In Verneuils Disease

Until now there have been no reports on zinc's efficacy in HS. At the Department of Dermatology of Nantes (France), we have treated 22 patients with Verneuil's disease with zinc gluconate (Rubozinc®) [10].

In total, 15 women and 7 men were included in the study. The mean age was 38.3 years, the mean age at the onset of lesions was 24. 6 years and the mean duration between the beginning of the illness and diagnosis was 6.5 years. Eleven patients were at Hurley's grade I, 10 at grade II, and 1 at grade III. Zinc gluconate was used at a dose of six capsules of 15 mg zinc gluconate per day (Rubozinc®). The mean follow-up was 23.7 months. Results were assessed depending on the degree of remission.

Of the included patients 8/22 (36%) experienced complete remission. Complete remission was defined as no new lesions for 6 months or more (Figs. 19.1, 19.2). For these patients an attempt to decrease the doses of zinc was made but relapses were seen at a dose of between two and four capsules. Recurrences disappeared when the dosage of zinc salts was increased again. Thus, the treatment appears clearly to be suppressive rather than curative. A dose-response relationship may be present, as it would

Zinc and Other Experimental Medical Treatments

Zinc and Other Experimental Medical Treatments

Fig. 19.1. Before treatment

r iv iv

Fig. 19.2. After 6 months of zinc gluconate, six capsules/ day

appear that a clinically suppressive effect only occurred at high doses.

Partial remissions were seen in 4/22 (18%) patients. Partial remission was defined as a decrease in the number of nodules and a shorter cycle of each inflammatory lesion, based solely on the patient's opinion. For an outcome to be classified as a partial remission, the patients' assessments should remain stable for 1 year.

Stabilization was defined as no progression under treatment, and categorized as the lesser of the positive outcomes. Almost half (10/22, 45%) of the included patients experienced stabilization. None of the patients experienced deterioration of their HS during treatment. Gastrointestinal side-effects (diarrhoea, gastralgia, nausea, abdominal pains) were noted in four patients. One patient had to stop the treatment.

The efficacy of zinc salts in Verneuil's disease probably relies mainly on its anti-inflammatory activity. A similar effect is seen in acne, where zinc salts are used at a lower dose (30 mg metal zinc) and treatment appears to be brought about essentially by action on inflammatory lesions [11, 12]. A prospective study is now ongoing to confirm this preliminary result.

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