Hidradenitis suppurativa: review of international clinical guidelines for the diagnosis and treatment of the disease

Abstract

Background. Hidradenitis suppurativa hidradenitis is a chronic recurrent inflammatory skin disease that develops after puberty and is characterized by the appearance of recurrent painful nodes, abscesses, the formation of fistula passages and scars on skin areas rich in apocrine sweat glands. Treatment of purulent hidradenitis is aimed at suppressing inflammation, relieving pain, preventing the formation of fistulas and scars. The objectives of this review. Summarize the information in the published international clinical guidelines for the diagnosis and treatment of purulent hidradenitis, their comprehensive assessment and comparison with each other. Methods. In the period from December 2022 to February 2023, scientific articles were searched in the PubMed database of the National Center for Biotechnological Information. Inclusion criteria: scientific articles in English, without date restrictions; interdisciplinary publications of specialists in which dermatovenereologists participated. Results. The analysis of the existing relevant international clinical recommendations for the diagnosis and treatment of purulent hidradenitis indicates the absence of specific treatment schemes and algorithms, criteria for evaluating the effectiveness of therapy. In the treatment of purulent hidradenitis, the use of external keratolytics, antiseptics and antibiotics is recommended. Among systemic drugs, antibiotics, retinoids, immunosuppressive agents, hormonal drugs are used. The highest therapeutic efficacy in patients with purulent hidradenitis was shown by genetically engineered drugs that inhibit TNF-α and IL-17A. Conclusions. Patients with purulent hidradenitis require various treatment approaches, including a variety of surgical interventions, depending on the stage, severity, prescription of the disease and the general condition of the patient. The basic principle is the individual selection of the treatment method for a particular patient. In this regard, there is a need to develop domestic clinical guidelines for the management of patients with purulent hidradenitis.