Hidradenitis suppurativa in 64 female patients: retrospective study comparing oral antibiotics and antiandrogen therapy.

Abstract

BACKGROUND:

Hidradenitis suppurativa (HS) is a recurrent disease confined to apocrine gland-bearing areas causing painful, deep-seated lesions and draining sinus tracts. Uniformly effective therapy is lacking. Improvements in current medical management strategies are needed.

OBJECTIVE:

We sought to determine the success rate for a variety of treatments in our female HS patients and whether androgen-related tests can predict a response to antiandrogen therapy. As HS has been linked to a hyperandrogen state, we sought to determine if it is also associated with polycystic ovary syndrome (PCOS).

METHODS:

A retrospective chart review was performed examining hormonal profiles and the response to a variety of treatments in female patients with HS.

RESULTS:

Sixty-four female HS patients were identified (mean age 33 years). Antiandrogen therapy was superior to oral antibiotic therapy (55% vs 26%) based on a two-sample, two-sided, t-test statistic (p < .04). The prevalence of PCOS among our study patients in whom androgen markers were available was 8 of 21 (38.1%), and even if taken over all study patients, not necessarily investigated for PCOS, the prevalence was 8 of 64 (12.5%). This reflects a greater than expected prevalence among all women (10%).

CONCLUSION:

As a proof-of-concept study, despite limitations inherent in a retrospective chart review, there is sufficient signal to suggest that a hormonal manipulation approach to therapy should be considered in all women presenting with HS. Female patients presenting with HS should prompt investigations for underlying PCOS and insulin resistance.

• Authors: John N Kraft, Gordon E Searles
• Journal: Journal of cutaneous medicine and surgery (J Cutan Med Surg) 2007 Jul-Aug Vol. 11 Issue 4 Pg. 125-31 ISSN: 1203-4754 [Print] United States
• PMID: 17601419 (Publication Type: Journal Article)

Chemical References

• Androgen Antagonists
• Anti-Bacterial Agents

Topics

• Administration, Oral
• Adolescent
• Adult
• Aged
• Androgen Antagonists (therapeutic use)
• Anti-Bacterial Agents (administration & dosage)
• Child
• Drug Therapy, Combination
• Female
• Hidradenitis Suppurativa (drug therapy)
• Humans
• Middle Aged
• Retrospective Studies