Hidradenitis suppurativa - current and promising non-surgical treatment

BARAN, Natalia, BOGUSZ, Klaudia, MAKSYMOWICZ, Marcela, BIELAK, Adriana, NOWAK, Aleksandra, CYWKA, Łucja, SZWED, Weronika, NOWAK, Alicja and MACHOWIEC, Piotr. Hidradenitis suppurativa - current and promising non-surgical treatment. Journal of Education, Health and Sport. 2023;26(1):129-148. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2023.26.01.012 https://apcz.umk.pl/JEHS/article/view/44806 https://zenodo.org/record/8173795 The journal has had 40 points in Ministry of Education and Science of Poland parametric evaluation. Annex to the announcement of the Minister of Education and Science of 17.07.2023 No. 32318. Has a Journal's Unique Identifier: 201159. Scientific disciplines assigned: Physical Culture Sciences (Field of Medical sciences and health sciences); Health Sciences (Field of Medical Sciences and Health Sciences). Punkty Ministerialne z 2019 - aktualny rok 40 punktów. Załącznik do komunikatu Ministra Edukacji i Nauki z dnia 17.07.2023 Lp. 32318. Posiada Unikatowy Identyfikator Czasopisma: 201159. Przypisane dyscypliny naukowe: Nauki o kulturze fizycznej (Dziedzina nauk medycznych i nauk o zdrowiu); Nauki o zdrowiu (Dziedzina nauk medycznych i nauk o zdrowiu). © The Authors 2023; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 28.06.2023. Revised: 20.07.2023. Accepted: 20.07.2023. Published: 25.07.2023. Hidradenitis suppurativa - current and promising non-surgical treatment Natalia Baran1, Klaudia Bogusz2, Marcela Maksymowicz3, Adriana Bielak4, Aleksandra Nowak5, Łucja Cywka2, Weronika Szwed6, Alicja Nowak2, Piotr Machowiec3 1 Independent Public Clinical Hospital of the prof W. Orlowski in Warsaw, Czerniakowska 231, 00-416 Warsaw, Poland 2 7th Navy Hospital in Gdańsk, Polanki 117, 80-305 Gdansk, Poland 3 Independent Public Clinical Hospital No. 4 in Lublin, Jaczewskiego 8, 20-954 Lublin, Poland 4 The Brothers Hospitallers of Saint John of God Hospital, Trynitarska 11, 31-061 Krakow, Poland 5 Sz. Starkiewicz Specialist Hospital in Dąbrowa Górnicza, Szpitalna 13, 41-300 Dabrowa Gornicza, Poland 6 Provincial Specialist Hospital in Olsztyn, Żołnierska 18, 10-561 Olsztyn, Poland Corresponding author: Natalia Baran, nataliabaran097@gmail.com ORCID ID: Natalia Baran: https://orcid.org/0000-0002-3221-9651 nataliabaran097@gmail.com Klaudia Bogusz: https://orcid.org/0009-0008-0818-2423 klaudia.bogusz7@wp.pl Marcela Maksymowicz: https://orcid.org/0000-0003-2611-1609 marcela.maksymowicz@gmail.com Adriana Bielak: https://orcid.org/0009-0000-4998-0458 a.bielak1@gmail.com Aleksandra Nowak: https://orcid.org/0009-0006-8572-8798 amm.nowak97@gmail.com Łucja Cywka: https://orcid.org/0009-0007-8314-4825 cywka.lj@gmail.com Weronika Szwed: https://orcid.org/0000-0001-9546-7970 weronikaszwed1997@gmail.com Alicja Nowak: https://orcid.org/0009-0000-4684-2877 alicja.nowak.97@gmail.com Piotr Machowiec: https://orcid.org/0000-0002-5418-0110 piotr.machowiec1997@gmail.com Abstract Introduction and purpose: Hidradenitis suppurativa (HS) also known as acne inversa is a chronic, inflammatory dermatosis with predilection to apocrine gland-rich regions. It is a multifactorial disease in which genetic and environmental factors play a key role. In this paper, we provide an overview of the current knowledge in most commonly used and emerging treatment options of HS. A brief description of the state of knowledge: The primary defect in HS pathophysiology involves follicular hyperkeratosis with occlusion of the pilosebaceous apparatus, followed by follicular rupture and immune responses. It typically develops after puberty with deep-seated painful nodules, abscesses, sinus tracts and scars. Due to the permanently painful, odorous lesions, hidradenitis suppurativa is one of the most distressing dermatological diseases with a substantial impact on patients’ quality of life. Inflammation in patients with HS is not limited to the skin but is systemic. Patients with HS frequently have significant comorbidities like metabolic syndrome, type 2 diabetes mellitus, spondyloarthropathy, inflammatory bowel disease and depression. Treatment is challenging and consists of pharmacological and surgical techniques, which must often be combined for best results. Materials and methods: A search was conducted using PubMed and GoogleScholar data bases. Articles were searched in English using the following key words: “hidradenitis suppurativa”, “acne invera”, “treatement”, “management”, “biological treatement”. Summary: Therapeutic options have rapidly evolved in the last decade and include the use of topical therapies, systemic antibiotics and a wide range of immunosuppressive medications such as anti-TNF-α biologics, but the number of therapies approved for HS is limited. Key words: hidradenitis suppurativa; acne inversa; treatment; management; biological treatement