Radiation-induced hidradenitis suppurativa: A case report

A Giant Squamous Cell Carcinoma Arising in a Patient with Hidradenitis Suppurativa

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease of follicular pilosebaceous units. Chronic, active, and poorly controlled disease may lead to squamous cell carcinoma (SCC). The diagnosis and treatment of SCC in HS is particularly challenging because SCC lesions may be easily mistaken for HS lesions. Current medical literature recommends aggressive surgical excision with at least 2-cm margins. In this article, the authors describe a giant perianal SCC arising in a patient with HS who was treated with surgical resection and radiotherapy.

Delivery of high-dose radiation for recurrence of breast cancer in a patient with hidradenitis suppurativa

Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition characterised by inflammatory nodules, abscesses, sinus tract formation and scarring. There is a lack of evidence for the use of radical radiotherapy for patients with a diagnosis of HS. A 56-year-old woman with a long-standing diagnosis of HS presented with a cutaneous local recurrence of breast cancer. Radical radiotherapy was offered despite issues with previous prolonged postoperative wound healing associated with the underlying HS. A multidisciplinary evaluation was conducted with breast surgeons, dermatologists and radiation oncologists to assess the safety of delivery of radical radiotherapy. Five weeks post radiotherapy, the patient had no significant residual symptoms from her breast cancer treatment for her HS and no escalation of treatment was required for her HS. Factors contributing to safe delivery of radical radiotherapy include medical optimisation prior to and during treatment, radiation dose, radiation technique and vigilant post-treatment surveillance.

Medical and Surgical Management of Hidradenitis Suppurativa: A Review of International Treatment Guidelines and Implementation in General Dermatology Practice

BACKGROUND

Hidradenitis suppurativa (HS) is a chronic painful skin disease that severely impairs patients' quality of life. While high-quality trials of HS therapies remain limited, medical knowledge of best treatment practices is rapidly evolving, leading to the recent publication of multiple international treatment guidelines for HS.

SUMMARY

This review compares international HS treatment guidelines, describes evidence for effectiveness of common and emerging HS therapies, and provides guidance for integrating evidence-based HS care into practice. Although over 50 medical and procedural treatments are mentioned across international HS guidelines, only adalimumab and infliximab have grade B/weak recommendation or higher across all major guidelines. This review describes the appropriate patient selection and effectiveness of the most commonly used medical and procedural treatments for HS. It also includes recommendations for counseling, dosing, and duration of medical therapies as well as procedure videos for the practicing dermatologist.