isotretinoin and Hidradenitis-Suppurativa

Acne vulgaris is a chronic, inflammatory, skin condition that involves the pilosebaceous follicles and is influenced by a variety of factors including genetics, androgen-stimulation of sebaceous glands with abnormal keratinization, colonization with Cutibacterium acnes (previously called Propionibacterium acnes), and pathological immune response to inflammation. Acne can occur at all ages and this discussion focuses on the first three decades of life. Conditions that are part of the differential diagnosis and/or are co-morbid with acne vulgaris are also considered. Acne in the first year of life includes neonatal acne (acne neonatorum) that presents in the first four weeks of life and infantile acne that usually presents between 3 and 6 months of the first year of life with a range of 3 to 16 months after birth. Acne rosacea is a chronic, inflammatory, skin condition that is distinct from acne vulgaris, typically presents in adults, and has four main types: erythemato-telangiectatic, papulopustular, phymatous and ocular. Treatment options for acne vulgaris include topical retinoids, topical benzoyl peroxide, antibiotics (topical, oral), oral contraceptive pills, isotretinoin, and others. Management must consider the increasing impact of antibiotic resistance in the 21st century. Psychological impact of acne can be quite severe and treatment of acne includes awareness of the potential emotional toll this disease may bring to the person with acne as well as assiduous attention to known side effects of various anti-acne medications (topical and systemic). Efforts should be directed at preventing acne-caused scars and depigmentation on the skin as well as emotional scars within the person suffering from acne.

Topics: Acne Vulgaris; Acquired Hyperostosis Syndrome; Administration, Oral; Administration, Topical; Adolescent; Anti-Bacterial Agents; Awareness; Benzoyl Peroxide; Child; Contraceptives, Oral; Dermatologic Agents; Diagnosis, Differential; Female; Hidradenitis Suppurativa; Humans; Isotretinoin; Male; Propionibacteriaceae; Psychological Distress

Hidradenitis suppurativa (HS) is a chronic, suppurative skin disease characterized by painful nodules, particularly in the axillae and groin. Isotretinoin can be used in the treatment of HS; however, it may paradoxically lead to skin lesions or worsen the existing lesions. Isotretinoin, which is commonly used in the treatment of severe acne, is associated with several side effects, including rheumatic side effects and rarely sacroiliitis. In this study, we discussed two cases who presented with low back pain after isotretinoin was used for the treatment of acne vulgaris. The patients did not have low back pain before isotretinoin use and did not have enthesitis, dactylitis, uveitis, psoriasis, recent infection, trauma, and family history spondylitis. HLA-B27 was negative. Bone-marrow edema was detected at the sacroiliac joint on magnetic resonance imaging. Because of these findings, sacroiliitis related to the drug was considered in our patients and isotretinoin treatments were discontinued. Because the patients' low back pain continued when they administered non-steroidal anti-inflammatory drugs, biological drug treatments were started. Both cases presented had a simultaneous HS lesion. After the treatment, both low back pain and HS lesions regressed. Patients with isotretinoin therapy should be alerted for inflammatory low back pain and HS lesions that may develop. We should note that biologic agents should be considered in the treatment of resistant cases.

Topics: Acne Vulgaris; Adult; Dermatologic Agents; Female; Hidradenitis Suppurativa; Humans; Isotretinoin; Low Back Pain; Male; Sacroiliitis; Young Adult

While the use of isotretinoin has revolutionized the treatment of acne vulgaris, isotretinoin is increasingly recognized as a useful therapeutic option for many other cutaneous conditions. We review the evidence underlying the use of isotretinoin for a variety of dermatological indications including hidradenitis suppurativa, sebaceous gland pathology, rosacea, scarring alopecia, cosmetic dermatology, and non-melanoma skin cancer prophylaxis amongst other uses, and thus consider alternative uses within dermatology practice. The studies found benefit of isotretinoin, however most trials lacked statistical power and in many cases the use was limited to case series. Isotretinoin, if used within the correct cohort with appropriate pretreatment counseling regarding side-effects, is a well-tolerated medication with potential as either an adjunctive treatment or a second-line agent in those recalcitrant cases unresponsive to first-line therapy.

