Abstract
Hidradenitis suppurativa is a chronic suppurative disease characterized by inflammatory nodules, fistulas and scarring predominantly in the armpits and the groins. Systemic therapy including oral antibiotics, retinoids or antiandrogens has only limited effect, advanced stages require surgical treatment of affected areas.
Recently, there were some reports of successfull therapy of hidradenitis suppurativa by TNF-α antagonists. In contrast to infliximab and etanercept, the positive effect of adalimumab was described only in small cohorts of patients.
Nine patients with severe, recalcitrant hidradenitis were treated for 1 year with adalimumab in a standard regimen and followed-up for 1 year. All patients improved within 4-6 weeks and laboratory parameters like CRP and leucocyte count were reduced significantly during the treatment.
In four patients we observed a long lasting improvement, five patients showed recurrences several months after the therapy discontinuation. Average recurrence-free interval was 9 months.
According to our experience therapy with adalimumab is suitable for treatment and induction of long-term remission in severe hidradenitis suppurativa