Fast Five Quiz: Hidradenitis Suppurativa Management

William D. James, MD


January 27, 2023

Figure 1. Hidradenitis suppurativa of the breast.

According to recently published guidelines, oral tetracyclines, such as doxycycline, 100 mg for 12 weeks, are recommended for the initial management of hidradenitis suppurativa in its early stages.

Other recommendations include considering clindamycin 1% solution for affected skin regions, recording Hurley stage (I, II, or II) for the areas most affected, assessing pain and treating as necessary, measuring quality of life and lesion count in the last month, screening for depression and anxiety, and providing patient information and referrals for smoking cessation and weight management as needed.

Twice-daily oral clindamycin, 300 mg and rifampicin, 300 mg for 10-12 weeks is the next step in the treatment algorithm when the initial treatment response is inadequate, followed by acitretin, 0.3-0.5 mg/kg or possibly dapsone.

Learn more about the medical management of hidradenitis suppurativa.


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