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Strobel A, Schultheis M, Staubach P, Grabbe S, Mann C, Hennig K, Szepietowski JC, Matusiak L, Krajewski P, von Stebut E, Garcovich S, Bayer H, Heise M, Podda M, Kirschner U, Nikolakis G. Real-world effectiveness and safety of the LAight-therapy in patients with hidradenitis suppurativa. J Dtsch Dermatol Ges 2024; 22:936-945. [PMID: 38807028 DOI: 10.1111/ddg.15403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 02/18/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND AND OBJECTIVES Hidradenitis suppurativa (HS)/Acne inversa (Ai) is a chronic debilitating disease with limited therapy options. The device-based LAight therapy was approved in Europe in 2017. The aim of this study was to evaluate the effect of real-world care with at least one treatment with LAight therapy on disease activity and burden in 3,437 patients. PATIENTS AND METHODS Patients were included in the analysis if they had a diagnosis of HS and received at least one treatment. The endpoints Hidradenitis Suppurativa Severity Score System (IHS4), pain on the numeric rating scale (pain-NRS) and Dermatology Life Quality Index (DLQI) were analyzed using a linear mixed model for repeated measures (MMRM) over 26 weeks of care with LAight therapy. Furthermore, responder rates were calculated for all endpoints, and the therapy's safety profile and patient satisfaction were thoroughly examined. RESULTS A significant decrease in IHS4, pain-NRS, and DLQI was achieved during 26 weeks of care with LAight. The BMI at baseline had a significant negative effect on therapy response for pain-NRS and DLQI. CONCLUSIONS This study confirms that LAight therapy leads to satisfactory disease control in all stages of severity and is a valuable addition to the therapeutic repertoire of HS.
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Affiliation(s)
- Alexandra Strobel
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Faculty of Medicine, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
- Profile Centre of Health Sciences Halle, Faculty of Medicine, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
| | - Michael Schultheis
- Dept. of Dermatology, University Medical Center, Johannes Gutenberg, University, Mainz, Germany
| | - Petra Staubach
- Dept. of Dermatology, University Medical Center, Johannes Gutenberg, University, Mainz, Germany
| | - Stephan Grabbe
- Dept. of Dermatology, University Medical Center, Johannes Gutenberg, University, Mainz, Germany
| | - Caroline Mann
- Dept. of Dermatology, University Medical Center, Johannes Gutenberg, University, Mainz, Germany
| | - Katharina Hennig
- Dept. of Dermatology, University Medical Center, Johannes Gutenberg, University, Mainz, Germany
| | - Jacek C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Lukasz Matusiak
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Piotr Krajewski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Esther von Stebut
- Department of Dermatology, Faculty of Medicine, University of Cologne, Cologne, Germany
| | | | - Hans Bayer
- Dermatology Outpatient Office Hautmedizin Bad Soden, Bad Soden, Germany
| | - Marcus Heise
- Profile Centre of Health Sciences Halle, Faculty of Medicine, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
- Institute for Health- and Nursing Science, Faculty of Medicine, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
- Institute of General Practice and Family Medicine, Faculty of Medicine, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
| | - Maurizio Podda
- Department of Dermatology, Medical Center Klinikum Darmstadt, Teaching Hospital Goethe-University Frankfurt, Darmstadt, Germany
| | - Uwe Kirschner
- Dermatology Outpatient Office Dr. Uwe Kirschner, Mainz, Germany
| | - Georgios Nikolakis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, Dessau, Germany
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2
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Barker C, Alshaikh H, Elston D. Dermatology practice updates in mycobacterial disease. Int J Dermatol 2024; 63:714-725. [PMID: 38095207 DOI: 10.1111/ijd.16969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 11/17/2023] [Accepted: 11/29/2023] [Indexed: 05/25/2024]
Abstract
Atypical mycobacterial infections are commonly acquired through exposure to water, and tuberculosis remains highly endemic in many parts of the world. In this era of global connection, travel, and immigration, it is more important than ever to maintain a high index of suspicion for infection from cutaneous tuberculosis and atypical mycobacteria. Epidemics related to surgical procedures have been related to inadequate sterilization, as almost 50% of public water supplies harbor mycobacteria. Improved diagnostic techniques for these microbes, including Auramine-Rhodamine staining and rapid detection of mycobacteria and drug susceptibilities through PCR and MALDI-TOF, have improved detection and treatment outcomes. Given an increasing number of patients on immunosuppressive therapies, clinicians must remain vigilant.
