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Lokale und neue apparative Therapien der milden Hidradenitis suppurativa

Topical and novel device-based therapies for mild hidradenitis suppurativa

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Zusammenfassung

Hintergrund

Hidradenitis suppurativa (HS) ist eine chronisch entzündliche Erkrankung der inversen Hautregionen, die zunehmend auch in den Fokus der ambulanten Versorgung rückt. Früher meist chirurgisch im stationären Bereich betreut, existieren heutzutage neue Therapieoptionen, die insbesondere bei milden und mittelschweren Fällen eine effektive ambulante Betreuung ermöglichen.

Fragestellung

Es erfolgt die Darstellung der aktuellen ambulanten lokalen und apparativen Therapieoptionen unter Beleuchtung der Effektivität und des Risikos sowie der Entwicklung von Therapieempfehlungen für die Praxis.

Material und Methode

Die klinische Evidenz zu den einzelnen Behandlungsoptionen und die Analyse der aktuellen Entwicklungen zur Einschätzung der zukünftigen ambulanten HS-Betreuung in Deutschland wurde aufbereitet.

Ergebnisse

Es existieren für den ambulanten Bereich mittlerweile effektive lokale Behandlungsoptionen, die von topischem Clindamycin, Resorcinol bis zur intraläsionalen Kortikosteroidinjektion reichen. Neue apparative Verfahren wie die LAight-Therapie (Lenicura, Wiesbaden) stehen zur Verfügung, die als Monotherapie oder in Kombination mit medikamentösen oder chirurgischen Behandlungsoptionen zu einem erfolgreichen Krankheitsmanagement der milden bis mittelschweren HS führen können.

Schlussfolgerung

Eine evidenzbasierte Anwendung von topischen Therapieverfahren kann zu einer effizienteren ambulanten Behandlung von HS-Patienten führen (in der Praxis oder durch die Patienten selbst). Dies wiederum wird die Lebensqualität der HS-Patienten verbessern, insbesondere derjenigen mit rekurrierenden, milden bis mittelschweren Verläufen.

Abstract

Background

Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the skin folds, which requires more outpatient treatment alternatives. Although the disease was previously treated using surgery, new treatment modalities now allow the effective treatment of mild and moderate cases in an ambulatory care setting.

Aim of study

Local and instrument-based therapies are presented and their efficacy and safety profiles are highlighted.

Materials and methods

Clinical evidence for each therapeutic modality are presented and current treatment developments are analyzed based on the future treatment of HS patients in Germany.

Results

Effective treatments for outpatient care of HS patients include topical clindamycin, resorcinol, and intralesional corticosteroids. New devices such as LAight therapy (combining intense pulsed light [IPL] with radiofrequency) are available, which can be used as monotherapy or adjunct therapy in combination with systemic treatment and/or surgery for the management of HS.

Conclusion

Evidence-based use of local treatments can provide more efficient outpatient and self-administered strategies, which improves the quality of life of HS patients, especially for patients with recurrent mild and moderate disease.

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Danksagung

Die Hochschulklinik für Dermatologie, Venerologie und Allergologie, Immunologisches Zentrum des Städtischen Klinikums Dessau ist Gesundheitsdienstleister des Europäischen Referenznetzwerkes für seltene und komplexe Hautkrankheiten (ERN Skin – ALLOCATE Skin group). EvS erhält Förderung aus dem ERA PerMed EU Projekt „Biomolecular Analyses for Tailored Medicine in AcneiNversa (BATMAN)“.

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Authors and Affiliations

  1. Hochschulklinik für Dermatologie, Venerologie und Allergologie, Immunologisches Zentrum, Städtisches Klinikum Dessau, Medizinische Hochschule Brandenburg Theodor Fontane und Fakultät für Gesundheitswissenschaften Brandenburg, Dessau, Deutschland

    G. Nikolakis

  2. European Hidradenitis Suppurativa Foundation e. V., Dessau, Deutschland

    G. Nikolakis

  3. Klinik für Dermatologie und Venerologie, Uniklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland

    E. von Stebut

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  1. G. Nikolakis
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Correspondence to E. von Stebut.

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Interessenkonflikt

G. Nikolakis gibt an, dass kein Interessenkonflikt besteht. E. von Stebut hat Berater- und Vortragshonorare von Almirall, InfectoPharm, Janssen, Leo Pharma, und Novartis erhalten, die nicht mit diesem Manuskript in Verbindung stehen.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Nikolakis, G., von Stebut, E. Lokale und neue apparative Therapien der milden Hidradenitis suppurativa. Hautarzt 72, 676–685 (2021). https://doi.org/10.1007/s00105-021-04849-7

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