Medical care of follicular forms, initial treatment, Centre de Preuves en Dermatologie

Guidelines hidradenitis suppurativa Updated on Aug 19

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Follicular forms
First-line treatment

Back to decision-making tree Print last updated on 22/09/2024

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)

Pristinamycin
(1g 3×/j)

→ for 7 days

read antibiotherapy

Prophylactic treatment

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

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:

fusiform
or marsupialisation

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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