علاج التهاب الغدد العرقية القيحي (المرحلة الثانية من تصنيف هيرلي) لدى المرضى البالغين

References

• Hurley stage I is characterized by recurrent nodules and abscesses with minimal scar, Hurley stage II is characterized by 1 or a limited number of sinuses and/or scarring within a body region, and Hurley stage III is characterized by multiple or extensive sinuses and/or scarring.
• Counsel smoking cessation.
• Screen for obesity and counsel weight loss.
• Topical clindamycin may reduce pustules in HS, but it carries a high risk of bacterial resistance.
• A prospective case series on the effect of intralesional triamcinolone, 10 mg/mL (0.2–2.0 mL), into inflamed HS lesions demonstrated significant reductions in physician-assessed erythema, edema, suppuration, and size.
• Tetracyclines are recommended in mild-to-moderate HS for a 12-week course or as long-term maintenance when appropriate.
• An Nd:YAG laser is recommended in patients with Hurley stage II or III disease on the basis of RCT and case series data and in patients with Hurley stage I disease on the basis of expert consensus.
• A 12-week randomized, placebo-controlled trial of 27 subjects with Hurley stage I or II disease demonstrated reduced pustules but no effect on inflammatory nodules and abscesses.
• A single randomized controlled trial (RCT) comparing tetracycline, 500 mg twice daily, with topical clindamycin demonstrated a 30% reduction of abscesses in both groups, but changes in patient-reported outcomes were not significant.