What Heals Hidradenitis Suppurativa: Surgery, Immunosuppression, or Both?.
What Heals Hidradenitis Suppurativa: Surgery, Immunosuppression, or Both?.
- 2016
BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the skin that is a significant source of impaired quality-of-life for affected individuals. For patients with refractory disease, radical resection of all involved tissue may offer the only potential option for a cure. However, high rates of recurrence after wide local excision have led investigators to seek alternative therapeutic combinations. We present our experience and a literature review. CONCLUSIONS: Recent trials demonstrating the safety and efficacy of biologic therapy alone in patients with moderate-to-severe HS have spurred questions regarding the potential utility of these agents as adjuncts to more traditional surgical interventions. The results of the literature search advocate a role for radical resection and biologic therapy in the setting of moderate-to-severe disease. Preliminary results from limited case series suggest a potential role for combined management in the setting of advanced, recalcitrant disease. METHODS: A comprehensive literature review (1982-2016) was performed on PubMed and Ovid MEDLINE, using key words relevant to HS. RESULTS: A total of 1842 publications were identified, and 15 publications were included in this review on: surgical intervention (n = 10), biologic therapy (n = 4), and joint surgical and biologic treatment (n = 1) of HS. The treatment type, level of evidence, and key findings are assessed and discussed.
English
0032-1052
*Dermatologic Surgical Procedures
*Hidradenitis Suppurativa/th [Therapy]
*Immunosuppressive Agents/tu [Therapeutic Use]
Combined Modality Therapy
Hidradenitis Suppurativa/di [Diagnosis]
Humans
Treatment Outcome
MedStar Washington Hospital Center
Surgery/Plastic Surgery
Journal Article
BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the skin that is a significant source of impaired quality-of-life for affected individuals. For patients with refractory disease, radical resection of all involved tissue may offer the only potential option for a cure. However, high rates of recurrence after wide local excision have led investigators to seek alternative therapeutic combinations. We present our experience and a literature review. CONCLUSIONS: Recent trials demonstrating the safety and efficacy of biologic therapy alone in patients with moderate-to-severe HS have spurred questions regarding the potential utility of these agents as adjuncts to more traditional surgical interventions. The results of the literature search advocate a role for radical resection and biologic therapy in the setting of moderate-to-severe disease. Preliminary results from limited case series suggest a potential role for combined management in the setting of advanced, recalcitrant disease. METHODS: A comprehensive literature review (1982-2016) was performed on PubMed and Ovid MEDLINE, using key words relevant to HS. RESULTS: A total of 1842 publications were identified, and 15 publications were included in this review on: surgical intervention (n = 10), biologic therapy (n = 4), and joint surgical and biologic treatment (n = 1) of HS. The treatment type, level of evidence, and key findings are assessed and discussed.
English
0032-1052
*Dermatologic Surgical Procedures
*Hidradenitis Suppurativa/th [Therapy]
*Immunosuppressive Agents/tu [Therapeutic Use]
Combined Modality Therapy
Hidradenitis Suppurativa/di [Diagnosis]
Humans
Treatment Outcome
MedStar Washington Hospital Center
Surgery/Plastic Surgery
Journal Article