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. 2020 Nov 3:7:591580.
doi: 10.3389/fmed.2020.591580. eCollection 2020.

The Efficacy and Effectiveness of Non-ablative Light-Based Devices in Hidradenitis Suppurativa: A Systematic Review and Meta-Analysis

Abdulhadi Jfri  1 , Anjali Saxena  1 , Julie Rouette  2   3 , Elena Netchiporouk  1 , Augustin Barolet  1 , Elizabeth O'Brien  1 , Daniel Barolet  1 , Ivan V Litvinov  1
Affiliations

The Efficacy and Effectiveness of Non-ablative Light-Based Devices in Hidradenitis Suppurativa: A Systematic Review and Meta-Analysis

Abdulhadi Jfri et al. Front Med (Lausanne). .

Abstract

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder that may be treated with non-ablative light-based devices; however, no systematic reviews on the topic exist to date. We conducted a systematic review and meta-analysis to determine efficacy of non-ablative light-based devices in treating HS. Specifically, a systematic review was conducted using MEDLINE, EMBASE, Web of Science and CINAHL. We analyzed the use of non-ablative light-based devices in the treatment of HS. At least two investigators performed title/abstract review and data extraction. Meta-analysis was conducted using comprehensive meta-analysis software. 5 RCTs and 11 case reports/series were included (n = 211 unique patients). No observational studies were found. For Nd:YAG laser, meta-analysis of 3 RCTs reported improvement in modified HS Lesion Area and Severity Index (HS-LASI) when compared to control subjects. In addition, three case reports/series reported HS-LASI, Physician Global Assessment (PGA) scores and number-of-lesion improvements in treated patients. For intense pulsed light (IPL), two RCTs reported HS-LASI and Dermatology Life Quality Index (DLQI) score improvements. For Alexandrite laser, one case report showed lesion improvement. In conclusion, meta-analysis of Nd:YAG laser in HS patients suggests significant improvement in HS-LASI scores. For IPL, evidence is limited, but suggests improvement in HS-LASI and DLQI scores. For Alexandrite laser, evidence precludes conclusions. Given small sample sizes and inconsistent reporting scales, larger RCTs are required to better determine the efficacy of these modalities in treating HS.

Keywords: alexandrite; hair removal; hidradenitis suppurativa; intense pulse light (IPL); lasers; light-based devices; neodymium-doped yttrium aluminum garnet (Nd:YAG).

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Figures

Figure 1
Figure 1
Study flowchart as per the preferred reporting items for systematic reviews and meta-analyses (PRISMA) criteria.
Figure 2
Figure 2
Forest plot of standardized mean differences and confidence intervals of HS-LASI for HS patients treated with Nd:YAG laser compared to controls. It demonstrates that Nd:YAG laser treated patients (n = 58) had significantly improved HS-LASI scores compared to the control group.
Figure 3
Figure 3
Sensitivity analysis of included randomized control trials. Sensitivity analysis shows non-significant change in pooled effect size pertaining to laser therapy in Hidradenitis suppurativa (HS).
Figure 4
Figure 4
Funnel plot for assessment of publication bias in reporting of outcomes. Publication bias was found to be non-significant.
See this image and copyright information in PMC

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