Topics: Acne Vulgaris; Dermatitis, Seborrheic; Dermatologic Agents; Hidradenitis Suppurativa; Humans; Isotretinoin; Rosacea; Warts

Systemic isotretinoin has been used to treat severe acne vulgaris for 20 years. However, isotretinoin also represents a potentially useful choice of drugs in many dermatologic diseases other than acne vulgaris. Diseases such as psoriasis, pityriasis rubra pilaris, condylomata acuminata, skin cancers, rosacea, hidradenitis suppurativa, granuloma annulare, lupus erythematosus and lichen planus have been shown to respond to the immunomodulatory, anti-inflammatory and antitumor activities of the drug. Isotretinoin also helps prevent skin cancers such as basal cell carcinoma or squamous cell carcinoma. A combination of systemic isotretinoin and interferon-alpha-2a may provide a more potent effect than isotretinoin alone in the prevention and treatment of skin cancers.Systemic isotretinoin may be considered as an alternative drug in some dermatologic diseases unresponsive to conventional treatment modalities. However, randomized clinical trials aimed at determining the role of systemic isotretinoin therapy in dermatologic diseases other than acne vulgaris are required.

Topics: Acne Vulgaris; Anti-Bacterial Agents; Anti-Infective Agents; Anti-Inflammatory Agents; Condylomata Acuminata; Dermatologic Agents; Drug Therapy, Combination; Granuloma Annulare; Hidradenitis Suppurativa; Humans; Isotretinoin; Keratolytic Agents; Lichen Planus; Lupus Erythematosus, Systemic; Pityriasis Rubra Pilaris; Psoriasis; Rosacea; Sebaceous Glands; Skin Diseases; Skin Neoplasms

Hidradenitis suppurativa (HS) is a recurrent, suppurative disease manifested by abscesses, fistulas, and scarring.. We reviewed the literature to identify reliable information regarding epidemiology, pathogenesis, clinical manifestations, evaluation and differential diagnosis, treatment, complications, and prognosis.. Hidradenitis suppurativa usually affects young women, with a prevalence of 0.3% to 4% in industrialized countries. Once considered to be "apocrine acne," HS is actually a defect of terminal follicular epithelium. Obesity, chemical irritants, or hyperandrogenism are not consistently associated; bacterial involvement is secondary. Hidradenitis suppurativa should be suspected in young adults with recurrent, deep furuncular lesions in flexural sites, especially when such lesions respond poorly to antibiotic therapy. Clindamycin and isotretinoin may be useful, though wide excision with healing by granulation is considered most efficacious. Anemia, arthropathy, and squamous cell carcinoma are potential complications.. Since spontaneous resolution is rare and progressive disability the rule, early definitive surgical treatment of HS is advisable.

Topics: Adult; Anti-Bacterial Agents; Apocrine Glands; Clindamycin; Diagnosis, Differential; Epithelium; Female; Furunculosis; Hair Follicle; Hidradenitis Suppurativa; Humans; Isotretinoin; Keratolytic Agents; Male; Prevalence; Prognosis; Recurrence; Sex Factors

Oral isotretinoin has been used to treat mild to severe hidradenitis suppurativa (HS).. We reviewed the results of low-dose isotretinoin for 4 to 6 months in the treatment of 68 patients with HS.. This is a retrospective study. Data are presented in terms of response rate, long-term follow-up, and the relation between response rate and severity.. In 16 patients (23.5%), the condition completely cleared during initial therapy and 11 patients (16.2%) maintained their improvement during the follow-up period. Treatment was more successful in the milder forms of HS.. Monotherapy with isotretinoin for patients with HS usually has a limited therapeutic effect.

Topics: Adult; Dose-Response Relationship, Drug; Female; Follow-Up Studies; Hidradenitis Suppurativa; Humans; Isotretinoin; Keratolytic Agents; Male; Retrospective Studies; Time Factors; Treatment Outcome