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Affiliation(s)
- Catherine Barker
- Department of Internal Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Hesham Alshaikh
- Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, SC, USA
- Department Mohs Micrographic and Dermatologic Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Dirk Elston
- Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, SC, USA
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3
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Molinelli E, De Simoni E, Candelora M, Sapigni C, Brisigotti V, Rizzetto G, Offidani A, Simonetti O. Systemic Antibiotic Therapy in Hidradenitis Suppurativa: A Review on Treatment Landscape and Current Issues. Antibiotics (Basel) 2023; 12:978. [PMID: 37370297 DOI: 10.3390/antibiotics12060978] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/19/2023] [Accepted: 05/24/2023] [Indexed: 06/29/2023] Open
Abstract
Hidradenitis suppurativa (HS) is a chronic, recurrent, and inflammatory skin disease characterized by painful, deep-seated, nodules, abscesses, and sinus tracts in sensitive areas of the body, including axillary, inguinal, and anogenital regions. Antibiotics represent the first-line pharmacological treatment of HS because of their anti-inflammatory properties and antimicrobial effects. This narrative review summarizes the most significant current issues on the role of systemic antibiotics in the management of HS, critically analyzing the main limits of their use (antibiotic resistance and toxicity). Although, in the last decades, several cytokines have been implicated in the pathomechanism of HS and the research on the use of novel biologic agents in HS has been intensified, antibiotics remain a valid therapeutic approach. Future challenges regarding antibiotic therapy in HS comprise their use in association with biologics in the management of acute flare or as a bridge therapy to surgery.
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Affiliation(s)
- Elisa Molinelli
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60126 Ancona, Italy
| | - Edoardo De Simoni
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60126 Ancona, Italy
| | - Matteo Candelora
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60126 Ancona, Italy
| | - Claudia Sapigni
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60126 Ancona, Italy
| | - Valerio Brisigotti
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60126 Ancona, Italy
| | - Giulio Rizzetto
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60126 Ancona, Italy
| | - Annamaria Offidani
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60126 Ancona, Italy
| | - Oriana Simonetti
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60126 Ancona, Italy
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Molinelli E, Sapigni C, D’Agostino GM, Brisigotti V, Rizzetto G, Bobyr I, Cirioni O, Giacometti A, Brescini L, Mazzanti S, Offidani A, Simonetti O. The Effect of Dalbavancin in Moderate to Severe Hidradenitis Suppurativa. Antibiotics (Basel) 2022; 11:1573. [PMID: 36358228 PMCID: PMC9686733 DOI: 10.3390/antibiotics11111573] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/23/2022] [Accepted: 10/31/2022] [Indexed: 09/06/2023] Open
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by painful nodules, abscesses, and fistulas, localized to the areas of the folds where apocrine glands are present: the armpits, groin, inframammary region, and genital or perineal region. The management is still challenging, and it includes mainly systemic antibiotics, immunosuppressors, and biologic agents. Antibiotics are frequently used in the management of HS for their anti-inflammatory, immunomodulatory, and antimicrobial properties, but no data have been reported regarding the use of dalbavancin in HS. The aim of our practice was to evaluate efficacy, flare, and disease-free survival after dalbavancin therapy in a selected population with HS. We report the experience of the Ancona Dermatology Clinic in treating HS flare-ups with dalbavancin and its rationale for use. Our observation shows that the use of dalbavancin is an effective and well-tolerated treatment for the management of Hurley stage II-III HS; currently, dalbavancin should be considered as a supportive therapy for selected patients.
