Background: Hidradenitis suppurativa (HS) is one of the most distressing conditions observed in dermatology and has a substantial negative effect on the quality of life of affected persons. Objectives: The aim of this study was to evaluate different treatment strategies in patients with HS. Methods: In a retrospective cohort, all patients with HS (July 2015 to March 2017) were reviewed. Collected data consisted of patients’ demographics, clinical characteristics, psychosocial situation, and previous and current treatments. In addition, therapy response to the most recent prescribed treatments was assessed. Results: 102 patients (38 females, 64 males; median age 37.5 years) were included in this study. 68.4% of patients had BMI ≥25, and 76.5% of patients were current smokers. Hurley stages I, II, and III were detected in 13.5, 53.1, and 33.3% of patients, respectively. The most commonly administered treatments were surgery (67.6%), nonantibiotic topical therapies (72.5%), antibiotic topical therapies (55.9%), systemic antibiotics (88.2%), and biologics in 11.8% of the patients. 84.6% of the patients showed a response (27.5 and 47.1% partial and complete response, respectively) to the treatments. Conclusion: HS as a chronic, recurrent inflammatory skin disease is associated with smoking and obesity. Application of systemic antibiotics is the most frequent treatment strategy for this disease. However, surgical intervention seems to be the most effective treatment strategy.

Deckers IE, van der Zee HH, Prens EP: Severe fatigue based on anaemia in patients with hidradenitis suppurativa: report of two cases and a review of the literature. J Eur Acad Dermatol Venereol 2016; 30: 174–175.
Jemec GBE: Hidradenitis suppurativa. N Engl J Med 2012; 366: 158–164.
Von der Werth JM, Williams HC: The natural history of hidradenitis suppurativa. J Eur Acad Dermatol Venereol 2000; 14: 389–392.
Riis PT, Boer J, Prens EP, et al: Intralesional triamcinolone for flares of hidradenitis suppurativa (HS): a case series. J Am Acad Dermatol 2016; 75: 1151–1155.
Revuz J: Hidradenitis suppurativa. J Eur Acad Dermatol Venereol 2009; 23: 985–998.
Jemec GB, Kimball AB: Hidradenitis suppurativa: epidemiology and scope of the problem. J Am Acad Dermatol 2015; 73:S4–S7.
Revuz JE, Canoui-Poitrine F, Wolkenstein P, et al: Prevalence and factors associated with hidradenitis suppurativa: results from two case-control studies. J Am Acad Dermatol 2008; 59: 596–601.
Palmer RA, Keefe M: Early-onset hidradenitis suppurativa. Clin Exp Dermatol 2001; 26: 501–503.
Alikhan A, Lynch PJ, Eisen DB: Hidradenitis suppurativa: a comprehensive review. J Am Acad Dermatol 2009; 60: 539–561; quiz 62–63.
Vekic DA, Frew J, Cains GD: Hidradenitis suppurativa, a review of pathogenesis, associations and management. Part 1. Australas J Dermatol 2018, Epub ahead of print.
Sartorius K, Emtestam L, Jemec GB et al: Objective scoring of hidradenitis suppurativa reflecting the role of tobacco smoking and obesity. Br J Dermatol 2009; 161: 831–839.
Kamp S, Fiehn AM, Stenderup K, et al: Hidradenitis suppurativa: a disease of the absent sebaceous gland? Sebaceous gland number and volume are significantly reduced in uninvolved hair follicles from patients with hidradenitis suppurativa. Br J Dermatol 2011; 164: 1017–1022.
Von Laffert M, Helmbold P, Wohlrab J, et al: Hidradenitis suppurativa (acne inversa): early inflammatory events at terminal follicles and at interfollicular epidermis. Exp Dermatol 2010; 19: 533–537.
Wolkenstein P, Loundou A, Barrau K, et al: Quality of life impairment in hidradenitis suppurativa: a study of 61 cases. J Am Acad Dermatol 2007; 56: 621–623.