Prolonged systemic antibiotic treatment is often a part of management of hidradenitis suppurativa (HS). Although biologic therapies are now available, the patient's treatment journey leading to biologic therapy is unclear.. To examine treatment patterns and duration of systemic treatment use in patients with HS preceding biologic therapy.. We identified all patients with HS receiving treatment with biologics in the Danish National Patient Registry from 2010 to 2018 and extracted their entire prescription history of specific systemic treatments from the Danish National Prescription Registry since its inception in 1995. The patients' treatment journeys are graphically displayed through Sankey diagrams and box plots generated to show temporal distributions. Descriptive patient characteristics were presented as frequencies with percentages for categorical variables and as means with SDs or medians with interquartile ranges (IQRs) for continuous variables.. A total of 225 patients with HS were included. Patients had most frequently been treated with penicillin (n = 214; 95·1%), dicloxacillin (n = 194; 86·2%), tetracycline (n = 145; 64·4%) and rifampicin/clindamycin (n = 111; 49·3%), as well as the retinoids isotretinoin and acitretin, and dapsone. Prior to biologic therapy, patients received a mean of 4·0 (SD 1·3) different systemic therapies, across a mean of 16·9 (SD 11·3) different treatment series. The mean time from first systemic therapy until biologic therapy was initiated was 15·3 (SD 5·1) years [8·2 (SD 5·9) years when excluding penicillin and dicloxacillin].. Patients with HS who receive biologic therapy have long preceding treatment histories with multiple drug classes and treatment series, many of which are supported by relatively weak evidence in HS. Delay in the initiation of biologic therapy may represent a missed opportunity to prevent disease progression. What is already known about this topic? The treatment journey leading to biologic therapy in patients with HS has not previously been investigated. What does this study add? Our data from 225 patients with HS illustrate that patients who receive biologic therapy have long preceding treatment histories with multiple drug classes and treatment series, many of which are supported by relatively weak evidence in HS.

Topics: Acitretin; Anti-Bacterial Agents; Biological Factors; Biological Products; Clindamycin; Dapsone; Dicloxacillin; Drug Utilization; Hidradenitis Suppurativa; Humans; Isotretinoin; Rifampin; Tetracyclines

Cohort studies on the use of retinoids for hidradenitis suppurativa (HS) have yielded contradicting results. As the clinical presentation of HS is heterogeneous, with different predilection sites and hallmark features, it can be hypothesized that HS phenotypes are associated with the effectiveness of specific retinoid treatments.. The aim of this study was to evaluate the drug survival of oral retinoids in the treatment of HS and to establish predictors for longer treatment duration.. A retrospective, dual-center study was conducted in the Netherlands in adult HS patients treated with oral retinoids between 2011 and 2021. Drug survival analyses were performed through Kaplan-Meier survival curves. Additionally, Cox regression models were used to determine predictors for a longer drug survival.. In total, 102 patients were included. Overall drug survival of (low-dose) isotretinoin (n = 66) at 12 and 24 months was 44.2% and 15.5%, respectively. Termination of treatment was mostly due to ineffectiveness (26%). Presence of widespread comedones (p = 0.03) and the use of concomitant systemic medication (p = 0.04) were associated with a prolonged treatment duration. For acitretin (n = 36), the overall drug survival was 42.0% at 12 months and 37.4% at 24 months, and was also predominantly determined by ineffectiveness (28%). Interestingly, the scarring folliculitis phenotype (p < 0.05) was associated with prolonged drug survival time for acitretin treatment relative to the regular phenotype.. Comparable drug survival rates at 12 months for isotretinoin and acitretin were found. HS patients with widespread comedones and the scarring folliculitis phenotype could benefit from treatment with isotretinoin or acitretin, respectively.

Topics: Acitretin; Acne Vulgaris; Cicatrix; Cohort Studies; Folliculitis; Hidradenitis Suppurativa; Humans; Isotretinoin; Retinoids; Retrospective Studies

Isotretinoin has been used off-label in hidradenitis suppurativa (HS) patients with variable results, making it difficult to predict which patients with HS are likely to benefit.. We conducted a retrospective review of HS patients who presented to UCLA HS clinic between August 2009 and March 2018 and collected data on their demographics, reported history of isotretinoin treatment for HS, and treatment response. A number of patient variables were analyzed between the responders and non-responders to see if any were associated with a higher likelihood of a beneficial response.. Of the 209 patients, 39 (18.7%) reported prior treatment with isotretinoin. A beneficial response to isotretinoin was reported by 14 (35.9%) patients, while 25 (64.1%) patients reported no response. When comparing responders to non-responders, responders were more likely to have a history of pilonidal cyst (. Our data suggest that for HS patients, having a history of pilonidal cyst is associated with a beneficial response to isotretinoin.

