Dermal tunnels influence time to clinical response and family history influences time to loss of clinical response in patients with hidradenitis suppurativa treated with adalimumab

Author(s):  
J. W. Frew ◽  
C. S. Jiang ◽  
N. Singh ◽  
D. Grand ◽  
K. Navrazhina ◽  
...  
Dermatology ◽  
2021 ◽  
pp. 1-6
Author(s):  
Dimitra Stergianou ◽  
Vassiliki Tzanetakou ◽  
Maria Argyropoulou ◽  
Theodora Kanni ◽  
Pantelis G. Bagos ◽  
...  

<b><i>Background:</i></b> Several patients with hidradenitis suppurativa (HS) present flare-ups during treatment with adalimumab (ADA), the cause of which is not clear. ADA is the only FDA-approved biologic for the therapy of moderate-to-severe HS. A previous study of our group has shown that <i>Staphylococcus aureus</i> stimulation of whole blood affects the production of human β-defensin 2 and modulates HS severity. It is, therefore, hypothesized, that carriage of <i>S. aureus</i> may drive HS flare-ups. <b><i>Objective:</i></b> To explore the association between carriage of <i>S. aureus</i> and loss of response to ADA. <b><i>Patients and Methods:</i></b> Among patients with moderate-to-severe HS without carriage of <i>S. aureus</i> at start of treatment with ADA, we investigated for carriage of <i>S. aureus</i> from the nares when flare-ups occurred. Flare-ups were pre-defined as at least 25% increase of inflammatory lesions (sum of inflammatory nodules and abscesses) from baseline. Samplings were also done after completion of 12 weeks of ADA treatment from all patients who did not present flare-ups. Clinical response to ADA was assessed by the HS Clinical Response score (HiSCR). <b><i>Results:</i></b> Thirty-nine patients were studied; 24 with Hurley II stage HS and 15 with Hurley III stage HS. Twenty-nine patients achieved HiSCR after 12 weeks of treatment without any flare-ups; 10 patients had flare-ups and failed HiSCR. Three (10.3%) and 5 (50%) patients, respectively, had nasal carriage of <i>S. aureus</i> (odds ratio 8.67; 95% CI 1.54–48.49; <i>p</i> = 0.014). Among 32 patients reaching follow-up week 48, 20 patients achieved HiSCR and 12 had flare-ups leading to ADA failure; 2 (10%) and 5 (41.7%) patients, respectively, had positive culture for <i>S. aureus</i> (odds ratio 6.42; 95% CI 1.00–41.20; <i>p</i> = 0.05). <b><i>Conclusion:</i></b> Nasal carriage of <i>S. aureus</i> may be associated with loss of response to ADA. Findings need confirmation in larger series of patients.


Dermatology ◽  
2018 ◽  
Vol 235 (1) ◽  
pp. 45-50 ◽  
Author(s):  
Alejandro Molina-Leyva ◽  
Carlos Cuenca-Barrales

Background/Aims: Hidradenitis suppurativa (HS) is a chronic inflammatory and destructive skin disorder. Early diagnosis and treatment are critical to stop its progression. Data concerning adolescent-onset HS are scarce. The aims of this study are to describe the prevalence of adolescent-onset HS and to explore potential risk factors and the disease features of these patients. Patients and Methods: A cross-sectional study including 134 patients was performed. Results: Adolescent-onset HS occurred in 51.5% (69/134) of patients. Adolescent-onset HS was associated with female sex, positive family history, presence of pilonidal sinus, acne conglobata, longer disease duration and a worse perception of disease severity. Conclusion: Adolescent-onset HS might be more frequent than previously reported. Female sex, positive family history and the presence of elements of the follicular occlusion tetrad identify individuals with a higher risk of early onset. These patients experience a longer disease duration and perceive their disease as severer.


1986 ◽  
Vol 19 (4) ◽  
pp. 257-266 ◽  
Author(s):  
Lon.S. Schneider ◽  
Eric.R. Fredrickson ◽  
James A. Severson ◽  
R.Bruce Sloane

Sign in / Sign up

Export Citation Format

Share Document