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Affiliation(s)
- Elisa Molinelli
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60121 Ancona, Italy
| | - Claudia Sapigni
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60121 Ancona, Italy
| | - Giovanni Marco D’Agostino
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60121 Ancona, Italy
| | - Valerio Brisigotti
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60121 Ancona, Italy
| | - Giulio Rizzetto
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60121 Ancona, Italy
| | - Ivan Bobyr
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60121 Ancona, Italy
| | - Oscar Cirioni
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60121 Ancona, Italy
| | - Andrea Giacometti
- Clinic of Infectious Diseases, Department of Biochemical Sciences and Public Health, Polytechnic University of the Marche Region, 60121 Ancona, Italy
| | - Lucia Brescini
- Clinic of Infectious Diseases, Department of Biochemical Sciences and Public Health, Polytechnic University of the Marche Region, 60121 Ancona, Italy
| | - Sara Mazzanti
- Clinic of Infectious Diseases, Department of Biochemical Sciences and Public Health, Polytechnic University of the Marche Region, 60121 Ancona, Italy
| | - Annamaria Offidani
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60121 Ancona, Italy
| | - Oriana Simonetti
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60121 Ancona, Italy
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Romaru J, Limelette A, Lebrun D, Bonnet M, Garnier VV, N'Guyen Y. Fusidic acid in a tertiary hospital: an observational study focusing on prescriptions, tolerance and susceptibility of Staphylococcus and Cutibacterium spp. strains from bone samples. Eur J Clin Microbiol Infect Dis 2022; 41:1107-1113. [PMID: 35780283 DOI: 10.1007/s10096-022-04469-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 06/22/2022] [Indexed: 11/25/2022]
Abstract
Adverse drug reactions of broad-spectrum fluoroquinolones or rifampicin are not uncommon during osteomyelitis and orthopaedic implant infections (OOII). Thus, we made an overview (i) of the prescription of fusidic acid (FA) and (ii) of FA susceptibility of Staphylococcus sp. and Cutibacterium sp. strains isolated from bone samples. All prescriptions of FA and all bone samples with positive culture for Staphylococcus sp. or Cutibacterium sp. (Reims University Hospital June 2017-May 2021) were included. All Staphylococcus aureus strains were considered as significant, whereas Coagulase-negative Staphylococcus and Cutibacterium spp. strains were not if these strains grew only on one sole sample. The antibiotic susceptibility of Staphylococcus sp. strains and the susceptibility to FA of Cutibacterium sp. strains had been determined using disk diffusion methods, as described for Staphylococcus sp. in the CASFM/EUCAST guidelines. The mean FA consumption was 0.6 daily defined doses/1000 patient days. FA was prescribed for OOII due to Staphylococcus sp. and Cutibacterium sp. in 24 and 2 cases, respectively. Among 401 Staphylococcus sp. strains, there were 254 S. aureus (63.3%), 84 methicillin-resistant (20.9%) and 333 FA-susceptible (83.0%) strains. S. aureus and methicillin-sensitive strains were more likely to be susceptible to FA (p < 0.001). Among 39 Cutibacterium sp. strains, the FA inhibition zone diameter geometric mean was 28.6 mm (24-35 mm), suggesting that all these strains could be considered as susceptible to FA. These data suggested that FA could be more frequently used in OOII due to Staphylococcus sp. and Cutibacterium sp., subject to the absence of other resistant bacteria.
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Affiliation(s)
- Juliette Romaru
- Service de Médecine Interne, Maladies Infectieuses Et Immunologie Clinique, Hôpital Robert Debré, Avenue du Général Koenig, 51100, Reims, France
| | - Anne Limelette
- Laboratoire de Bactériologie, Pôle de Biologie, 51100, Reims, France
| | - Delphine Lebrun
- Service d'Orthopédie, Hôpital Maison Blanche, 51100, Reims, France
| | - Morgane Bonnet
- Pharmacie Hospitalière, Hôpital Robert Debré, 51100, Reims, France
| | | | - Yohan N'Guyen
- Service de Médecine Interne, Maladies Infectieuses Et Immunologie Clinique, Hôpital Robert Debré, Avenue du Général Koenig, 51100, Reims, France.
