Effective modified conservative tissue preserving protocol to treat stage I axillary hidradenitis suppurativa: a prospective cohort study of 627 patients with five years follow-up

Background: Hidradenitis suppurativa is a chronic inflammatory cutaneous disorder that involves the infundibular terminal follicles in areas rich in apocrine glands and associated with the formation of abscesses and fistulating sinus. The clinical course is variable, and definitive evidence-based gu...

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Main Authors: Bader Hamza Shirah, Hamza Asaad Shirah
Format: Article
Language:English
Published: Taylor & Francis Group 2017-07-01
Series:Journal of Dermatological Treatment
Subjects:
Online Access:http://dx.doi.org/10.1080/09546634.2016.1273470
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author Bader Hamza Shirah
Hamza Asaad Shirah
author_facet Bader Hamza Shirah
Hamza Asaad Shirah
author_sort Bader Hamza Shirah
collection DOAJ
description Background: Hidradenitis suppurativa is a chronic inflammatory cutaneous disorder that involves the infundibular terminal follicles in areas rich in apocrine glands and associated with the formation of abscesses and fistulating sinus. The clinical course is variable, and definitive evidence-based guidelines for the management are not well-established. Conservative treatment is controversial, and surgical excision is the recommended method. Herein, we aim to analyze the results of a modified conservative tissue preserving management protocol for stage I axillary hidradenitis suppurativa. Methods: A prospective cohort study of the results of 627 patients who were diagnosed and treated for stage I axillary hidradenitis suppurativa between January 2001 and December 2010 was done. Three hundred and forty nine (55.7%) were females, and 278 (44.3%) were males. The modified conservative treatment protocol consisted of three times per day washing the affected area with antibacterial soap, application of warm compresses for 10 min, followed by application of topical sodium fusidate 2% ointment (fusidic acid), with abstinence of armpits shaving during the treatment period. Results: Four hundred and sixty one (73.5%) patients had complete healing within two weeks, 127 (20.3%) within three weeks, 39 (6.2%) within four weeks. The recurrence rate was 5.9% (37 patients) in which all patients were retreated conservatively and had complete healing, none required surgical intervention. Conclusions: We conclude that hidradenitis suppurativa continues to be a challenging disease for patients and physicians. Tissue preserving conservative method using the fusidic acid ointment for treating stage I axillary hidradenitis suppurativa showed a promising result. Further research should be conducted on the optimal treatment regimen.
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spelling doaj.art-49998ecc401a457bbd122875f3a9418e2023-09-15T10:48:03ZengTaylor & Francis GroupJournal of Dermatological Treatment0954-66341471-17532017-07-0128545846310.1080/09546634.2016.12734701273470Effective modified conservative tissue preserving protocol to treat stage I axillary hidradenitis suppurativa: a prospective cohort study of 627 patients with five years follow-upBader Hamza Shirah0Hamza Asaad Shirah1King Abdullah International Medical Research Center/King Saud bin Abdulaziz University for Health SciencesAl Ansar General HospitalBackground: Hidradenitis suppurativa is a chronic inflammatory cutaneous disorder that involves the infundibular terminal follicles in areas rich in apocrine glands and associated with the formation of abscesses and fistulating sinus. The clinical course is variable, and definitive evidence-based guidelines for the management are not well-established. Conservative treatment is controversial, and surgical excision is the recommended method. Herein, we aim to analyze the results of a modified conservative tissue preserving management protocol for stage I axillary hidradenitis suppurativa. Methods: A prospective cohort study of the results of 627 patients who were diagnosed and treated for stage I axillary hidradenitis suppurativa between January 2001 and December 2010 was done. Three hundred and forty nine (55.7%) were females, and 278 (44.3%) were males. The modified conservative treatment protocol consisted of three times per day washing the affected area with antibacterial soap, application of warm compresses for 10 min, followed by application of topical sodium fusidate 2% ointment (fusidic acid), with abstinence of armpits shaving during the treatment period. Results: Four hundred and sixty one (73.5%) patients had complete healing within two weeks, 127 (20.3%) within three weeks, 39 (6.2%) within four weeks. The recurrence rate was 5.9% (37 patients) in which all patients were retreated conservatively and had complete healing, none required surgical intervention. Conclusions: We conclude that hidradenitis suppurativa continues to be a challenging disease for patients and physicians. Tissue preserving conservative method using the fusidic acid ointment for treating stage I axillary hidradenitis suppurativa showed a promising result. Further research should be conducted on the optimal treatment regimen.http://dx.doi.org/10.1080/09546634.2016.1273470hidradenitis suppurativaconservative treatmentsurgical excisionsodium fusidate 2% ointment (fusidic acid)
spellingShingle Bader Hamza Shirah
Hamza Asaad Shirah
Effective modified conservative tissue preserving protocol to treat stage I axillary hidradenitis suppurativa: a prospective cohort study of 627 patients with five years follow-up
Journal of Dermatological Treatment
hidradenitis suppurativa
conservative treatment
surgical excision
sodium fusidate 2% ointment (fusidic acid)
title Effective modified conservative tissue preserving protocol to treat stage I axillary hidradenitis suppurativa: a prospective cohort study of 627 patients with five years follow-up
title_full Effective modified conservative tissue preserving protocol to treat stage I axillary hidradenitis suppurativa: a prospective cohort study of 627 patients with five years follow-up
title_fullStr Effective modified conservative tissue preserving protocol to treat stage I axillary hidradenitis suppurativa: a prospective cohort study of 627 patients with five years follow-up
title_full_unstemmed Effective modified conservative tissue preserving protocol to treat stage I axillary hidradenitis suppurativa: a prospective cohort study of 627 patients with five years follow-up
title_short Effective modified conservative tissue preserving protocol to treat stage I axillary hidradenitis suppurativa: a prospective cohort study of 627 patients with five years follow-up
title_sort effective modified conservative tissue preserving protocol to treat stage i axillary hidradenitis suppurativa a prospective cohort study of 627 patients with five years follow up
topic hidradenitis suppurativa
conservative treatment
surgical excision
sodium fusidate 2% ointment (fusidic acid)
url http://dx.doi.org/10.1080/09546634.2016.1273470
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