Topics: Acne Vulgaris; Adolescent; Adult; Female; Hidradenitis Suppurativa; Humans; Isotretinoin; Male; Middle Aged; Pilonidal Sinus; Retrospective Studies; Young Adult

Topics: Acne Vulgaris; Folic Acid; Hidradenitis Suppurativa; Homocysteine; Humans; Hyperhomocysteinemia; Isotretinoin; Retinoids; Vitamin B 12

An inappropriate immunologic response has been suggested to play a role in the pathogenesis of hidradenitis suppurativa (HS). Adalimumab was the first TNF-α inhibitor approved for moderate to severe HS. We report on a case of HS (Hurley stage 2) in a 39-year-old man, who had received fusidic acid and isotretinoin treatments without evident benefit during the last 8 years. The patient noticed a reduction in the number of lesions and quality of life (DLQI from 27 to 6) in the 2 months following verapamil initiation for cluster headache. When verapamil was stopped, the lesions recurred within 1.5 months. The patient resumed taking verapamil as before and a remission occurred. Verapamil has been shown to inhibit TNF-α and IL-1β in vitro and in vivo. We hypothesize that verapamil inhibits the inflammatory process through the TNF-α/IL-1 pathway involved in the HS physiopathology. Compared to biologic agents as anti-TNF-α (adalimumab) and anti-IL1 (anakinra), verapamil is safer and cheaper. Given its possible role on TNF-α/IL-1, verapamil may represent an alternative therapeutic option in mild and moderate HS.

Topics: Adult; Calcium Channel Blockers; Fusidic Acid; Hidradenitis Suppurativa; Humans; Isotretinoin; Male; Quality of Life; Treatment Outcome; Tumor Necrosis Factor-alpha; Verapamil

Isotretinoin is the most potent treatment for acne but paradoxical flares can occur. HS lesions of the face may be mistaken for acne. We report on 4 patients in whom an "acne" flare on isotretinoin led to the correct diagnosis of HS.. Four young male patients aged 15 to 28 years were referred to us because of an acne flare on isotretinoin. Three of them had clinical features considered unusual in acne : involvement of the nape of the neck (2), retroauricular cysts (2), a rope-like pre-sternal lesion (1), a large bag-like sinus on the face (1), large deep depressed U-type scars on the back (3). Questioning revealed that all three had previously experienced several attacks of inflammatory nodules in the axillae and/or inguinal folds; they had not mentioned these lesions since they seemed so minor. The fourth patient had lesions typical of HS comprising nodules, sinus, rope-like hypertrophic scars on the face mistaken for acne, epidermal cysts on the scrotum and pubic folliculitis. Treatment with systemic antibiotics resulted in regression of lesions in all 4 patients.. An acne flare on isotretinoin requires investigations with a view to potential diagnosis of HS. Patients presenting "acne" and atypical features such as involvement of the neck, large U scars and cord-like structures should be questioned about the presence of nodules in the axillae and groin since patients with mild HS may not spontaneously acknowledge such typical symptoms.

Topics: Acne Vulgaris; Adolescent; Adult; Dermatologic Agents; Diagnosis, Differential; Diagnostic Errors; Hidradenitis Suppurativa; Humans; Isotretinoin; Male; Young Adult

We report eight cases of patients with severe acne who were treated with isotretinoin and developed painful nodules in the axillae and groin, consistent with hidradenitis suppurativa (HS). The pathogenesis of HS is still not completely understood; recent research from a study in 2011 of biopsies from HS lesions showed a reduction or absence of sebaceous glands compared with normal skin in patients with HS, with the report suggesting that this contributes to the pathogenesis of the disease. Interestingly, the main effect of isotretinoin is to decrease the size and action of sebaceous glands, so hypothetically, as isotretinoin acts by reducing the sebaceous glands further it could potentially aggravate HS. Our experience has instilled caution in our prescribing of isotretinoin, and we question patients, particularly those with acne conglobata, about symptoms of HS prior to and during treatment.

Topics: Acne Vulgaris; Adolescent; Adult; Axilla; Dermatologic Agents; Female; Groin; Hidradenitis Suppurativa; Humans; Isotretinoin; Male; Middle Aged; Sebaceous Glands; Young Adult