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6
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Schultheis M, Staubach P, Grabbe S, Ruckes C, von Stebut E, Kirschner U, Matusiak Ł, Szepietowski JC, Nikolakis G. LAight® Therapy Is an Effective Treatment Option to Maintain Long-Term Remission of Hurley I and II Hidradenitis Suppurativa: Results from Period B of RELIEVE, a Multicenter Randomized, Controlled Trial. Dermatology 2022; 238:1092-1103. [PMID: 35679831 PMCID: PMC9808664 DOI: 10.1159/000524739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 04/14/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Hidradenitis suppurativa is a chronic, inflammatory, burdensome skin disease where current first-line treatments are limited to topical and/or systemic antibiotics which cannot be applied for long-term disease management. Period B of the RELIEVE study analyzes whether LAight® therapy can sustain or even increase remission after a first topical antibiotic treatment cycle. METHODS The RELIEVE study was performed as a two-period multicenter randomized controlled trial with blinded assessment. For period A from week 0 to week 16, the 88 participating Hurley I and II patients were randomized to either a group receiving topical clindamycin 1% solution combined with 8 additional bi-weekly treatments with LAight® therapy (group TC + L) or a group which was treated with topical clindamycin 1% solution only (group TC). After 16 weeks, patients entered open-label period B and both groups were treated exclusively with LAight® therapy for an additional 16 weeks (8 sessions, group TC + L/L and group TC/L). RESULTS In total, 88 patients were enrolled in RELIEVE. Seventy-eight patients entered period B; 39 belonged to group TC + L/L and 39 to group TC/L. The IHS4-response at the start of period B was 62% (group TC + L/L) and 33% (group TC + L). During the 16 weeks of additional monotherapy with LAight, in both groups >90% of patients who responded to therapy in period A maintained their IHS4-response at week 32. IHS4 response rates continued to rise up to 79% of the TC + L/L group and up to 71% of the TC/L group during period B at week 32. Achievement of HiSCR and certain patient reported outcomes confirmed primary endpoint results. CONCLUSION LAight® therapy is an effective approved therapy option for Hurley I and II HS that can be used continuously to maintain treatment success. During 16 weeks of follow-up in period B, over 90% of patients with response after period A maintained their treatment outcome, while more than 60% of prior nonresponders gained response. The fact that LAight® therapy can be applied continuously, is very effective and is well tolerated makes it a valuable treatment tool in the design of HS long-term treatment modalities.
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Affiliation(s)
- Michael Schultheis
- Department of Dermatology, University Medical Center, Johannes Gutenberg University, Mainz, Germany
| | - Petra Staubach
- Department of Dermatology, University Medical Center, Johannes Gutenberg University, Mainz, Germany
| | - Stephan Grabbe
- Department of Dermatology, University Medical Center, Johannes Gutenberg University, Mainz, Germany
| | - Christian Ruckes
- Interdisciplinary Centre for Clinical Studies, University Medical Center, Johannes Gutenberg University, Mainz, Germany
| | - Esther von Stebut
- Department of Dermatology, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Uwe Kirschner
- Dermatology Outpatient Office Dr. Uwe Kirschner, Mainz, Germany
| | - Łukasz Matusiak
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Jacek C. Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Georgios Nikolakis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, Dessau, Germany
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Marasca C, Tranchini P, Marino V, Annunziata MC, Napolitano M, Fattore D, Fabbrocini G. The pharmacology of antibiotic therapy in hidradenitis suppurativa. Expert Rev Clin Pharmacol 2020; 13:521-530. [DOI: 10.1080/17512433.2020.1762571] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Claudio Marasca
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Paolo Tranchini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Vincenzo Marino
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Maria Carmela Annunziata
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Maddalena Napolitano
- Department of Medicine and Health Sciences Vincenzo Tiberio, University of Molise, Campobasso, Italy
| | - Davide Fattore
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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8
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Orenstein LAV, Nguyen TV, Damiani G, Sayed C, Jemec GBE, Hamzavi I. Medical and Surgical Management of Hidradenitis Suppurativa: A Review of International Treatment Guidelines and Implementation in General Dermatology Practice. Dermatology 2020; 236:393-412. [PMID: 32408306 PMCID: PMC8177083 DOI: 10.1159/000507323] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 03/15/2020] [Indexed: 12/11/2022] Open
Abstract
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.
