Topical and Intralesional Therapies for Hidradenitis Suppurativa : A Systematic Literature Review
Copyright © 2023 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved..
BACKGROUND AND OBJECTIVE: Topical and intralesional (IL) treatments may be considered the first-line therapy in patients with hidradenitis suppurativa (HS); however, the evidence supporting their use is limited. The aim of our review is to evaluate the efficacy and safety profile of topical and IL treatments in patients with HS.
MATERIALS AND METHODS: We designed a systematic review of the current medical literature available following the PICO(T) method. And including all types of studies (Study type [T]) of individuals with HS of any sex, age, and ethnicity (Population [P]) who received any topical or IL treatment for HS (Intervention [I]) compared to placebo, other treatments, or no treatment at all (Comparator [C]), and reported efficacy and/or safety outcomes (Outcomes [O]). Two outcomes were defined: quality of life and the no. of patients with, at least, one adverse event. The search was conducted in the Cochrane Library, MEDLINE, and EMBASE databases; study selection was performed based on pre-defined criteria. The risk of bias was determined in each study.
RESULTS: We obtained a total of 11,363 references, 31 of which met the inclusion criteria. These studies included 1143 patients with HS, 62% of whom were women. A total of 10, 8, 6, 2, and 5 studies, respectively, evaluated the use of photodynamic therapy (PDT), glucocorticoids, resorcinol, topical antibiotics, and other interventions. Most articles were case series (n=25), with only five randomized clinical trials (RCTs) and one cohort study. RCTs showed improvement in disease activity with topical clindamycin and botulinum toxin (BTX) vs placebo, and PDT with methylene blue (MB) niosomal vs free MB; however, intralesional triamcinolone acetonide was not superior to placebo. The risk of bias was low in three RCTs and high in two RCTs.
CONCLUSION: The quality of evidence supporting the use of topical, or IL treatments is low. However, it supports the use of topical clindamycin, PDT, and BTX. Well-designed RCTs with standardized outcomes and homogeneous populations of patients and lesions are needed to support decision-making in the routine clinical practice.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2023 |
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| Enthalten in: |
Actas dermo-sifiliograficas - (2023) vom: 28. Dez. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Pascual, J C [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Revised 26.01.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1016/j.ad.2023.12.001 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM366504754 |
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| 245 | 1 | 0 | |a Topical and Intralesional Therapies for Hidradenitis Suppurativa |b A Systematic Literature Review |
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| 520 | |a Copyright © 2023 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved. | ||
| 520 | |a BACKGROUND AND OBJECTIVE: Topical and intralesional (IL) treatments may be considered the first-line therapy in patients with hidradenitis suppurativa (HS); however, the evidence supporting their use is limited. The aim of our review is to evaluate the efficacy and safety profile of topical and IL treatments in patients with HS | ||
| 520 | |a MATERIALS AND METHODS: We designed a systematic review of the current medical literature available following the PICO(T) method. And including all types of studies (Study type [T]) of individuals with HS of any sex, age, and ethnicity (Population [P]) who received any topical or IL treatment for HS (Intervention [I]) compared to placebo, other treatments, or no treatment at all (Comparator [C]), and reported efficacy and/or safety outcomes (Outcomes [O]). Two outcomes were defined: quality of life and the no. of patients with, at least, one adverse event. The search was conducted in the Cochrane Library, MEDLINE, and EMBASE databases; study selection was performed based on pre-defined criteria. The risk of bias was determined in each study | ||
| 520 | |a RESULTS: We obtained a total of 11,363 references, 31 of which met the inclusion criteria. These studies included 1143 patients with HS, 62% of whom were women. A total of 10, 8, 6, 2, and 5 studies, respectively, evaluated the use of photodynamic therapy (PDT), glucocorticoids, resorcinol, topical antibiotics, and other interventions. Most articles were case series (n=25), with only five randomized clinical trials (RCTs) and one cohort study. RCTs showed improvement in disease activity with topical clindamycin and botulinum toxin (BTX) vs placebo, and PDT with methylene blue (MB) niosomal vs free MB; however, intralesional triamcinolone acetonide was not superior to placebo. The risk of bias was low in three RCTs and high in two RCTs | ||
| 520 | |a CONCLUSION: The quality of evidence supporting the use of topical, or IL treatments is low. However, it supports the use of topical clindamycin, PDT, and BTX. Well-designed RCTs with standardized outcomes and homogeneous populations of patients and lesions are needed to support decision-making in the routine clinical practice | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Hidradenitis suppurativa | |
| 650 | 4 | |a Hidradenitis supurativa | |
| 650 | 4 | |a IL | |
| 650 | 4 | |a Intralesional | |
| 650 | 4 | |a Revisión sistemática de la literatura | |
| 650 | 4 | |a Systematic literature review | |
| 650 | 4 | |a Topical | |
| 650 | 4 | |a Tratamiento intralesional | |
| 650 | 4 | |a Tratamiento tópico | |
| 700 | 1 | |a Hernández-Quiles, R |e verfasserin |4 aut | |
| 700 | 1 | |a Sánchez-García, V |e verfasserin |4 aut | |
| 700 | 1 | |a Viudez-Martínez, A |e verfasserin |4 aut | |
| 700 | 1 | |a Belinchón, I |e verfasserin |4 aut | |
| 700 | 1 | |a Sivera, F |e verfasserin |4 aut | |
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