Masson Rahul, Ma Elaine, Parvathala Neha, Shih Terri, Atluri Swetha, Hogeling Marcia, Hughes Meagan, Sayed Christopher J, Shi Vivian Y, Hsiao Jennifer L
Keck School of Medicine of USC, University of Southern California, Los Angeles, California, USA.
David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.
Pediatr Dermatol. 2023 Sep-Oct;40(5):775-788. doi: 10.1111/pde.15404. Epub 2023 Aug 1.
Hidradenitis suppurativa (HS) is a chronic, inflammatory skin condition that has been insufficiently studied in the pediatric population. Timely and effective medical treatments may improve quality of life, mitigate disease burden, and prevent the need for invasive procedural interventions such as surgical excisions. However, there is a paucity of research on the efficacy of medical management strategies for HS in children and adolescents. The aim of this study was to perform a systematic review of the literature on the efficacy and safety of medical treatments for HS in patients <18 years of age. In April 2022, MEDLINE and EMBASE databases were searched for articles on the efficacy of medical treatments for HS in the pediatric population. Between 1984 and 2022, 35 articles (101 patients) met the inclusion criteria. Most patients had Hurley Stage II disease (46.7%, 35/75) followed by Stage I (36%, 27/75), and Stage III (17.3%, 13/75). 100% (23/23) of patients responded to antibiotics, 100% (8/8) to finasteride, 93.9% (31/33) to biologics, 80% (4/5) to oral retinoids, and 50% (6/12) to metformin. Overall, this study demonstrates that medical treatment regimens can improve HS symptoms in pediatric patients, but the extent of improvement is unclear, and the results were largely based on case reports or case series. Prospective studies are warranted to better understand the efficacy and safety of medical treatments for pediatric HS. Clinical trials of HS therapies need to be inclusive of pediatric patients to help define the optimal timing of treatment initiation and guide patient selection.
化脓性汗腺炎（HS）是一种慢性炎症性皮肤病，在儿科人群中尚未得到充分研究。及时有效的药物治疗可能会改善生活质量、减轻疾病负担，并避免诸如手术切除等侵入性程序干预的必要性。然而，关于儿童和青少年HS药物管理策略疗效的研究很少。本研究的目的是对18岁以下患者HS药物治疗的疗效和安全性进行系统的文献综述。2022年4月，检索了MEDLINE和EMBASE数据库中关于儿科人群HS药物治疗疗效的文章。在1984年至2022年期间，有35篇文章（101例患者）符合纳入标准。大多数患者患有Hurley II期疾病（46.7%，35/75），其次是I期（36%，27/75）和III期（17.3%，13/75）。100%（23/23）的患者对抗生素有反应，100%（8/8）对非那雄胺有反应，93.9%（31/33）对生物制剂有反应，80%（4/5）对口服用维甲酸有反应，50%（6/12）对二甲双胍有反应。总体而言，本研究表明药物治疗方案可以改善儿科患者的HS症状，但改善程度尚不清楚，结果主要基于病例报告或病例系列。有必要进行前瞻性研究，以更好地了解儿科HS药物治疗的疗效和安全性。HS治疗的临床试验需要纳入儿科患者，以帮助确定最佳治疗起始时间并指导患者选择。