Topics: Hidradenitis Suppurativa; Humans; Isotretinoin; Keratolytic Agents

Topics: Hidradenitis Suppurativa; Humans; Isotretinoin; Retinoids

Hidradenitis suppurativa (HS) is a disease characterized by the development of painful, deep-seeded nodules and abscesses. Treatment guidelines include a combination of lifestyle, surgical, and medical interventions. Isotretinoin has not been included in the treatment guidelines due to the limited number of studies and conflicting reports of efficacy.. The purpose of this study is to evaluate the clinical response to isotretinoin in HS patients and to determine whether there is a particular patient population that may benefit more from this treatment.. A retrospective chart review was conducted on all HS patients treated with isotretinoin within the years of 2014-2016. Sex, age, weight, history of acne, Hurley stage, and treatment dose and duration were extracted from patient charts.. Of the 25 patients included in the study, 32% (8/25) had no response, 32% (8/26) showed partial response, and 36% (9/25) demonstrated complete response to isotretinoin treatment. Complete response was seen only in Hurley stage I and II patients. Hurley III patients made up 50% of the non-responders. Those with any sort of treatment response were more likely to be female, younger, weigh less, and have a higher prevalence of acne compared to non-responders.. This is a retrospective chart review with a small sample size of 25 patients.. Physicians should consider isotretinoin as a potential treatment for HS, as it may be beneficial in patients with mild and moderate disease and patients who are female, younger, weigh less, and have a personal history of acne.

Topics: Acne Vulgaris; Adolescent; Adult; Age Factors; Body Weight; Dermatologic Agents; Female; Hidradenitis Suppurativa; Humans; Isotretinoin; Male; Middle Aged; Retrospective Studies; Severity of Illness Index; Sex Factors; Treatment Outcome; Young Adult

Topics: Hidradenitis Suppurativa; Humans; Isotretinoin; Keratolytic Agents

Topics: Hidradenitis Suppurativa; Humans; Isotretinoin; Mechanistic Target of Rapamycin Complex 1

We report two unique cases of patients with Darier disease and hidradenitis suppurativa. Although it is unknown whether there is a connection between the two diseases, it is possible that an interaction between sarcoendoplasmic reticulum calcium transport ATPase and Notch homolog 1, translocation-associated (Drosophila) caused both diseases in these individuals.

Topics: Anti-Bacterial Agents; Darier Disease; Female; Glucocorticoids; Hidradenitis Suppurativa; Humans; Isotretinoin; Young Adult

Within the plastic surgery community, it is widely believed that waiting a minimum of 6 to 12 months after patient cessation of systemic retinoid therapy is necessary before proceeding with elective surgery.. The authors investigate partial- and full-thickness wound healing after treatment with systemic isotretinoin in a porcine model.. Following institutional approval, 2 Hanford miniature pigs were obtained. One pig received isotretinoin at a dose of 2 mg/kg/d, administered orally along with pig feed over a 60-day period; the other (control) pig received only pig feed over the same time period. After the treatment period ended, a total of 24 full-thickness wounds and 24 partial-thickness wounds were made on each pig. The wounds were evaluated by photographic and histological analysis at 7, 14, and 28 days.. The average full-thickness wound size in the control animal was 0.4346 cm(2) at 14 days and 0.0689 cm(2) at 28 days. The average full-thickness wound size in the isotretinoin-treated animal was 0.4685 cm(2) at 14 days and 0.0363 cm(2) at 28 days. The differences were not statistically significant between the 2 animals at either time point. On histological analysis, the healing characteristics of partial- and full-thickness wounds were similar at 7, 14, and 28 days for both animals.. Invasive surgery might be safely performed even in the presence of recent isotretinoin therapy. This finding challenges the current practice of waiting longer than 6 months after completion of therapy to perform surgery.

Topics: Administration, Oral; Adult; Animals; Drug Administration Schedule; Elective Surgical Procedures; Female; Hidradenitis Suppurativa; Humans; Isotretinoin; Models, Animal; Patient Selection; Risk Factors; Swine; Swine, Miniature; Time Factors; Treatment Outcome; Wound Healing

Hidradenitis suppurativa (HS) may be associated with face and back lesions which are considered as acne.. To describe the skin lesions of a group of patients with HS.. Twelve patients were selected from a series of 648 patients on the basis of their specific skin lesions.. The patients (mostly male) had typical hidradenitis. On their face or back they had one or several of the following skin lesions which are not seen in acne: hypertrophic rope-like bridged scars, raised plaques with multiple carbuncle-like openings or with ulcerations, 'worm-eaten scars' and coalescent nodules with round ulcerations. All patients had deep round scars. Several had a pilonidal cyst or large epidermal cysts. Isotretinoin had been used by 7 patients with no effect.. Some HS patients have specific lesions of the face and back which are not acne and have to be treated differently.

