Hidradenitis Suppurativa: A Guide for the Practicing Physician

Area of Science:

• Dermatology
• Inflammatory Diseases
• Medical Research

Background:

• Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition affecting apocrine gland-bearing skin.
• While factors like genetics, obesity, and smoking are implicated, HS pathogenesis and treatment effects remain unclear.
• Chronic inflammation in HS leads to scarring, complications like squamous cell carcinoma, and reduced quality of life.

Purpose of the Study:

• To review existing literature on hidradenitis suppurativa (HS) treatments up to July 2014.
• To develop an evidence-based algorithm for HS management in primary care settings.
• To identify gaps in research regarding HS pathogenesis, natural history, and treatment efficacy.

Main Methods:

• Systematic literature review of medical databases (PubMed, Embase, Google Scholar) using keywords 'hidradenitis suppurativa' and 'acne inversa'.
• Inclusion of case reports and prospective/retrospective studies due to limited treatment literature.
• Development of a management algorithm based on the synthesized evidence.

Main Results:

• No ideal treatment regimen for HS has been established.
• Several therapies can reduce lesion severity and improve symptoms.
• An evidence-based algorithm for primary care management was proposed.

Conclusions:

• Further research is essential to evaluate comparative effectiveness of topical and systemic HS treatments.
• More studies are needed to elucidate HS pathogenesis, natural history, and disease subtypes.
• The proposed algorithm aims to guide primary care management of hidradenitis suppurativa.