What is the role of corticosteroids in the treatment of hidradenitis suppurativa (HS)?

Updated: Aug 30, 2019
  • Author: Marina Jovanovic, MD, PhD; Chief Editor: William D James, MD  more...
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Answer

Data on the use of corticosteroids in hidradenitis suppurativa are limited. [1] The anti-inflammatory effects of systemic corticosteroids may be useful in acute exacerbations. Prednisolone at 60 mg/day with lower maintenance doses provides some long-term control. [40] Oral prednisone reduces inflammation, facilitates the healing of existing hidradenitis suppurativa lesions, and prevents future lesions from forming. [2] A dose of 0.5–0.7 mg/kg oral prednisolone is recommended for short-term use for acute flares; the dose should be rapidly tapered to stop over weeks. [1]

Immunosuppressants

This was supported by several reports in the literature of patients with hidradenitis suppurativa and Crohn disease who responded to infliximab. [63, 108, 109, 110, 111] Infliximab is an inhibitor of TNF-alpha. Although approved by the US Food and Drug Administration (FDA) for the treatment of Crohn disease and rheumatoid arthritis, infliximab has also been used in hidradenitis suppurativa. [112] The benefits outweigh the risks associated with its use, especially when it is administrated in severe chronic cases resistant to standard therapies. [94]


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