What is the role of immunosuppression therapy 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

Therapeutic experience with nonspecific immunosuppression in hidradenitis suppurativa using methotrexate is unlikely to offer any significant advance. Different immunosuppressive medications, including methotrexate and cyclosporin A, have been used in case reports. [2] Before finally determining the value (or lack of value) of methotrexate in hidradenitis suppurativa, investigation of different dosage schedules in future patients with hidradenitis suppurativa would be worthwhile. Data assessing the appropriate dose or duration of cyclosporin A for hidradenitis suppurativa are limited. Beneficial effects of cyclosporin A are reported in limited cases. Use should therefore be reserved for cases in which standard first-, second-, and third-line therapies have failed until further evidence is available. Daily doses of 2-6 mg/kg have been used for variable duration (6 weeks to 7 months). [1]

Estrogen derivatives

The therapy is mainly indicated for female patients with menstrual abnormalities, signs of hyperandrogenism, or upper normal or high serum levels of dehydroepiandrosterone, androstenedione, and/or sexual hormone-binding protein. [1]


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