Publication Bias

The paucity of controlled trials is apparent for local therapy of HS. There is therefore a strong bias towards anecdotal therapies. For anecdotal therapies there is a strong and well known bias towards false-positive reports.

In this review of treatments the authors have attempted to assess the local therapies in view of personal experience with the treatment modalities, but this does obviously not substitute for controlled trials or careful follow-up studies of cohorts of patients.

Just as in the development of new surgical techniques a lower degree of evidence is acceptable in order to establish the necessary data for planning a future trial and providing immediate information. The key features of any investigations should therefore be an explicit randomization procedure, appropriate documentation and a follow-up of not less than 3 months.

For bilateral HS lesions randomized intra-in-dividual left to right comparison of physical therapies is possible, but it is not advised to directly compare axillary and genitofemoral lesions, for example, as their natural prognoses often differ significantly (it is better for axillary lesions).

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