Intralesional Triamcinolone for Fistulous Tracts in Hidradenitis Suppurativa: An Uncontrolled Prospective Trial with Clinical and Ultrasonographic Follow-Up
Intralesional Triamcinolone for Fistulous Tracts in Hidradenitis Suppurativa: An Uncontrolled Prospective Trial with Clinical and Ultrasonographic Follow-Up
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DOI：
10.1159/000499934
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发表时间：
2020-02-01
期刊：
影响因子：
3.4
通讯作者：
Carlos Pascual, Jose
中科院分区：
文献类型：
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作者：
Alvarez, Pedro;Javier Garcia-Martinez, F.;Carlos Pascual, Jose
背景：关于局部使用曲安奈德（ILT）治疗化脓性汗腺炎（HS）瘘管的证据很少。目的：评价超声与ILT治疗HS患者单发瘘病变的临床疗效。方法：进行了一项前瞻性开放标签研究，以评估ILT （40mg /mL）对HS瘘管的疗效。于2016年8月至2018年8月连续招募到我科就诊的患者（仅限于Hurley II期）。他们接受了单次注射ILT作为唯一的治疗。在基线和90天对病变进行临床和超声评估。结果：53例伴有瘘管的HS患者中，女性36例（67.9%），吸烟者30例（56.6%），肥胖或超重36例（67.9%）（体重指数>= 25）。中位Sartorius评分为9.0 (IQR 9.0-36.0)，病灶治疗的中位持续时间为6个月（IQR 3.0-12.0）。瘘道注射曲安奈德40 mg/mL 0.5 mL。7例患者失访。90 d时，20例（43.5%）病变表现为临床和超声消退，13例（28.3%）病变仅表现为临床消退并坚持超声检查，13例（28.3%）病变在临床和超声检查均持续。平均临床尺寸从17.0减小到5.1 mm (p < 0.0001)，超声平均长度从16.0减小到8.6 mm （p < 0.0001）。局限性：样本量小，无对照组。结论：我们的研究表明ILT对HS的小瘘管是有益的。
Background: There is little evidence on the use of intralesional triamcinolone (ILT) for managing fistulous tracts in hidradenitis suppurativa (HS). Objective: To assess the clinical and ultrasound response to ILT for single fistulous lesions in HS patients. Methods: A prospective open-label study was conducted to assess response to ILT (40 mg/mL) for fistulous tracts in HS. Consecutive patients (Hurley II stage exclusively) presenting to our department were recruited from August 2016 to August 2018. They received a single injection of ILT as the sole treatment. Lesions were assessed clinically and by ultrasound at baseline and 90 days. Results: Of the 53 included HS patients with fistulous tracts, 36 (67.9%) were women, 30 (56.6%) were smokers, and 36 (67.9%) were obese or overweight (body mass index >= 25). Median Sartorius score was 9.0 (IQR 9.0-36.0), and median duration of the lesion treated was 6 months (IQR 3.0-12.0). Fistulous tracts were injected with 0.5 mL triamcinolone 40 mg/mL. Seven patients were lost to follow-up. At 90 days, 20 (43.5%) lesions showed clinical and ultrasound resolution, 13 (28.3%) showed only clinical resolution while persisting on ultrasound, and 13 (28.3%) persisted both clinically and on ultrasound. Mean clinical size decreased from 17.0 to 5.1 mm (p < 0.0001), while mean length on ultrasound decreased from 16.0 to 8.6 mm (p < 0.0001). Limitations: Small sample size and no control group. Conclusions: Our study suggests that ILT is beneficial for small fistulous tracts in HS.