North American clinical management guidelines for hidradenitis suppurativa: A publication from the United States and Canadian Hidradenitis Suppurativa Foundations: Part II: Topical, intralesional, and systemic medical management

• Published in: Journal of the American Academy of Dermatology Vol. 81; no. 1; pp. 91 - 101
• Main Authors: Alikhan, Ali, Sayed, Christopher, Alavi, Afsaneh, Alhusayen, Raed, Brassard, Alain, Burkhart, Craig, Crowell, Karen, Eisen, Daniel B, Gottlieb, Alice B, Hamzavi, Iltefat, Hazen, Paul G, Jaleel, Tara, Kimball, Alexa B, Kirby, Joslyn, Lowes, Michelle A, Micheletti, Robert, Miller, Angela, Naik, Haley B, Orgill, Dennis, Poulin, Yves
• Format: Journal Article
• Language: English
• Published: United States 01-07-2019
• Subjects: Administration, Oral; Administration, Topical; Androgen Antagonists - therapeutic use; Anti-Bacterial Agents - therapeutic use; Canada; Evidence-Based Medicine; Female; Hidradenitis Suppurativa - diagnosis; Hidradenitis Suppurativa - drug therapy; Humans; Immunosuppressive Agents - therapeutic use; Injections, Intralesional; Male; North America; Practice Guidelines as Topic; Prognosis; Risk Assessment; Treatment Outcome; United States; Canada; United States; North America; acne inversa; biomarkers; infliximab; hidradenitis suppurativa; Nd:YAG; microbiome; spironolactone; adalimumab; carbon dioxide laser; oral contraceptive pills; comorbidities; laser; lifestyle modification; rifampin; guidelines; clindamycin; finasteride; ertapenem
• ISSN: 1097-6787; 0190-9622; 1097-6787
• DOI: 10.1016/j.jaad.2019.02.068

Hidradenitis suppurativa is a severe and debilitating dermatologic disease. Clinical management is challenging and consists of both medical and surgical approaches, which must often be combined for best outcomes. Therapeutic approaches have evolved rapidly in the last decade and include the use of topical therapies, systemic antibiotics, hormonal therapies, and a wide range of immunomodulating medications. An evidence-based guideline is presented to support health care practitioners as they select optimal medical management strategies and is reviewed in this second part of the management guidelines. A therapeutic algorithm informed by the evidence available at the time of the review is provided.