Hidradenitis suppurativa, report with dual therapy: small molecules and biological therapy
DOI:
https://doi.org/10.5281/zenodo.14617170Keywords:
Hidradenitis Suppurativa, Antibodies, Monoclonal, Humanized, Janus Kinase, Drug Therapy, CombinationAbstract
Abstract
Background: Hidradenitis suppurativa is an immune-mediated inflammatory disease that affects the pilosebaceous-apocrine unit, characterized by deep abscesses, painful nodules, and fistulas that connect them to each other or to the surface. This leads to infections that are difficult to control, abnormal healing, retractile tracts, and painful ulcers, complicating its management and affecting the patient’s wellbeing, favoring the development of depression and anxiety. Despite therapeutic advances, the available treatments offer inconsistent results, especially in advanced stages.
Clinical case: A 27-year-old female patient with five years of evolution of this condition in modified Hurley stage III is presented. Due to lack of response to conventional therapies, treatment with an anti-IL-17 biologic was started, with limited improvement. Due to the persistence of symptoms and functional impairment, a JAK inhibitor was added, achieving a favorable response within four weeks, with a reduction in pain as measured by the EVA scale, quality of life index (DLQI), and severity according to the modified Hurley scale.
Conclusion: Combined therapy mediated by cytokines and humoral response cells is proposed as an effective therapeutic strategy in patients with hidradenitis suppurativa in advanced stages, particularly in those with retractile and fistulous lesions (Hurley stages II and III), to improve clinical response in chronic or refractory cases.
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