Topics: Acne Vulgaris; Adult; Back; Cicatrix; Clindamycin; Dermatologic Agents; Epidermal Cyst; Face; Female; Hidradenitis Suppurativa; Humans; Isotretinoin; Male; Middle Aged; Pilonidal Sinus; Rifampin; Skin Ulcer; Treatment Outcome; Young Adult

In analogy to acne, oral isotretinoin has been considered in the treatment of hidradenitis suppurativa (HS).. To assess the efficacy of oral isotretinoin according to patients.. From 1999 to 2006, 358 consecutive HS patients were interviewed and examined. A standardized record of the data was performed for each patient during the first consultation. Patients were questioned regarding the effect of previous treatment with oral isotretinoin: patients had to grade the effect as either 'improved', 'no effect' or 'worse'.. Fourteen patients (16.1%) declared an improvement, 67 patients (77%) no effect and 6 patients (6.9%) worsening of HS.. According to our patients, oral isotretinoin is not effective in the treatment of HS.

Topics: Administration, Oral; Adult; Dermatologic Agents; Female; Hidradenitis Suppurativa; Humans; Isotretinoin; Male; Retrospective Studies; Severity of Illness Index; Surveys and Questionnaires; Treatment Failure

Isotretinoin is a vitamin-A derivative most commonly utilized in the treatment of severe recalcitrant nodulocystic acne. Derangement of lipid metabolism leading to increased triglyceride and cholesterol level has been reported after taking this drug. We report the case of a 43-year-old female with no identifiable risk factor for pancreatitis who developed acute pancreatitis associated with hyperlipidemia while being treated with isotretinoin for hidradenitis suppurativa. To our knowledge, this is the third reported case of isotretinoin-induced hyperlipidemia leading to acute pancreatitis.

Topics: Acute Disease; Adult; Female; Hidradenitis Suppurativa; Humans; Hyperlipidemias; Isotretinoin; Pancreatitis

Acne inversa (synonyms are hidradenitis suppurativa, pyodermia fistulans sinifica) is a chronic inflammatory disorder of the terminal hair follicles of the intertrigines. Abscesses and fistules develop mostly in both axillae, in the anogenital region, and under the breasts. The disease is common, but the right diagnosis is often missed. Local incision gives only a short relief of pain. The therapy of choice is wide local excision. We report on 12 patients with acne inversa who were surgically treated from 1991-1999 in our department. Surgical results and patient satisfaction were assessed on an average of 4.2 years. In all, 20 excisions in the axillae and 5 excisions anogenital were done. Seven patients were treated preoperatively with isotretinoin over at least 2 months. All patients could move their limbs without trouble. The cosmetic result was good in nine patients and three expressed dissatisfaction. Nine patients did not develop new lesions in the treated area. Three patients had new inflammations in both treated and previously uninvolved and therefore not resected regions. Wide local excision gives very good functional and cosmetic results. It usually heate long-lasting disease for nearly disabled patients. Isotretinoin reduces the disease activity and allows radical surgical treatment.

Topics: Adolescent; Adult; Axilla; Child; Female; Follow-Up Studies; Hidradenitis Suppurativa; Humans; Isotretinoin; Male; Patient Satisfaction; Perineum; Premedication

A patient with arthropathy associated with cystic acne, hidradenitis suppurativa, and perifolliculitis capitis abscedens et suffodiens who showed a dramatic response to isotretinoin is described. This, to our knowledge, is the first report documenting effective treatment of this condition, whose nosologic position with respect to other spondyloarthropathies associated with cutaneous disease is considered.

Topics: Acne Vulgaris; Acquired Hyperostosis Syndrome; Adult; Arthritis; Hidradenitis Suppurativa; Humans; Isotretinoin; Keratolytic Agents; Male; Scalp Dermatoses

Topics: Hidradenitis Suppurativa; Humans; Isotretinoin; Keratolytic Agents

A patient with Crohn's disease (CD) subsequently developed the clinical and histological features of hidradenitis suppurative (HS). So far, only five cases with such an association have been reported. Azathioprine (150 mg/d) and methylprednisolone (16 mg/d) for CD combined with isotretinoin (0.7 mg/kg) and periodic administration of antibiotics for HS were used. The treatment was satisfactory, and the patient is now in clinical remission for both diseases.

Topics: Adult; Anti-Bacterial Agents; Azathioprine; Crohn Disease; Drug Therapy, Combination; Hidradenitis Suppurativa; Humans; Isotretinoin; Male; Methylprednisolone

Topics: Adult; Contusions; Female; Hidradenitis Suppurativa; Humans; Isotretinoin