Is There a Role for Antiandrogen Therapy for Hidradenitis Suppurativa? A Systematic Review of Published Data

@article{Nikolakis2019IsTA,
  title={Is There a Role for Antiandrogen Therapy for Hidradenitis Suppurativa? A Systematic Review of Published Data},
  author={Georgios Nikolakis and A Kyrgidis and Christos C. Zouboulis},
  journal={American Journal of Clinical Dermatology},
  year={2019},
  pages={1-11}
}
BackgroundHidradenitis suppurativa/acne inversa is a disease with deep-seated chronic painful nodules, abscesses, and draining sinus tracts, which manifests on the apocrine gland-rich skin areas of the body. Observational findings demonstrate that the disease usually appears after puberty, exhibits pre-menstrual flares in women, improves in pregnancy, and worsens post-partum, which indicates a role of hormones and particularly of androgens in its pathophysiology. Because increased androgen… Expand
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Hidradenitis Suppurativa in a Patient Affected by Mayer-Rokitansky-Küster-Hauser Syndrome: Insight into the Role of Hormones in HS
TLDR
HS usually appears after puberty, exhibits premenstrual flare, improves in pregnancy, and worsens postpartum, which indicates a role of hormones and particularly of androgens in its pathophysiology. Expand
Cortexolone 17α‐propionate for hidradenitis suppurativa
TLDR
Clascoterone is most likely to be effective in early stages of disease as it targets the initial pathogenesis of follicular plugging and perifollicular inflammation, and is likely to produce the greatest benefits if initiated as close to disease onset as possible with current safety data supporting its use in those as young as 9 years of age. Expand
Multidisciplinary Update on Genital Hidradenitis Suppurativa: A Review.
TLDR
A variety of reconstructive techniques based on the size and location of the skin deficiency are described, which require a thorough understanding of medical and surgical techniques for prevention, treatment, and reconstruction of genital defects. Expand
The Role of Oral Contraceptive Pills in Hidradenitis Suppurativa: A Cohort Study
TLDR
OCPs might be effective for improving AN count in women with HS, and women whose HS worsens in relation to the menstrual cycle and have a shorter disease may benefit more from the therapeutic effect of OCPs. Expand
Spironolactone in Dermatology: Uses in Acne, Hidradenitis Suppurativa, Female Pattern Hair Loss, and Hirsutism
TLDR
It is thought that spironolactone merits a place among the medications commonly used in routine clinical practice and is reviewed new evidence that stresses the safety of long-term therapy and supports the use of this drug without the need for complementary testing in young women. Expand
What causes hidradenitis suppurativa ?—15 years after
TLDR
This anniversary article of 43 research‐performing authors from all around the globe in the official journal of the European Hidradenitis Suppurativa Foundation e.V. summarizes the evidence of the intense HS clinical and experimental research during the last 15 years in all aspects of the disease. Expand
Target molecules for future hidradenitis suppurativa treatment
TLDR
The most promising molecules currently under investigation from a pathophysiological and clinical point of view are addressed in the treatment of hidradenitis suppurativa/acne inversa. Expand
Spironolactone therapy for hidradenitis suppurativa
TLDR
Hidradenitis suppurativa is a chronic inflammatory skin disease characterised by recurrent nodules, abscesses and sinus tract formation and may play a role through increased proliferation of follicular keratinocytes. Expand
Insights into the Pathogenesis of HS and Therapeutical Approaches
TLDR
This review will update readers on recent advances in understanding of HS pathogenesis and novel (potential) medical therapies for patients with moderate-to-severe HS. Expand
Antiandrogens and Androgen Inhibitors
TLDR
This chapter provides an overview of various antiandrogens (drugs that block the AR) and androgen inhibitors (enzyme inhibitors and other mechanisms). Expand
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References

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European S1 guideline for the treatment of hidradenitis suppurativa/acne inversa
Hidradenitis suppurativa/acne inversa (HS) is a chronic, inflammatory, recurrent, debilitating skin disease of the hair follicle that usually presents after puberty with painful, deep‐seated,… Expand
Hidradenitis Suppurativa in 64 Female Patients: Retrospective Study Comparing Oral Antibiotics and Antiandrogen Therapy
TLDR
There is sufficient signal to suggest that a hormonal manipulation approach to therapy should be considered in all women presenting with HS, and female patients presenting withHS should prompt investigations for underlying PCOS and insulin resistance. Expand
Finasteride in Hidradenitis Suppurativa: A "Male" Therapy for a Predominantly "Female" Disease.
TLDR
In hidradenitis suppurativa, finasteride could be considered in adults of both sexes as well as in select female children and adolescents, particularly those with concurrent metabolic and hormonal alterations present. Expand
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TLDR
An overview of most drug treatments reported on for HS is provided, where possible with their mode of action and side effects, and surgical interventions are often needed to achieve remission. Expand
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TLDR
The current view on the hormonal dysregulation and metabolic syndrome and their role in HS is described. Expand
The Role of Androgens and Estrogens in Hidradenitis Suppurativa - A Systematic Review.
TLDR
The results show that patients with HS do not seem to have increased levels of sex hormones and that their hormone levels lie within the normal range, and antiandrogen treatment could be a valuable approach in treating HS, however randomized control trials are lacking. Expand
Hidradenitis suppurativa: A practical review of possible medical treatments based on over 350 hidradenitis patients.
TLDR
This article summarizes my treatment experience with over 350 HS patients and centers on medical therapies and will only passingly mention surgical and laser treatments. Expand
A Disease-Modifying Approach for Advanced Hidradenitis Suppurativa (Regimen with Metformin, Liraglutide, Dapsone, and Finasteride): A Case Report
TLDR
A 19-year-old female with an 8-year history of progressively debilitating cicatricial HS disease presented with obesity, profound anemia, leukocytosis, increased platelet count, hypoalbuminemia, and elevated liver enzymes, and a combination of metformin, liraglutide, levonorgestrel-ethinyl estradiol, dapsone, and finasteride was initiated. Expand
The SAHA Syndrome
TLDR
The SAHA syndrome generally occurs in young to middle-aged women and involves either the presence of elevated blood levels of androgens or increased androgen-driven peripheral response with normal circulating androgen levels. Expand
The pathogenesis of hidradenitis suppurativa: a closer look at apocrine and apoeccrine glands
TLDR
Observations provide direct evidence in an in vivo model that follicular occlusion by keratinous material, with subsequent active folliculitis and secondary destruction of the skin adnexae and subcutis, occur as an integral step in the pathogenesis of hidradenitis suppurativa. Expand
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