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

  title={Is There a Role for Antiandrogen Therapy for Hidradenitis Suppurativa? A Systematic Review of Published Data},
  author={Georgios Nikolakis and Athanassios Kyrgidis and Christos C. Zouboulis},
  journal={American Journal of Clinical Dermatology},
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… 

Hidradenitis Suppurativa in a Patient Affected by Mayer-Rokitansky-Küster-Hauser Syndrome: Insight into the Role of Hormones in HS

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.

Topical finasteride: A potential therapeutic option for hidradenitis suppurativa

This is the first study that describes topical antiandrogen therapy in HS, and 4 patients that received a commercially available topical finasteride on 2–3 HS affected sites at dosage 50 μl of 2275 mg/ml for each area are described.

Cortexolone 17α‐propionate for hidradenitis suppurativa

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.

New perspectives on the treatment of hidradenitis suppurativa

Evidence for effectiveness of current and emerging HS therapies is described, and new therapeutic options are being studied, targeting different specific cytokines involved in HS pathogenesis.

Multidisciplinary Update on Genital Hidradenitis Suppurativa: A Review.

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.

The Role of Oral Contraceptive Pills in Hidradenitis Suppurativa: A Cohort Study

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.

Spironolactone in Dermatology: Uses in Acne, Hidradenitis Suppurativa, Female Pattern Hair Loss, and Hirsutism

What causes hidradenitis suppurativa ?—15 years after

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.

Hidradenitis Suppurativa and Comorbid Disorder Biomarkers, Druggable Genes, New Drugs and Drug Repurposing—A Molecular Meta-Analysis

Evidence is provided for the importance of molecular studies to advance the knowledge regarding pathogenesis, future treatment and biomarker-supported clinical course follow-up in HS.

Target molecules for future hidradenitis suppurativa treatment

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.



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,

Hidradenitis Suppurativa in 64 Female Patients: Retrospective Study Comparing Oral Antibiotics and Antiandrogen Therapy

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.

Finasteride in Hidradenitis Suppurativa: A "Male" Therapy for a Predominantly "Female" Disease.

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.

An Update on Medical Treatment Options for Hidradenitis Suppurativa

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.

Hidradenitis suppurativa/Acne inversa: an endocrine skin disorder?

The current view on the hormonal dysregulation and metabolic syndrome and their role in HS is described.

The Role of Androgens and Estrogens in Hidradenitis Suppurativa - A Systematic Review.

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.

Hidradenitis suppurativa: A practical review of possible medical treatments based on over 350 hidradenitis patients.

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.

A Disease-Modifying Approach for Advanced Hidradenitis Suppurativa (Regimen with Metformin, Liraglutide, Dapsone, and Finasteride): A Case Report

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.

The SAHA Syndrome

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.

The pathogenesis of hidradenitis suppurativa: a closer look at apocrine and apoeccrine glands

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.