Weber P, Seyed Jafari SM, Yawalkar N, et al: Apremilast in the treatment of moderate to severe hidradenitis suppurativa: a case series of 9 patients. J Am Acad Dermatol 2017; 76: 1189–1191.
Houriet C, Seyed Jafari SM, Thomi R, Schlapbach C, et al: Canakinumab for severe hidradenitis suppurativa: preliminary experience in two cases. JAMA Dermatol 2017; 153: 1195–1197.
Ahmad OB, Boschi-Pinto C, Lopez AD et al: Age Standardization of Rates: A New WHO Standard. Geneva, World Health Organization, 2001, vol 31, pp 1–14.
Zouboulis CC, Desai N, Emtestam L, et al: European S1 guideline for the treatment of hidradenitis suppurativa/acne inversa. J Eur Acad Dermatol Venereol 2015; 29: 619–644.
Jemec GB: Clinical practice. Hidradenitis suppurativa. N Engl J Med 2012; 366: 158–164.
Micheletti RG: Hidradenitis suppurativa: current views on epidemiology, pathogenesis, and pathophysiology. Semin Cutan Med Surg 2014; 33:S48–S50.
Saunte DM, Boer J, Stratigos A, et al: Diagnostic delay in hidradenitis suppurativa is a global problem. Br J Dermatol 2015; 173: 1546–1549.
Aysan E, Ilhan M, Bektas H, et al: Prevalence of sacrococcygeal pilonidal sinus as a silent disease. Surg Today 2013; 43: 1286–1289.
Meixner D, Schneider S, Krause M, et al: Acne inversa. J Dtsch Dermatol Ges 2008; 6: 189–196.
Scheinfeld N: Diseases associated with hidradenitis suppurativa: part 2 of a series on hidradenitis. Dermatol Online J 2013; 19: 18558.
Tennant F, Bergeron JR, Stone OJ, et al: Anemia associated with hidradenitis suppurativa. Arch Dermatol 1968; 98: 138–140.
Dauden E, Lazaro P, Aguilar MD, et al: Recommendations for the management of comorbidity in hidradenitis suppurativa. J Eur Acad Dermatol Venereol 2018; 32: 129–144.
Matusiak L, Bieniek A, Szepietowski JC: Psychophysical aspects of hidradenitis suppurativa. Acta Derm Venereol 2010; 90: 264–268.
Esmann S, Jemec GB: Psychosocial impact of hidradenitis suppurativa: a qualitative study. Acta Derm Venereol 2011; 91: 328–332.
Deckers IE, Janse IC, van der Zee HH, et al: Hidradenitis suppurativa (HS) is associated with low socioeconomic status (SES): a cross-sectional reference study. J Am Acad Dermatol 2016; 75: 755–759. e1.
Lakerveld J, Ben Rebah M, Mackenbach JD, et al: Obesity-related behaviours and BMI in five urban regions across Europe: sampling design and results from the SPOTLIGHT cross-sectional survey. BMJ Open 2015; 5:e008505.
SECO: Die Lage auf dem Arbeitsmarkt – März 2017. Bern, SECO, April 4, 2017.
BSV: Statistiken zur sozialen Sicherheit: IV-Statistik 2016, Tabellenteil. Neuchâtel, BSV, 2016.
Theut Riis P, Thorlacius L, Knudsen List E, et al: A pilot study of unemployment in patients with hidradenitis suppurativa in Denmark. Br J Dermatol 2017; 176: 1083–1085.
Jemec GB, Heidenheim M, Nielsen NH: Hidradenitis suppurativa – characteristics and consequences. Clin Exp Dermatol 1996; 21: 419–423.
Vekic DA, Cains GD: Hidradenitis suppurativa – management, comorbidities and monitoring. Aust Fam Physician 2017; 46: 584–588.
Posch C, Monshi B, Quint T, et al: The role of wide local excision for the treatment of severe hidradenitis suppurativa (Hurley grade III): retrospective analysis of 74 patients. J Am Acad Dermatol 2017; 77: 123–239. e5.
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