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Practice Guideline
. 2019 Apr;94(2 Suppl 1):7-19.
doi: 10.1590/abd1806-4841.20198607. Epub 2019 Jun 3.

Consensus on the treatment of hidradenitis suppurativa - Brazilian Society of Dermatology

Renata Ferreira Magalhães  1 , Maria Cecília Rivitti-Machado  2 , Gleison Vieira Duarte  3 , Roberto Souto  4 , Daniel Holthausen Nunes  5 , Mario Chaves  4 , Sérgio Henrique Hirata  6 , Andrea Machado Coelho Ramos  7
Affiliations
Practice Guideline

Consensus on the treatment of hidradenitis suppurativa - Brazilian Society of Dermatology

Renata Ferreira Magalhães et al. An Bras Dermatol. 2019 Apr.

Abstract

Hidradenitis suppurativa is a chronic immune mediated disease of universal distribution that causes great damage to the quality of life of the affected individual, whose prevalence is estimated at 0.41% in the Brazilian population. The objective of this work was update on physiopathogenesis, diagnosis and classification of hidradenitis suppurativa and to establish therapeutic recommendations in the Brazilian reality. It was organized as a work group composed of eight dermatologists from several institutions of the country with experience in the treatment of hidradenitis suppurativa and carried out review on the topic. Recommendations were elaborated and voted by modified Delphi system and statistical analysis of the results was performed. The Brazilian consensus on the clinical approach of hidradenitis suppurativa had the support of the Brazilian Society of Dermatology.

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Conflict of interest statement

Conflict of interest: The members of this council declare they took part in scientific meetings, lectures and/or received support for events of the following pharmaceutical companies: Renata Ferreira Magalhães: Abbvie, Janssen-Cilag, Pfizer, Novartis and Lilly. Maria Cecília Rivitti-Machado: Abbvie and Bayer. Gleison Vieira Duarte: Abbvie, Janssen-Cilag, Leo Pharma, Galderma, Bayer, Pfizer, Novartis and Biolab. Roberto Souto: Abbvie, Novartis, Janssen-Cilag, Pfizer and Lilly. Daniel Holthausen Nunes: Abbvie, Janssen-Cilag, Novartis, Pfizer and Sanofi. Mario Chaves: Abbvie. Sérgio Henrique Hirata has no conflict of interests. Andrea Machado Coelho Ramos: Abbvie, Janssen-Cilag, Novartis and Sanofi.

Figures

Figure 1
Figure 1
Recommendation for treatment of suppurative hidradenitis according to the Brazilian HS Consensus. Interventions in darker tones have higher grades of recommendation, those in red should be considered with caution. Surgical interventions and general measures should be considered throughout patient follow-up. Recommended doses for medications can be adjusted according to medical indication (trime-thoprim + sulfamethoxazole 160mg/800mg bid; tetracycline 500mg bid (up to 2g/day), doxycycline 100 to 200mg/day, clindamycin 600 to 1800mg/day + ofloxacin 200 to 400mg bid, clindamycin 300mg qid + rifampicin 600mg/day, adalimumab subcutaneously 160mg D0, 80mg D14, 40mg/week
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References

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