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Affiliation(s)
- Lauren A V Orenstein
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia, USA,
| | - Tien V Nguyen
- Bellevue Dermatology Clinic and Research Center, Bellevue, Washington, USA
| | - Giovanni Damiani
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Unità Operativa di Dermatologia, IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | - Christopher Sayed
- Department of Dermatology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Gregor B E Jemec
- Department of Dermatology, Zealand University Hospital Roskilde, Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark
| | - Iltefat Hamzavi
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan, USA
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Rowland Payne PCME. Hidradenitis suppurativa treatment - medical or surgical? J Eur Acad Dermatol Venereol 2019; 33:981-982. [PMID: 31124252 DOI: 10.1111/jdv.15647] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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10
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Grimstad Ø, Tzellos T, Dufour DN, Bremnes Ø, Skoie IM, Snekvik I, Jarnaess E, Kyrgidis A, Ingvarsson G. Evaluation of medical and surgical treatments for hidradenitis suppurativa using real-life data from the Scandinavian registry (HISREG). J Eur Acad Dermatol Venereol 2019; 33:1164-1171. [PMID: 30451320 DOI: 10.1111/jdv.15353] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 10/23/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) substantially affects health-related quality-of-life outcomes. Most treatment options are supported by low quality of evidence without validated outcomes. OBJECTIVE The aim of this study was to evaluate the efficacy of surgical and medical interventions using physician- and patient-reported outcomes registered in HISREG. METHODS Data were extracted for all adult patients registered in HISREG between January 2013 and April 2016. Primary endpoints included Dermatology Life Quality Index (DLQI) scores, pain as measured using a numeric rating scale (NRS), Sartorius score and Hurley classification. Minimum clinically important differences (MCIDs) for DLQI and NRS pain were analysed. Secondary endpoints included comparisons among different treatment groups, safety and complications of various treatments. RESULTS Two hundred and fifty-five patients were included in the study: 31, 188, and 36 patients had Hurley stages I, II and III disease, respectively. Treatment with CO2 lasers was the most common treatment modality. One hundred and forty-nine patients (58.4%) were treated with surgical intervention, 87 (34.1%) received antibiotics and/or anti-inflammatory treatments, and 19 (7.5%) were treated with both surgery and medical intervention. No patients received biologic treatment. In patients with surgical treatments, Sartorius scores were significantly improved compared with baseline (P = 0.001), 83 patients (55%) achieved a DLQI MCID, and 75 patients (49.7%) achieved an NRS pain MCID. In patients with medical treatments, Sartorius scores were not significantly improved compared with baseline (P = 0.582); 25 patients (28%) achieved a DLQI MCID and 28 patients (31%) achieved an NRS pain MCID. In patients treated with surgical and medical combination, 9 (48%) achieved DLQI and NRS pain MCIDs and Sartorius scores were significantly improved. CONCLUSIONS CO2 laser treatment is more effective than the non-biologic medical treatments in this analysis based on physician- and patient-derived outcomes. The study provides limited evidence for the combination of medical and surgical therapies in patients with HS.
