University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC.
Department of Internal Medicine, Carolinas Medical Center, Chapel Hill, NC.
Dermatol Surg. 2020 May;46(5):685-689. doi: 10.1097/DSS.0000000000002112.
Hidradenitis suppurativa (HS) is a chronic, inflammatory condition characterized by recurrent nodules, sinus tracts, comedones, and scarring. Hidradenitis suppurativa is often associated with pain and decreased quality of life. Limited clinical trial data exist regarding the management of acute HS lesions, but clinical experience and a prospective case series suggest that intralesional triamcinolone may be useful.
To compare the efficacy of intralesional triamcinolone to placebo for the treatment of HS inflammatory lesions.
This is a double-blind, randomized, placebo-controlled trial comparing intralesional triamcinolone 10 mg/mL, triamcinolone 40 mg/mL, and normal saline (NS). Thirty-two subjects at University of North Carolina Dermatology and Skin Cancer Centers were enrolled for a total of 67 lesions. Subjects reported pain scores, days to resolution, and satisfaction on a standardized survey over a 14-day period.
When intralesional injections of triamcinolone 10 mg/mL, triamcinolone 40 mg/mL, and NS were compared, no significant difference was found for days to HS inflammatory lesion clearance, pain reduction at Day 5, or patient satisfaction.
No statistically significant difference was found between varying concentrations of triamcinolone and NS for the treatment of HS lesions. Steroid injections may be less effective for the management of acute HS than typically presumed.
化脓性汗腺炎（HS）是一种慢性炎症性疾病，其特征为反复出现结节、窦道、粉刺和瘢痕。化脓性汗腺炎常伴有疼痛和生活质量下降。目前关于急性 HS 病变的管理，仅有有限的临床试验数据，但临床经验和一项前瞻性病例系列研究表明，皮损内注射曲安奈德可能是有用的。
比较皮损内注射曲安奈德与安慰剂治疗 HS 炎症性病变的疗效。
这是一项双盲、随机、安慰剂对照试验，比较了 10mg/mL 曲安奈德、40mg/mL 曲安奈德和生理盐水（NS）。北卡罗来纳大学皮肤科和皮肤癌中心的 32 名受试者共纳入 67 处病变。受试者在 14 天内通过标准化调查报告疼痛评分、病变消退时间和满意度。
当比较 10mg/mL 曲安奈德、40mg/mL 曲安奈德和 NS 的皮损内注射时，HS 炎症性病变清除时间、第 5 天疼痛减轻程度或患者满意度均无显著差异。
不同浓度的曲安奈德与 NS 治疗 HS 病变之间未发现统计学显著差异。与通常的假设相比，类固醇注射可能对急性 HS 的治疗效果较差。
