The effect of smoking and age on the response to first-line therapy of hidradenitis suppurativa: An institutional retrospective cohort study
详细信息 查看全文
- 作者：George Denny ; MDb ; manadkat@dom.wustl.edu ; Milan J. Anadkat ; MDa ; b
- 关键词：acne inversa ; first-line treatment ; hidradenitis suppurativa ; increased age ; medical therapy ; patient response ; smoking
- 刊名：Journal of the American Academy of Dermatology
- 出版年：2017
- 出版时间：January 2017
- 年：2017
- 卷：76
- 期：1
- 页码：54-59
- 全文大小：160 K
- 卷排序：76
文摘
Treatment for hidradenitis suppurativa is often empiric and inadequate, and determining which patients will respond is difficult.ObjectiveWe sought to determine which patient factors are associated with a positive response to first-line medical therapy.MethodsA single-center retrospective cohort study of all patients with hidradenitis suppurativa seen between January 1, 1992, and October 1, 2014, was conducted. Response to first-line medical therapy (oral/topical antibiotics, intralesional corticosteroids, and topical washes) was examined at follow-up within 6 months of initiating therapy. A multivariate binary logistic regression model was built examining response to treatment and the interplay of patient factors and treatment initiated.ResultsIn all, 198 patients were included in the final model. Nonsmokers (odds ratio 2.634, 95% confidence interval 1.301-5.332, P = .007) and older individuals (odds ratio 1.046 for each additional year, 95% confidence interval 1.020-1.072, P < .001) were more likely to have improvement at follow-up. In addition, current smokers differed significantly from nonsmokers in several regards.LimitationsThe retrospective nature of this study is a limitation, as is relying on classification of disease severity from physical examination findings in some patients.ConclusionsThe results of this study suggest that clinicians may be able to more accurately predict which patients with hidradenitis suppurativa will respond to first-line medical therapy, and which patients may require therapy escalation.