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Affiliation(s)
- Ø Grimstad
- Department of Dermatology, University Hospital of North Norway, Tromsø, Norway.,Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - T Tzellos
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.,Department of Dermatology, University Hospital of North Norway, Harstad, Norway
| | - D N Dufour
- Department of Dermatology, University Hospital of North Norway, Tromsø, Norway.,HISREG-Registry for Hidradenitis Suppurativa, University Hospital of North Norway, Tromsø, Norway
| | - Ø Bremnes
- Department of Dermatology, University Hospital of North Norway, Tromsø, Norway.,HISREG-Registry for Hidradenitis Suppurativa, University Hospital of North Norway, Tromsø, Norway
| | - I M Skoie
- Department of Dermatology, Stavanger University Hospital, Stavanger, Norway
| | - I Snekvik
- Department of Dermatology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - E Jarnaess
- Medical Affairs, AbbVie AS, Fornebu, Norway
| | - A Kyrgidis
- Skin Cancer Unit, Arcispedale Santa Maria Nuova Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy
| | - G Ingvarsson
- Department of Dermatology, University Hospital of North Norway, Tromsø, Norway.,HISREG-Registry for Hidradenitis Suppurativa, University Hospital of North Norway, Tromsø, Norway
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11
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Rosi E, Pescitelli L, Ricceri F, Di Cesare A, Novelli A, Pimpinelli N, Prignano F. Clindamycin as unique antibiotic choice in Hidradenitis Suppurativa. Dermatol Ther 2018; 32:e12792. [DOI: 10.1111/dth.12792] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 12/03/2018] [Indexed: 02/03/2023]
Affiliation(s)
- Elia Rosi
- Department of Surgery and Translational Medicine, Section of DermatologyUniversity of Florence Florence Italy
| | - Leonardo Pescitelli
- Department of Surgery and Translational Medicine, Section of DermatologyUniversity of Florence Florence Italy
| | - Federica Ricceri
- Department of Surgery and Translational Medicine, Section of DermatologyUniversity of Florence Florence Italy
| | - Antonella Di Cesare
- Department of Surgery and Translational Medicine, Section of DermatologyUniversity of Florence Florence Italy
| | - Andrea Novelli
- Department of Health Sciences, Clinical Pharmacology and Oncology SectionUniversity of Florence Florence Italy
| | - Nicola Pimpinelli
- Department of Surgery and Translational Medicine, Section of DermatologyUniversity of Florence Florence Italy
| | - Francesca Prignano
- Department of Surgery and Translational Medicine, Section of DermatologyUniversity of Florence Florence Italy
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van Straalen KR, Schneider-Burrus S, Prens EP. Current and future treatment of hidradenitis suppurativa. Br J Dermatol 2018; 183:e178-e187. [PMID: 29981245 DOI: 10.1111/bjd.16768] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2018] [Indexed: 12/13/2022]
Abstract
This scholarly review on the current and future treatment of hidradenitis suppurativa (HS) focuses on medical and surgical treatment options, while novel pipeline drugs are also discussed. Treatment goals are to limit the incidence and duration of flares, reducing inflammation and suppuration, achieving local cure after surgery and, most importantly, to improve the quality of life of patients with HS. The type of medication and/or surgery should be chosen based on the stage of the disease and the degree of inflammation. However, the lack of a simple scoring system and the lack of clear surgical outcome definitions hamper the interpretation of treatment efficacy and the comparison between different treatment strategies. The therapeutic pipeline for HS is gradually expanding, and will probably lead to a broader panel of more effective therapeutic options.
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Affiliation(s)
- K R van Straalen
- Department of Dermatology, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - S Schneider-Burrus
- Department of Dermatology, University Hospital Charité, Berlin, Germany.,Centre for Dermatosurgery, Havelklinik, Berlin, Germany
| | - E P Prens
- Department of Dermatology, Erasmus University Medical Centre, Rotterdam, the Netherlands
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Albrecht J, Mehta S, Bigby M. Development of resistance to Mycobacterium tuberculosis is manageable in hidradenitis suppurativa. Response to 'Treatment of hidradenitis suppurativa with rifampicin: have we forgotten tuberculosis?'. Br J Dermatol 2017; 178:300. [PMID: 28960253 DOI: 10.1111/bjd.16013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- J Albrecht
- Division of Dermatology, Department of Medicine, J.H. Stroger Hospital of Cook County, Chicago, IL, U.S.A.,Department of Dermatology, Rush Medical College, Chicago, IL, U.S.A
| | - S Mehta
- Division of Dermatology, Department of Medicine, J.H. Stroger Hospital of Cook County, Chicago, IL, U.S.A
| | - M Bigby
- Department of Dermatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, U.S.A
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