Hidradenitis suppurativa/acne inversa: a practical framework for treatment optimization – systematic review and recommendations from the HS ALLIANCE working group

摘要: Hidradenitis suppurativa (HS)/acne inversa is a debilitating chronic disease that remains poorly understood and difficult to manage. Clinical practice variable, there need for international, evidence-based easily applicable consensus on HS management. We report here the findings of systematic literature review, which were subsequently used as basis development international recommendations management patients with HS. A review was performed each nine clinical questions in (defined by an expert steering committee), covering comorbidity assessment, therapy (medical, surgical combinations) response treatment. Included articles underwent data extraction graded according Oxford Centre Evidence-based Medicine criteria. then drafted, refined voted upon, using modified Delphi process. Overall, 5310 screened, 171 analysed, 65 derive recommendations. These included six randomized controlled trials plus cohort studies case series. The highest level evidence concerned dosing topical clindamycin mild (with systemic tetracyclines more frequent/widespread lesions) biologic (especially adalimumab) second-line agents (following conventional failure). Good-quality available hidradenitis (HiSCR) dichotomous outcome measure inflammatory areas under Lower-level supported triclosan oral zinc mild-to-moderate HS, rifampicin moderate intravenous ertapenem selected severe disease. Intralesional or steroids may also be considered. Local excision suggested wide extensive Despite paucity good-quality decisions this has enabled robust physicians based evidence.