Antibiotic, hormonal/metabolic, and retinoid therapies for hidradenitis suppurativa.

Abstract

Hidradenitis suppurativa (HS), a chronic painful inflammatory skin condition, remains a persistent challenge in dermatology. Its complex pathogenesis has yet to be fully understood, complicating the identification of effective therapeutic strategies. This study aims to investigate the latest insights on antibiotics, hormonal/metabolic interventions, and oral retinoids in the management of HS. A narrative review was conducted to gather data on the efficacy and safety of oral antibiotics, hormonal interventions, and oral retinoids in HS from relevant studies and clinical trials. Oral antibiotics, such as tetracyclines and clindamycin-rifampin combination therapy, demonstrated significant improvements in disease severity scores. Hormonal interventions, targeting androgen receptors and insulin resistance, showed promising results in symptom management and improving disease severity. Oral retinoids, including isotretinoin and acitretin, displayed variable efficacy, with acitretin demonstrating more pronounced improvements. The variability in study designs, patient populations, and duration of follow-up across the reviewed literature may affect the generalizability of these findings. While antibiotics continue to play a foundational role, hormonal/metabolic therapies and oral retinoids offer additional avenues for alleviating HS symptoms and addressing its intricate pathogenesis. These findings underscore the importance of personalized treatment approaches tailored to individual patient needs.