What Can We Achieve With Therapy

The obvious goal of therapy in HS is to heal existing lesions and prevent the development of new lesions. This is potentially possible in early lesions (Hurley stage I), where scarring does not dominate the clinical picture, although this form of treatment is more likely to alleviate symptoms than to cure patients. Therapy may furthermore not influence established fibrosis, although intralesional steroids, for example, are commonly used to treat hypertrophic scars.

Immunosuppression however has immediate benefits for patients. The main symptom for most patients with HS is pain, which in turn is due to inflammation. By offering patients immunosuppressive therapies inflammation is reduced and pain alleviated. Immunosuppres-sive therapy therefore has both immediate and potential long-term benefits for patients.

18.3 Immunosuppressive Therapies

A limited body of data exists to describe the therapeutic experience of using immunosup-pressants in HS. It is not clear whether it is the immunosuppressive or the anti-inflammatory effect of these drugs which is the stronger when used for HS, although it may be speculated that long-term results stem from immunosuppres-sion rather than anti-inflammatory therapy. The therapies are however at best described through small case series, and the evidence base of these therapies therefore needs to be expanded. Dose-finding or testing observations are both necessary and interesting, and any positive findings have to be confirmed in actual randomized controlled trials (see Table 18.1).

How To Reduce Acne Scarring

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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