From the Guidelines
Hidradenitis suppurativa treatment should be tailored to disease severity, with adalimumab being the recommended biologic for moderate-to-severe cases, as it improves disease severity and quality of life 1.
Treatment Approach
The treatment of hidradenitis suppurativa (HS) requires a holistic approach, considering the patient's overall health and disease severity.
- For mild cases, topical clindamycin 1% solution or gel applied twice daily for 12 weeks is recommended, or tetracycline 500mg orally twice daily for 4 months 1.
- For moderate disease, oral antibiotics such as clindamycin 300mg twice daily with rifampicin 600mg once daily for 10 weeks can be effective 1.
- For severe or refractory cases, biologics such as adalimumab are recommended, with a dosing regimen of 160mg initially, followed by 80mg two weeks later, then 40mg weekly 1.
Lifestyle Modifications and Pain Management
Lifestyle modifications are crucial in managing HS, including:
- Weight loss if overweight
- Smoking cessation
- Wearing loose clothing
- Avoiding shaving affected areas Pain management with NSAIDs or acetaminophen is also important.
Surgical Options
Surgical options, such as incision and drainage, deroofing procedures, or wide excision, may be necessary for severe cases or recurrent lesions.
Regular Follow-up
Regular follow-up is essential to adjust treatment based on response and to monitor disease severity. The use of patient-reported outcomes, such as the DLQI, itch, and pain assessment, is strongly recommended to evaluate treatment effectiveness 1.
From the FDA Drug Label
1.8 Hidradenitis Suppurativa HUMIRA is indicated for the treatment of moderate to severe hidradenitis suppurativa in patients 12 years of age and older. The recommended dosage for hidradenitis suppurativa is not explicitly stated in the provided text, but HUMIRA is indicated for the treatment of moderate to severe hidradenitis suppurativa in patients 12 years of age and older 2.
From the Research
Hidradenitis Suppurativa Treatment Options
- Hidradenitis suppurativa (HS) is a chronic inflammatory disease that requires a multifaceted approach for treatment, including medical therapy, surgery, and adjuvant therapy 3.
- The treatment of HS involves a combination of anti-inflammatory therapies, such as antimicrobials and regular anti-inflammatory drugs, as well as surgery for fibrotic lesions 3.
- Current treatment options for HS include drug therapy, combined drug and surgical therapy, or surgery alone, depending on the stage of the disease 4.
- Systemic therapies, such as adalimumab, secukinumab, and bimekizumab, have been approved for the treatment of moderate-to-severe HS, targeting TNF and IL-17 4, 5.
- Topical therapy, such as clindamycin-benzoyl peroxide gel, has shown favorable clinical efficacy results in the treatment of mild to moderate HS, and may be used as an alternative to clindamycin lotion to prevent antibiotic resistance 6.
Treatment Approach
- A comprehensive three-pronged approach with adjuvant therapy, medical therapy, and surgery is recommended for the management of HS 3.
- Adjuvant therapy, including pain management, wound care, and attention, plays a major role in patients' perception of a successful treatment and is of practical importance to their coping and self-management 3.
- Early intervention is crucial to prevent irreversible skin damage, and a multidisciplinary approach is necessary to create the right management of HS 4, 7.