Hidradenitis Suppurativa

Discussion in 'Men's Health Forum' started by jj341, Feb 17, 2013.

  1. jj341

    jj341 Junior Member

    A friend of mine has Hidradenitis. It is such a rare condition it is called an orphan disease in that not much research has occurred on it as so few individuals have it. In his case it has resulted in the growth of significant sized cysts in his lower back that keep returning after the surgeries.
    In the majority of cases this condition begins at the onset of puberty, the time when hormones kick in. Does anyone have any experience or knowledge about what may benefit this condition. My buddy has just about given up hope. Thanks.
     
  2. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Rambhatla PV, Lim HW, Hamzavi I. A Systematic Review of Treatments for Hidradenitis Suppurativa. Arch Dermatol.2012;148(4):439-446. JAMA Network | JAMA Dermatology | A Systematic Review of Treatments for Hidradenitis SuppurativaTherapies for Hidradenitis Suppurativa

    Objectives To conduct a systematic review of the effectiveness of various modalities to treat hidradenitis suppurativa (HS) and to establish recommendations on its appropriate management.

    Data Sources MEDLINE, Cochrane, and PubMed databases.

    Study Selection English-language prospective, retrospective, and case studies describing at least 4 patients with HS.

    Data Extraction Data quality and validity were addressed by multiple reviewers using independent extraction.

    Data Synthesis Studies were categorized as treatments using antibiotics, biological agents, laser surgery, excisional surgery, or miscellaneous modalities. Of 62 publications included in the review, 4 studies met criteria to be assigned the highest grade for quality of evidence.

    Conclusions Shown to be effective treatments for HS were a clindamycin-rifampin combination regimen, a course of infliximab, monthly Nd:YAG laser sessions, and surgical excision and primary closure with a gentamicin sulfate–collagen sponge. Most therapies used to treat HS were supported by limited or weak scientific evidence. A treatment approach is presented based on the evidence and on clinical experience at the Follicular Disorders Clinic, Department of Dermatology, Henry Ford Hospital, Detroit, Michigan. This review emphasizes the need for large randomized controlled trials to evaluate treatment options for HS.
     

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  3. 1erCru

    1erCru Member

    I had hidradentis. No joke. Im not sure if it had any correlation to my hormones as Im pretty sure I had it when my T was very low. It did not kick in until I was in my twenties.
    After a period of extensive research I came across a forum where a woman stated her severe case of hidradentis was put into remission by REMOVING GLUTEN FROM HER DIET. Three weeks after going gluten free my tracks began to heal. Over two years later and they are completely healed. Havent had a single break out since.
     
  4. jj341

    jj341 Junior Member

    Thanks for the replies. I'll share the info with my buddy.
     
  5. 1erCru

    1erCru Member

    Does your friend smoke? Have he tried removing gluten? Its worked for many people on the HS boards.
     
  6. jj341

    jj341 Junior Member

    My friend does smoke. I told him about the Gluten and he was hesitant because he loves to eat. I told him to try it for 3 weeks and see how he feels. He may do it.
     
  7. Michael Scally MD

    Michael Scally MD Doctor of Medicine



    Key Points

    Question How has the diagnosis and treatment of hidradenitis suppurativa (HS) recently changed?

    Findings Weight reduction is important for obese patients. Drug treatment usually begins with systemic antibiotics although this approach is based on clinical experience rather than through randomized clinical trials. Adalimumab is the first drug specifically approved by the US Food and Drug Administration for the treatment of HS, but other biologics are useful. Newer surgical approaches include skin tissue–sparing excision with electrosurgical peeling (STEEP) and carbon dioxide laser evaporation.

    Meaning Hidradenitis suppurativa has a new array of medical and surgical treatments to facilitate its treatment.


    Saunte D, Jemec G. Hidradenitis suppurativa: Advances in diagnosis and treatment. JAMA [Internet] 2017;318(20):2019–32. Available from: Advances in Diagnosis and Treatment of Hidradenitis Suppurativa

    Importance Hidradenitis suppurativa (HS) is relatively common, with the prevalence of 0.05% to 4.10%, yet many patients receive inadequate treatment.

    Objective To review the diagnosis, epidemiology, and treatment of HS with an emphasis on advances in the last 5 years.

    Evidence Review A literature search was conducted using PubMed, MEDLINE (Medical Subject Headings [MeSH]), and EMBASE to include recently published treatment studies (searched from September 1, 2011, to May 1, 2017). Reviews, guidelines, conference abstracts, and studies with less than 10 patients were excluded. Furthermore, internet searches for guidelines on hidradenitis suppurativa using Baidu, Bing, Google, and Qwant browsers were performed.

    Findings The diagnosis of HS is made by lesion morphology (nodules, abscesses, tunnels, and scars), location (axillae, inframammary folds, groin, perigenital, or perineal), and lesion progression (2 recurrences within 6 months or chronic or persistent lesions for ≥3 months). HS is more common than was previously thought based on epidemiological analysis (0.05%-4.10%). Disability from HS can be significant. Patients with HS may have significant comorbidities (eg, obesity, metabolic syndrome, diabetes, and arthritis) and increased all-cause mortality (incidence rate ratio, 1.35 [95% CI, 1.15-1.59]). Antibiotic treatment with combinations of clindamycin and rifampicin, or ertapenem followed by combination rifampicin, moxifloxacin, and metronidazole for 6 months is effective. Adalimumab is effective in a significant proportion of patients and treatment with IL-1 and IL-12 receptor subunit beta 1 (Rb1) antibodies may also be useful. Tissue-sparing surgical techniques and carbon dioxide laser treatments also are available, but the evidence on clinical outcomes with these approaches is limited.

    Conclusions and Relevance Hidradenitis suppurativa is more common than previously thought and may be treated by an array of pharmacological and surgical techniques. Hidradenitis suppurativa should be considered in the differential diagnosis of nodular lesions or sinus tracts present in the axillae, groin, perineal, and mammillary fold regions.