younger (31.7 vs. 40.9 years, p < 0.001), thinner (28.62 vs. 33.35 kg/m2), and have a higher number of areas affected (2.32 vs. 1.38, p = 0.02) than those without OCPs. After 12-weeks of treatment, it was observed that the percentage of AN reduction was higher in HS women receiving OCP than in patients without OCP (53.9% vs. 38.42%, p = 0.049). It was observed that OCP prescription (β = 3.79, p = 0.034) and concomitant therapy (β = 3.91, p = 0.037) were independently associated with a higher % AN when controlling for disease duration, concomitant therapy, and treatment with/without OCP (R^2 = 0.67). The factors potentially associated with the percentage AN reduction at week 12 in HS women treated with OCPs were disease duration (β = −1.327, p = 0.052), concomitant therapy (β = 11.04, p = 0.079), and HS worsening with the menstrual cycle (β = 10.55, p = 0.087). In conclusion, OCPs might be effective for improving AN count in women with HS. Women whose HS worsens in relation to the menstrual cycle and have a shorter disease may benefit more from the therapeutic effect of OCPs.

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Special considerations for women with hidradenitis suppurativa

Cited by 20 publications

References 28 publications

Reproductive Potential and Outcomes in Patients with Hidradenitis Suppurativa: Clinical Profile and Therapeutic Implications

Reproductive Potential and Outcomes in Patients with Hidradenitis Suppurativa: Clinical Profile and Therapeutic Implications

Clinical Epidemiology and Management of Hidradenitis Suppurativa

The Role of Oral Contraceptive Pills in Hidradenitis Suppurativa: A Cohort Study

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