Volume 27, Issue 132, February 2023

The use of azithromycin and fusidic acid in the treatment of mild to moderate forms of hidradenitis suppurativa

Anas Fathuldeen¹, Fauwaz Fahad Alrashid¹, Fahaad Saad Alenazi², Fawwaz Freih Alshammrie³, Wael Saleh Alanazi⁴, Salem Fayez Alshaghdali⁴, Mohammed Abdulkarim Alduheim⁴, Rasheed Marzouq Abutaimah⁵, Bayan Redwan⁶, Halima Mustafa Elagib⁷, Saadeldin Ahmed Idris^8♦

¹Department of Surgery, College of Medicine, University of Hail, KSA
²Department of Pharmacology, College of Medicine, University of Hail, KSA
³Department of Dermatology, College of Medicine, University of Hail, KSA
⁴King Salman Specialist Hospital, Hail, KSA
⁵Department of Surgery, Alanwar Medical Hospital, Hail, KSA
⁶Department of Dermatology and Venereal Diseases, King Abdulaziz University, Jeddah, KSA
⁷Department of Pharmacology, College of Medicine, University of Hail, KSA & Department of Pharmacology, College of Pharmacy, Omdurman Islamic University, Khartoum, Sudan
⁸Department of Surgery, College of Medicine, University of Hail, KSA & Department of Surgery, Faculty of Medicine, Alzaeim Alazhari University, Khartoum, Sudan

^♦Corresponding author
Department of Surgery, College of Medicine, University of Hail, KSA & Department of Surgery, Faculty of Medicine, Alzaeim Alazhari University, Khartoum, Sudan

ABSTRACT

Background: Hidradenitis suppurativa is a chronic disease with universal spread and it has a major influence on the kind of patients’ life. Management should rely on the disease severity. Objective: We aimed to explore our experience with the use of topical fusidic acid and systemic azithromycin in mild to moderate forms of hidradenitis suppurativa (Hurley stage I and II). Materials and methods: A cohort study (June 2016 to June 2022) included all patients with mild or moderate forms of hidradenitis suppurativa (Hurley stage I and II). Patients with severe disease (stage III) were excluded. The outcome was measured by recurrence rate and patient satisfaction. Results: A- 113 patients, whose mean age was 32.4± 12.1 years, were included. There was female predominance. Disease prevalence was 0.032 per 100,000 of the clinic population. The mean disease duration was 4.1± 1.5 days, not affected by gender (𝑝 = 0.3). In stage I, 18 (38.3%) patients excellently responded and 22 (46.8%) had a good response. Whereas, in stage II, 21 (31.8%) patients excellently responded and 29 (43.9%) had a good response. The overall response was excellent and good in 39 (34.5%) and 51 (45.1%) patients, respectively. The differences between subgroups (stages I and II) in the efficacy was statistically significant (p-value 0.001). The disease recurred in 3 (2.7%) of patients with HS, whereas it was higher in those with stage II disease. Patient satisfaction with those treated by nonsurgical means was very good / excellent in 98% of patients. Conclusion: The treatment regimen used was shown to be effective. Thus, they can be a first-line option for the treatment of mild to moderate conditions of hidradenitis suppurativa.

Keywords: Hidradenitis suppurativa, Acne inversa, Treatment, Management, Azithromycin, Fusidic Acid

Medical Science, 2023, 27, e83ms2813

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DOI: https://doi.org/10.54905/disssi/v27i132/e83ms2813

Published: 11 February 2023