Treatment of hidradenitis suppurativa with intense pulsed light: a prospective study.

Abstract

Hidradenitis suppurativa is a chronic skin condition characterized by recurrent inflammation and infection of skin in intertriginous areas containing apocrine glands. Intense pulsed light uses high-energy broad-spectrum light. Current applications include hair removal and the treatment of acne vulgaris, which has a pathogenesis similar to that of hidradenitis suppurativa. The authors conducted a study to determine whether intense pulsed light is an effective treatment for hidradenitis suppurativa. Eighteen patients were randomized to treatment of one axilla, groin, or inframammary area with intense pulsed light two times per week for 4 weeks using a Harmony Laser. The contralateral side received no treatment and acted as a control. The response to treatment was assessed using a validated examination and clinical photographs, and by measuring patient satisfaction on a Likert scale. After treatment, there was a significant improvement in the mean examination score that was maintained at 12 months (p < 0.001, logistical regression analysis). The improvement was confirmed by independent assessment of clinical photographs (interrater reliability, 0.79; p < 0.001). Patients reported high levels of satisfaction with the treatment. There was no concurrent improvement on the untreated control side. This small study suggests that intense pulsed light may be an effective treatment for hidradenitis suppurativa. It could be added to treatments used for this condition, particularly for patients keen on avoiding surgery and those with groin and inframammary disease. Further studies are required to confirm the efficacy and mechanism of action of intense pulsed light in hidradenitis suppurativa.