This frustrating chronic disease is treated by measures that reduce friction and moisture. Weight reduction, loose undergarments, topical antiseptic soaps, and topical aluminum chloride are helpful in some patients.
- Acute exacerbations can be treated with systemic antibiotics. Problem cases should have bacterial cultures and sensitivities taken, although not all cultures grow pathogenic bacteria. The chronic use of topical clindamycin proves beneficial in some patients.
- Chronic inflammatory nodules can be treated with intralesional steroids. Systemic retinoids may help some patients but are not as effective as when used to treat severe acne vulgaris, and relapses are quite common.
- Severe refractory hidradenitis is best treated by complete surgical excision of the involved area. Incision and drainage should be minimized because it often leads to chronic sinus tract formation. Carbon dioxide laser stripping with secondary intention healing has been used as well.
- Newer treatments, such as the anti–TNF-a biologics and photodynamic therapy, have had mixed success.
Revuz J: Hidradenitis supperativa,
J Eur Acad Dermatol Venereol 23:985–998, 2009.
