Martora Fabrizio, Annunziata Maria Carmela, Potestio Luca, Battista Teresa, Ruggiero Angelo, Megna Matteo
Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy.
Clin Cosmet Investig Dermatol. 2024 May 30;17:1275-1279. doi: 10.2147/CCID.S468268. eCollection 2024.
This case study outlines the management of a 24-year-old male with a history of juvenile nephronophthisis who underwent renal transplantation at age 12 and later required dialysis at 18 due to chronic rejection and hypertension. Subsequently, the patient developed severe Hidradenitis Suppurativa (HS) affecting the axillary, groin, and gluteal regions. Despite undergoing various systemic and intravenous antibiotic therapies, as well as Adalimumab treatment, the HS remained refractory. Adalimumab was discontinued due to a detected ejection fraction of 45% during cardiologic follow-up, likely due to COVID-19 related myocarditis. Following this, the patient was initiated on secukinumab therapy, initially undergoing an induction phase followed by maintenance dosing. Significant improvements were observed in quality of life, pain scores, and HS activity after 5 weeks of secukinumab therapy, with sustained benefits at the 6-month follow-up. Secukinumab was well tolerated, with no reported adverse events. This case underscores the effectiveness and safety of secukinumab as a therapeutic option for refractory HS, particularly in patients with comorbidities such as renal transplant recipients.
本病例研究概述了一名24岁男性的治疗情况,该男性有青少年肾单位肾痨病史,12岁时接受了肾移植,18岁时因慢性排斥反应和高血压而需要透析。随后,该患者患上了严重的化脓性汗腺炎(HS),累及腋窝、腹股沟和臀部区域。尽管接受了各种全身和静脉抗生素治疗以及阿达木单抗治疗,但HS仍然难治。在心脏科随访期间检测到射血分数为45%,可能是由于与COVID-19相关的心肌炎,阿达木单抗被停用。在此之后,患者开始接受司库奇尤单抗治疗,最初经历诱导期,随后进行维持给药。司库奇尤单抗治疗5周后,患者的生活质量、疼痛评分和HS活动有显著改善,在6个月的随访中持续受益。司库奇尤单抗耐受性良好,未报告不良事件。本病例强调了司库奇尤单抗作为难治性HS治疗选择的有效性和安全性,特别是对于有合并症的患者,如肾移植受者。