Treatment of Hidradenitis Suppurativa Hurley Stage III

No curative effect can be expected with medical therapy in Stage III disease. All medical therapy therefore aims to be palliative and temporary, i.e., the disease recurs shortly after the treat ment is stopped. The antibiotic combination of clindamycin and rifampicin may also be helpful.

An alternative viable strategy for gaining better control of the disease at this stage may be an immunosuppressive therapy. Traditionally corticosteroids and ciclosporin have been used. Recently the use of tumour necrosis factor alpha (TNF-alpha) inhibitors has been suggested by several authors (see Chap. 20), and randomized studies may confirm these observations in the future. Currently this therapy should be seen as experimental.

At this stage, however, the only possibilities for curative treatment are extensive surgery and radiation therapy, if one is not afraid of the risk of cancer promotion (see Table 25.4). Healing by secondary intention has generally been advocated, although this extends the postoperative need for additional nursing and wound care. In general, postoperative scarring is less of a problem than scarring from the disease itself.

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How To Reduce Acne Scarring

Acne is a name that is famous in its own right, but for all of the wrong reasons. Most teenagers know, and dread, the very word, as it so prevalently wrecks havoc on their faces throughout their adolescent years.

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