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Centre of Evidence of Dermatology Best practice guidelines

Guidelines hidradenitis suppurativa Updated on august 2019

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The information provided by this website comes from sources deemed reliable. However, the French Dermatology Society recommends that the user ensure the validity of this information. Some may prove to be erroneous or be subject to typos or display errors.

The use of this data is under the sole responsibility of the user. The French Dermatology Society cannot be blamed for a misinterpretation of the data provided by the site, or in the event of erroneous information. This decision tree and all the contents of this site have been developed in the context of updated data from science according to the HAS methodology, expert opinions and reviewers of the various documents and in the context of the French healthcare system.


Follicular forms
First-line treatment

Back to decision-making tree Print last updated on 13/02/2020

Initial treatment

Suggest the same regimen as for Hurley stage Ⅰ ≥ 4 outbreaks/year:

During outbreaks:

  • Cleansing with soap and water
  • Amoxicillin-clavulanic acid
    50 mg/kg/d (1 g 3×/d; maximum 4.5 g)

OR

  • Pristinamycin
    (1g 3×/j)

→ for 7 days

read antibiotherapy

Prophylactic treatment

  • Cyclin
    (doxycycline 100 mg/d [C] ou lymecycline 300 mg/d)

OR

  • Co-trimoxazole [A]
    400/80 (1 cp/d) [C]

→ revaluation at 6 months

+ delivery of prescriptions in advance

During outbreaks, recommendations are identical as for the initial prescription.

+ during outbreaks: incision and drainage to relieve pain.


In case of relapse at same location

Limited excision:

read surgical treatment


A
In cases of treatment failure, intolerance or contraindication for cyclins antibiotics (risk of serious toxidermia)
B
Medical and surgical concertation meeting specifically on HS
C
Double dose if weight > 80 kg
D
MA, but not reimbursed
E
No MA
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