Intralesional triamcinolone for flares of hidradenitis suppurativa (HS): A case series

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the hair follicle. Standard practice of managing acute flares with corticosteroid injection lacks scientific evidence. Objective: We sought to assess the outcomes of routine treatment using intralesional triamcinolone (triamcinolone acetonide 10 mg/mL) in the management of acute flares in HS. Methods: This was a prospective case series evaluating the effect of intralesional corticosteroids for alleviation of acute flares in HS. Physician- and patient-reported outcomes were noted. Results: Significant reductions in physician-assessed erythema (median score from 2-1, P <.0001), edema (median score from 2-1, P <.0001), suppuration (median score from 2-1, P <.0001), and size (median score from 3-1, P <.0001) was demonstrated at follow-up. A significant difference in patient-reported pain visual analog scale scores occurred after 1 day (from 5.5-2.3, P <.005) and from day 1 to day 2 (from 2.3-1.4, P <.002). Limitations: Small study size, open single-arm design, and short follow-up time are the limitations of this study. Conclusion: Intralesional injection of corticosteroids is perceived as beneficial by physicians and patients in the management of HS flares by reducing pain after 1 day and signs of inflammation approximately 7 days later.