Abstract：
BACKGROUND:Paradoxical hidradenitis suppurativa (HS) induced by biologic agents (BA) is scarcely reported. OBJECTIVE:We sought to describe the clinical characteristics and outcome of patients developing paradoxical HS under BA. METHODS:This was a multicenter nationwide retrospective study asking physicians to report all cases of HS, confirmed by a dermatologist, occurring during treatment of an inflammatory disease by a BA. RESULTS:We included 25 patients (15 inflammatory rheumatism, 9 Crohn's disease, 1 psoriasis) treated by 5 BA (adalimumab = 12, infliximab = 6, etanercept = 4, rituximab = 2, tocilizumab = 1). Median duration of BA exposure before HS onset was 12 (range 1-120) months. Patients were mostly Hurley stage I (n = 13) or II (n = 11). Simultaneously to HS or within 1 year, 11 patients developed additional inflammatory diseases, including paradoxical reactions (psoriasis = 9, Crohn's disease = 3, alopecia areata = 1, erythema elevatum diutinum = 1). Complete improvement of HS was more frequently obtained after BA discontinuation or switch (n = 6/10, 60%) rather than maintenance (n = 1/14, 7%). Reintroducing the same BA resulted in HS relapse in 3 of 3 patients. LIMITATIONS:Retrospective nature and lack of complete follow-up for some patients are limitations. CONCLUSION:HS is a rare paradoxical adverse effect of BA, but fortuitous association cannot be excluded in some cases. We observed a trend toward better outcome when the BA was discontinued or switched.
journal_name
J Am Acad Dermatoljournal_title
Journal of the American Academy of Dermatologyauthors
Faivre C,Villani AP,Aubin F,Lipsker D,Bottaro M,Cohen JD,Durupt F,Jeudy G,Sbidian E,Toussirot E,Badot V,Barbarot S,Debarbieux S,Delaporte E,Goegebeur G,Morel J,Nassif A,Duru G,Jullien D,French Society of Dermatologydoi
10.1016/j.jaad.2016.01.018subject
Has Abstractpub_date
2016-06-01 00:00:00pages
1153-9issue
6eissn
0190-9622issn
1097-6787pii
S0190-9622(16)00066-9journal_volume
74pub_type
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