Data from a recent study shows that patients commonly choose different treatment for hidradenitis suppurativa, with acupuncture and other alternative methods, especially in a primary care setting. However, the most popular treatment is massage therapy.
HS manifests as a cutaneous disease predominantly seen in women, but presents in every age group. Patients with HS may experience significant QOL impairments, and the majority of patients suffer from comorbidities associated with the severity and persistence of the condition.
A full complement of diagnostic tests such as biopsy, ultrasonography, magnetic resonance imaging and lymphoscintigraphy are urgently needed for confirmation of the diagnosis. It is crucial that patients have an accurate understanding of their disease and that they take appropriate action if symptoms worsen. It is important to realize that no one test is 100% reliable, although for symptomatic patients, ultrasonography gives a higher accuracy compared to magnetic resonance imaging. Lymphoscintigraphy enables us to achieve a higher diagnostic yield (100%) and to identify the most relevant lymph nodes involved, being a valuable staging tool.
The prevalence of HS is quite high in the United States, particularly among people in their 30s, and in women but not exclusively to African American or Hispanic races.
Based on the results of the study we are able to believe that hidradenitis suppurativa of the face may be treated by the use of non-invasive techniques, like physiotherapy.
It is important to recognize the presence of HS in patients with acute febrile episodes to make them less susceptible to being misdiagnosed as having an infection.
RF is a versatile technology allowing for treatment in areas of the body with challenging access or in the extremities. Furthermore, the minimally invasive and minimal exposure surgery makes RF an excellent, safer and more convenient treatment modality for patients with refractory disease, thereby making RF an efficacious adjunct to the surgical approach. This article describes the most recent developments of RF treatment in HS and other diseases.
We found that the use of laser can heal chronic hidradenitis suppurativa, especially in patients with chronic hidradenitis suppurativa with fistulas. Laser therapy has the advantage of providing pain relief and wound healing and it is suggested that laser is an excellent adjuvant treatment option for hidradenitis suppurativa that does not respond to anti-inflammatory treatment.
Radiofrequency is effective and well tolerated for treatment of HS. Although there was no significant reduction in symptom severity, there was a significant decrease in overall disease severity and improvements in quality of life. Patients with severe active disease treated with radiofrequency reported improvement in their quality of life. A longer follow-up study may be needed to confirm long-term remission.
RF-based treatment for HS is safe with no increase in serious adverse effects or side effects, contrary to some reports; however, there remains no convincing evidence that RF-based treatment is preferable over cold-air machine treatment.
Treatment options for HS include radiofrequency ablation and carbon dioxide laser. The use of a radiofrequency generator allows for simultaneous manipulation of heat and coagulation within tissue that is targeted for treatment. In patients, radiofrequency-based ablation of HS is associated with an increased risk of damage to surrounding structures due to higher rates of vascular injury and postablative bleeding. Thermal damage and a reduction in tissue viability appear to be the primary mechanisms of tissue necrosis after radiosurgery, while coagulopathies (abnormalities in the coagulation system) seem to only contribute to complications following radiosurgery for treatment of HS. Thus, radiosurgery is not a viable option for treating HS in patients.
Thermochemical RFB is sometimes used as a supplemental treatment for HID in combination with conventional treatments. More studies are needed to evaluate RFB as monotherapy, especially in case-control studies with well-defined randomized controlled trials.