Division of Dermatology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA.
Int J Dermatol. 2021 Feb;60(2):217-221. doi: 10.1111/ijd.15124. Epub 2020 Aug 17.
Hidradenitis suppurativa (HS) is a chronic inflammatory disorder of hair follicles characterized by recurrent, painful nodules, abscesses, and sinus tracts ("tunnels") typically refractory to treatment. This debilitating condition results in poor quality of life due to high disease burden. Intralesional triamcinolone (ILTAC) is a standard of care for acute inflammation and drainage associated with HS; however, the optimal therapeutic dose has not been determined. We investigated the utility of high-dose ILTAC 20 mg/ml (ILTAC-20) or 40 mg/ml (ILTAC-40), for inflammatory lesions of HS.
A retrospective chart review and telephone questionnaire included HS patients treated with high-dose ILTAC-20 or ILTAC-40 between April and December 2018. Patients with Hurley stages I-III were included. Data were obtained from electronic medical records and telephone interviews. A short questionnaire pertained to satisfaction with therapy, changes of disease state, and modifications in quality of life.
Of 54 patients interviewed, the average age was 36.9 ± 11.6 years; 36 (66.7%) were female. Forty patients (76.9%) were very satisfied (n = 19) or satisfied (n = 21) with high-dose ILTAC therapy. Fifty patients (92.6%) demonstrated improvements in disease state, and 41 patients (75.9%) experienced enhanced quality of life. Forty-four patients (86.3%) were amenable to additional injections of high-dose ILTAC, if clinically indicated. No adverse effects of therapy were reported.
The majority of patients reported improvements in disease state, quality of life, and overall satisfaction after administration of high-dose ILTAC (20-40 mg/ml). These findings support the use of high-dose ILTAC for acute lesions of HS.
化脓性汗腺炎（HS）是一种慢性毛囊炎症性疾病，其特征为反复发作、疼痛的结节、脓肿和窦道（“隧道”），通常对治疗有抗性。这种使人虚弱的疾病会因疾病负担高而导致生活质量下降。皮损内曲安奈德（ILTAC）是治疗 HS 相关急性炎症和引流的标准治疗方法；然而，尚未确定最佳治疗剂量。我们研究了高浓度（20 mg/ml，ILTAC-20）和高浓度（40 mg/ml，ILTAC-40）皮损内曲安奈德治疗 HS 炎症性病变的疗效。
回顾性病历审查和电话问卷调查纳入了 2018 年 4 月至 12 月期间接受高浓度 ILTAC-20 或 ILTAC-40 治疗的 HS 患者。纳入 Hurley 分期 I-III 期的患者。数据来自电子病历和电话访谈。简短的问卷涉及对治疗的满意度、疾病状态的变化和生活质量的改变。
接受访谈的 54 例患者中，平均年龄为 36.9±11.6 岁；36 例（66.7%）为女性。40 例（76.9%）患者对高浓度 ILTAC 治疗非常满意（n=19）或满意（n=21）。50 例（92.6%）患者的疾病状态得到改善，41 例（75.9%）患者的生活质量得到提高。44 例（86.3%）患者如果临床需要，可接受高浓度 ILTAC 的进一步注射。未报告治疗的不良反应。
大多数患者在接受高浓度 ILTAC（20-40 mg/ml）治疗后，疾病状态、生活质量和总体满意度均有改善。这些发现支持高浓度 ILTAC 用于 HS 的急性病变。
