Esme Pelin, Akoglu Gulsen, Caliskan Ercan
Department of Dermatology and Venereology, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey.
Skin Appendage Disord. 2021 Jan;7(1):58-61. doi: 10.1159/000511284. Epub 2020 Dec 9.
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease of hair follicles which usually affects patients' quality of life negatively. Although there are various therapeutic approaches including topical and systemic antibiotics, retinoids, biological agents, and also surgical modalities, there is no curative treatment option and clinical management of HS is still challenging.
Herein, we present a 43 year-old man with HS who had used different treatments in 15 years. The patient showed improvement initially with adalimumab, then exhibited secondary unresponsiveness after 18 months. While worsening of HS was recorded due to increased discharge under secukinumab, no additional benefit was observed with methotrexate. He was not willing to undergo surgical procedures due to previous surgical experience. Finally, certolizumab pegol has been started to patient with similar dosing to psoriasis patients. Sartorius, 10-point visual analogue scale (VAS), and dermatological life quality index (DLQI) scores regressed from 171 to 105, 9/10 to 3/10, and 27 to 19 after 3 months with certolizumab pegol treatment.
DISCUSSION/CONCLUSION: Certolizumab pegol is a humanized antigen-binding fragment of a monoclonal antibody which binds to TNF-alpha. However, certolizumab pegol is only approved for plaque psoriasis in dermatology; it is likely to be a promising effective agent for HS, especially in challenging cases.
化脓性汗腺炎（HS）是一种毛囊慢性炎症性皮肤病，通常会对患者的生活质量产生负面影响。尽管有多种治疗方法，包括局部和全身使用抗生素、维甲酸、生物制剂以及手术方式，但目前尚无治愈性治疗方案，HS的临床管理仍然具有挑战性。
在此，我们报告一名43岁的HS男性患者，他在15年里接受了不同的治疗。患者最初使用阿达木单抗治疗有改善，但18个月后出现继发性无反应。在使用司库奇尤单抗治疗期间，由于分泌物增多，HS病情恶化，而甲氨蝶呤未观察到额外益处。由于之前的手术经历，他不愿意接受手术治疗。最后，开始给患者使用赛妥珠单抗，剂量与银屑病患者相似。使用赛妥珠单抗治疗3个月后，缝匠肌、10分视觉模拟量表（VAS）和皮肤病生活质量指数（DLQI）评分分别从171降至105、9/10降至3/10、27降至19。
讨论/结论：赛妥珠单抗是一种结合肿瘤坏死因子-α的单克隆抗体的人源化抗原结合片段。然而，赛妥珠单抗仅在皮肤科被批准用于斑块状银屑病；它可能是HS的一种有前景的有效药物，尤其是在具有挑战性的病例中。
