Treatment of hidradenitis suppurativa with rifampicin: have we forgotten tuberculosis?

Mendes-Bastos, P.; Macedo, R.; Duarte, R.

http://hdl.handle.net/10400.18/5468

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Authors

Mendes-Bastos, P.

Macedo, R.

Duarte, R.

Abstract(s)

Hidradenitis suppurativa (HS) is a chronic, recurrent and debilitating skin disease of the hair follicle that is accompanied by systemic inflammation. Treating HS is challenging, and therapeutic tools as diverse as topical and systemic antibiotics, biologics, intralesional steroids, surgical procedures or light and laser therapies are frequently needed. The combination of oral clindamycin and rifampicin has been suggested as a possible treatment regimen. Five studies have evaluated the efficacy of this combination, the majority of which reported the use of clindamycin 600 mg daily + rifampicin 600 mg daily with an average length of 10 consecutive weeks.1–5 In three out of four studies, 10-week follow-up yielded complete remission in 32% (32/116) of patients1–3; in another study, a 1-year follow-up demonstrated sustained efficacy in only seven of 26 patients.5 Scheinfeld has discussed why rifampicin is a key drug in the treatment of HS, pointing out its antibacterial and anti-inflammatory effects, its activity on bacterial biofilms, its effect against granulomas and its immunomodulatory properties on neutrophils. (...)