Department of Dermatovenereology, Third Faculty of Medicine, Charles University, Prague, Czech Republic.
Int J Dermatol. 2010 Dec;49(12):1445-9. doi: 10.1111/j.1365-4632.2010.04638.x.
Hidradenitis suppurativa is a chronic suppurative condition featuring inflammatory nodules, fistulas and scars. It occurs predominantly in the axillae and groin. The disease is poorly responsive to any treatment and is connected with significant morbidity. Systemic therapy, including oral antibiotics, retinoids and antiandrogens, usually has only limited effect. Surgical treatment of affected areas is necessary in advanced stages.
Several reports support the beneficial effect of tumor necrosis factor-α (TNF-α) antagonists for the treatment of severe hidradenitis suppurativa. By contrast with data on infliximab and etanercept, data describing the potential positive influence of adalimumab on disease outcome are limited and refer to only small cohorts of patients.
Eight patients with severe, recalcitrant hidradenitis were treated for 1 year with adalimumab in a standard regimen and were subsequently followed for 1 year.
All patients improved within 4-6 weeks and laboratory parameters of C-reactive protein (CRP) and leukocyte count reduced significantly during treatment. Three patients demonstrated long-lasting improvement and five showed recurrences several months after discontinuation of the therapy. The average recurrence-free interval was 9.5 months.
Adalimumab is suitable for the long-term treatment of hidradenitis suppurativa and presents a further conservative treatment approach.
化脓性汗腺炎是一种慢性化脓性疾病，表现为炎症性结节、瘘管和瘢痕。它主要发生在腋窝和腹股沟。这种疾病对任何治疗都反应不佳，且与显著的发病率有关。包括口服抗生素、类维生素 A 和抗雄激素在内的全身治疗通常仅具有有限的效果。在晚期需要对受影响的区域进行手术治疗。
有几项报告支持肿瘤坏死因子-α（TNF-α）拮抗剂对严重化脓性汗腺炎的治疗效果。与英夫利昔单抗和依那西普的数据相比，描述阿达木单抗对疾病结局可能产生积极影响的数据有限，且仅涉及小队列的患者。
8 例严重、难治性化脓性汗腺炎患者接受阿达木单抗标准方案治疗 1 年，随后随访 1 年。
所有患者在 4-6 周内均有改善，且在治疗期间 C 反应蛋白（CRP）和白细胞计数等实验室参数显著降低。3 例患者表现出持久改善，5 例患者在停药后数月内复发。无复发的平均间隔时间为 9.5 个月。
阿达木单抗适合化脓性汗腺炎的长期治疗，提供了一种更保守的治疗方法。
