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Treatment of Hidradenitis Suppurativa with Intense Pulsed Light: A Prospective Study

Highton, Lyndsey M.A., B.M.B.Ch.; Chan, Woan-Yi M.Sc., M.Ed.; Khwaja, Nadeem M.B.Ch.B., M.D.; Laitung, J. K. G. M.B.Ch.B., Ch.M.

Plastic & Reconstructive Surgery: August 2011 - Volume 128 - Issue 2 - pp 459-466
doi: 10.1097/PRS.0b013e31821e6fb5
Reconstructive: Trunk: Original Articles

Background: Hidradenitis suppurativa is a chronic skin condition characterized by recurrent inflammation and infection of skin in intertriginous areas containing apocrine glands. Intense pulsed light uses high-energy broad-spectrum light. Current applications include hair removal and the treatment of acne vulgaris, which has a pathogenesis similar to that of hidradenitis suppurativa. The authors conducted a study to determine whether intense pulsed light is an effective treatment for hidradenitis suppurativa.

Methods: Eighteen patients were randomized to treatment of one axilla, groin, or inframammary area with intense pulsed light two times per week for 4 weeks using a Harmony Laser. The contralateral side received no treatment and acted as a control. The response to treatment was assessed using a validated examination and clinical photographs, and by measuring patient satisfaction on a Likert scale.

Results: After treatment, there was a significant improvement in the mean examination score that was maintained at 12 months (p < 0.001, logistical regression analysis). The improvement was confirmed by independent assessment of clinical photographs (interrater reliability, 0.79; p < 0.001). Patients reported high levels of satisfaction with the treatment. There was no concurrent improvement on the untreated control side.

Conclusions: This small study suggests that intense pulsed light may be an effective treatment for hidradenitis suppurativa. It could be added to treatments used for this condition, particularly for patients keen on avoiding surgery and those with groin and inframammary disease. Further studies are required to confirm the efficacy and mechanism of action of intense pulsed light in hidradenitis suppurativa.

Fulwood, Preston, United Kingdom

From the Department of Plastic Surgery, Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital.

Received for publication November 26, 2010; accepted February 8, 2011.

Presented at the British Association of Plastic, Reconstructive and Aesthetic Surgery Summer Scientific Meeting, in Leeds, United Kingdom, July 1 through 3, 2009; the 11th Congress of the European Society of Plastic Reconstructive and Aesthetic Surgery, in Rhodes, Greece, September 20 through 26, 2009; and the 29th Annual Scientific Conference of the American Society for Laser Medicine and Surgery, April 1 through 5, 2009.

Disclosure: The authors have no financial interest to declare in relation to the content of this article.

Lyndsey Highton, M.A., B.M.B.Ch., Department of Plastic Surgery, Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Sharoe Green Lane, Fulwood, Preston PR2 9HT, United Kingdom, lyndseyhighton@hotmail.com

©2011American Society of Plastic Surgeons