Isotretinoin in the treatment of hidradenitis suppurativa: a retrospective study

Abstract

Objective

Isotretinoin has been used off-label in hidradenitis suppurativa (HS) patients with variable results, making it difficult to predict which patients with HS are likely to benefit.

Material and Methods

We conducted a retrospective review of HS patients who presented to UCLA HS clinic between August 2009 and March 2018 and collected data on their demographics, reported history of isotretinoin treatment for HS, and treatment response. A number of patient variables were analyzed between the responders and non-responders to see if any were associated with a higher likelihood of a beneficial response.

Results

Of the 209 patients, 39 (18.7%) reported prior treatment with isotretinoin. A beneficial response to isotretinoin was reported by 14 (35.9%) patients, while 25 (64.1%) patients reported no response. When comparing responders to non-responders, responders were more likely to have a history of pilonidal cyst (p = .024). Having a concomitant history of regular or cystic acne did not appear to enhance HS treatment response to isotretinoin.

Conclusions

Our data suggest that for HS patients, having a history of pilonidal cyst is associated with a beneficial response to isotretinoin.

Keywords:

• isotretinoin
• hidradenitis suppurativa
• follicular occlusion

Disclosure statement

VYS is a stock shareholder of Learn Health, and has served as an advisor, investigator and/or speaker for Sanofi, Regeneron, AbbVie, Novartis, Pfizer, Leo, Dermira, Eli Lilly, SUN Pharma, Menlo Therapeutics, GpSkin, Burt’s Bees and Skin Actives Scientific. There were no financial incentives or transactions otherwise relevant to this manuscript. NP, SM, CH, AT, LC, TG, RB, and JLH report no conflicts of interest.

Additional information

Funding

This research was supported by NIH National Center for Advancing Translational Science (NCATS) UCLA CTSI Grant Number [UL1TR001881].