From the Guidelines
Hidradenitis suppurativa is a chronic inflammatory skin condition that requires a comprehensive treatment approach, and I strongly recommend a combination of medical and surgical interventions, as well as lifestyle modifications, to manage the condition and improve quality of life, as suggested by the British Association of Dermatologists guidelines for the management of hidradenitis suppurativa (acne inversa) 2018 1.
Treatment Approach
The treatment of hidradenitis suppurativa typically involves a combination of approaches, including:
- Topical antibiotics, such as clindamycin 1% solution, applied twice daily for 2-3 months, which can help reduce pustules and inflammation, as recommended by the North American clinical management guidelines for hidradenitis suppurativa 1
- Oral antibiotics, such as doxycycline 100mg twice daily or a combination of clindamycin 300mg twice daily with rifampin 300mg twice daily for 10-12 weeks, which can help manage moderate to severe cases, as suggested by the North American clinical management guidelines for hidradenitis suppurativa 1
- Biologics, such as adalimumab (Humira) 40mg weekly, which can be prescribed for severe or refractory cases, as recommended by the European guidelines for hidradenitis suppurativa 1
- Lifestyle modifications, including weight loss if overweight, smoking cessation, wearing loose clothing, and using antibacterial soap, which can help reduce the risk of flare-ups and improve overall health, as suggested by the European guidelines for hidradenitis suppurativa 1
- Surgical options, such as incision and drainage, deroofing, laser, local excision, or wide excision, which may be considered for persistent or severe cases, as recommended by the British Association of Dermatologists guidelines for the management of hidradenitis suppurativa (acne inversa) 2018 1
Disease Management
Hidradenitis suppurativa is a chronic condition that requires ongoing management to prevent flare-ups and improve quality of life. This includes:
- Regular follow-up appointments with a dermatologist or other healthcare professional to monitor the condition and adjust treatment as needed, as recommended by the European guidelines for hidradenitis suppurativa 1
- Keeping a symptom diary to track flare-ups and identify potential triggers, which can help inform treatment decisions, as suggested by the North American clinical management guidelines for hidradenitis suppurativa 1
- Practicing good hygiene and wound care to prevent infection and promote healing, which is essential for managing the condition, as recommended by the British Association of Dermatologists guidelines for the management of hidradenitis suppurativa (acne inversa) 2018 1
Quality of Life
Hidradenitis suppurativa can have a significant impact on quality of life, causing pain, discomfort, and emotional distress. It is essential to address these issues through a comprehensive treatment approach that includes medical and surgical interventions, as well as lifestyle modifications, to improve overall health and well-being, as suggested by the European guidelines for hidradenitis suppurativa 1.
From the Research
Anhyradenitis Superiva
There are no research papers to assist in answering this question as the provided studies are related to ectodermal dysplasia, specifically hypohidrotic or anhidrotic ectodermal dysplasia.
Ectodermal Dysplasia
- Ectodermal dysplasia is a rare genetic disorder that affects the developmental disturbance of ectoderm-derived tissues, organs, and accessory appendages, i.e. skin, hair, tooth, nail, and sweat glands 2.
- The most common form of ED is linked to the X chromosome and usually affects men, while another form of the disease affects men and women equally 3.
- Hypohidrotic ectodermal dysplasia (HED) comprises a large group of inherited disorders of ectodermal structures, characterised by hypo- or anhidrosis, hypotrichosis and hypo- or oligo- or anodontia 4.
Clinical Manifestations and Management
- Patients with anhidrotic forms suffer from heat intolerance due to lack of sweat glands and mild infections may lead to death in infancy from hyperthermia 5.
- A multidisciplinary approach is required including dentists, nutritionists, dermatologists, and physicians to manage ectodermal dysplasia 2, 3.
- Prosthodontic rehabilitation should start in early childhood and needs to be revised in accordance with the patients' growth 4.
- Removable full or partial (over)dentures represented standard treatment in children aged 2-17 years, while in adults, fixed or removable reconstructions with the help of up to eight implants per jaw were standard 4.