J Drugs Dermatol. 2020 Dec 1;19(12):1231-1234. doi: 10.36849/JDD.2020.5447.
Hidradenitis suppurativa (HS) is a chronic inflammatory disorder seen in adolescents and adults characterized by abscesses, sinus tracts and scarring, typically affecting intertriginous skin. Treatments often provide suboptimal control of the disease, and there are limited reports of therapies utilized in the pediatric population. There are no published guidelines or consensus for the treatment of pediatric HS.
To evaluate the clinical efficacy and safety of metformin as adjunctive treatment in adolescent patients with HS who have not responded to standard therapies at a single institution.
Retrospective chart review identified 16 pediatric patients treated with metformin as adjunctive therapy for HS. Baseline scores were Hurley 1 in eleven (69%) and Hurley 2 in five (31%) patients. Follow-up visit data showed six (67%) patients were Hurley 1 and three (33%) patients were Hurley 2; five patients showed improvement on metformin with decreased frequency of flares, and five patients had no improvement. Six patients were lost to follow up or data was not available. Two patients discontinued metformin therapy due to side effects, including gastrointestinal distress and mood changes; the third patient discontinued due to lack of improvement. Two patients had mildly elevated liver transaminases prior to metformin initiation which improved while on metformin therapy.
For some pediatric patients, metformin as an adjunctive therapy may help improve control of HS with minimal side effects. Adequately designed and controlled studies are needed to further evaluate the role of metformin, and efficacy, tolerability and safety in the pediatric HS patients. J Drugs Dermatol. 2020;19(12): doi:10.36849/JDD.2020.5447.
化脓性汗腺炎（HS）是一种发生于青少年和成人的慢性炎症性疾病，其特征为脓肿、窦道和瘢痕形成，通常影响皱褶部位的皮肤。治疗方法通常无法充分控制疾病，且有关儿科人群中使用的疗法的报告有限。目前尚无治疗儿童 HS 的指南或共识。
评估二甲双胍作为单一机构中标准治疗方案未应答的青少年 HS 患者的辅助治疗的临床疗效和安全性。
回顾性病历审查确定了 16 例接受二甲双胍辅助治疗 HS 的儿科患者。基线评分中 11 例（69%）为 Hurley 1 级，5 例（31%）为 Hurley 2 级。随访时发现 6 例（67%）患者为 Hurley 1 级，3 例（33%）患者为 Hurley 2 级；5 例患者的二甲双胍治疗有改善，表现为病情发作频率降低，5 例患者无改善。6 例患者失访或数据不可用。2 例因副作用（包括胃肠道不适和情绪变化）停止使用二甲双胍，第 3 例因无改善而停药。2 例患者在开始使用二甲双胍前出现轻度肝转氨酶升高，在使用二甲双胍治疗期间得到改善。
对于一些儿科患者，二甲双胍作为辅助治疗可能有助于改善 HS 的控制，且副作用最小。需要设计和开展充分的研究，以进一步评估二甲双胍在儿科 HS 患者中的作用、疗效、耐受性和安全性。J 皮肤病药物学杂志。2020；19（12）：doi：10.36849/JDD.2020.5447。
