Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Jul;81(1):91-101.
doi: 10.1016/j.jaad.2019.02.068. Epub 2019 Mar 11.

North American clinical management guidelines for hidradenitis suppurativa: A publication from the United States and Canadian Hidradenitis Suppurativa Foundations: Part II: Topical, intralesional, and systemic medical management

Ali Alikhan  1 , Christopher Sayed  2 , Afsaneh Alavi  3 , Raed Alhusayen  3 , Alain Brassard  4 , Craig Burkhart  5 , Karen Crowell  6 , Daniel B Eisen  4 , Alice B Gottlieb  7 , Iltefat Hamzavi  8 , Paul G Hazen  9 , Tara Jaleel  10 , Alexa B Kimball  11 , Joslyn Kirby  12 , Michelle A Lowes  13 , Robert Micheletti  14 , Angela Miller  8 , Haley B Naik  15 , Dennis Orgill  16 , Yves Poulin  17
Affiliations
Review

North American clinical management guidelines for hidradenitis suppurativa: A publication from the United States and Canadian Hidradenitis Suppurativa Foundations: Part II: Topical, intralesional, and systemic medical management

Ali Alikhan et al. J Am Acad Dermatol. 2019 Jul.

Abstract

Hidradenitis suppurativa is a severe and debilitating dermatologic disease. Clinical management is challenging and consists of both medical and surgical approaches, which must often be combined for best outcomes. Therapeutic approaches have evolved rapidly in the last decade and include the use of topical therapies, systemic antibiotics, hormonal therapies, and a wide range of immunomodulating medications. An evidence-based guideline is presented to support health care practitioners as they select optimal medical management strategies and is reviewed in this second part of the management guidelines. A therapeutic algorithm informed by the evidence available at the time of the review is provided.

Keywords: Nd:YAG; acne inversa; adalimumab; biomarkers; carbon dioxide laser; clindamycin; comorbidities; ertapenem; finasteride; guidelines; hidradenitis suppurativa; infliximab; laser; lifestyle modification; microbiome; oral contraceptive pills; rifampin; spironolactone.

PubMed Disclaimer

Figures

Fig 1.
Fig 1.
Overview of treatment strategies based on Hurley staging. I&D, Incisioin and drainage; IL, intralesional; IV, intravenous; Nd:YAG, neodymium-doped yttrium-aluminum-garnet; TNF, tumor necrosis factor.
See this image and copyright information in PMC

Comment in

References

    1. Clemmensen OJ. Topical treatment of hidradenitis suppurativa with clindamycin. Int J Dermatol. 1983;22(5):325–328. - PubMed
    1. Jemec GB, Wendelboe P. Topical clindamycin versus systemic tetracycline in the treatment of hidradenitis suppurativa. J Am Acad Dermatol. 1998;39(6):971–974. - PubMed
    1. Danesh MJ, Kimball AB. Pyrithione zinc as a general management strategy for hidradenitis suppurativa. J Am Acad Dermatol. 2015;73(5):e175. - PubMed
    1. Boer J, Jemec GB. Resorcinol peels as a possible self-treatment of painful nodules in hidradenitis suppurativa. Clin Exp Dermatol. 2010;35(1):36–40. - PubMed
    1. Mahmoud BH, Tierney E, Hexsel CL, Pui J, Ozog DM, Hamzavi IH. Prospective controlled clinical and histopathologic study of hidradenitis suppurativa treated with the long-pulsed neodymium:yttrium-aluminium-garnet laser. J Am Acad Dermatol. 2010;62(4):637–645. - PubMed