Local wound care and topical management of hidradenitis suppurativa

Hidradenitis suppurativa (HS) is a chronic, recurrent, debilitating disease predominantly involving apocrine gland–bearing skin. The folliculoinfundibular dysfunction and an aberrant cutaneous immune response to commensal bacteria are recognized as potential contributors. Topical antibiotics, such as clindamycin, and keratolytic agents have been used in the management of early stages of HS. Proper wound care is a key part of management, particularly in patients with advanced HS. The evidence for the optimal topical therapy or optimal local wound care is limited. As such, a multidisciplinary approach is necessary to address all aspects of HS, including topical therapy, systemic therapy, and proper wound care. The focus of this paper is to review the evidence for the topical management and local wound care strategies in patients with HS.

Introduction

Patients with hidradenitis suppurativa (HS) suffer the dilemma of living with a chronic, recurrent draining wound.¹ The smell, exudate, pain, and the need for frequent dressing changes all significantly affect their activities of daily living.²

Despite the enigmatic etiology of HS, the folliculoinfundibular dysfunction and an aberrant cutaneous immune response to commensal bacteria are known as the main contributors. HS requires a multidisciplinary team approach to address associated comorbidities and offer effective medical and surgical treatments. In this paper, we focus on topical care.