Topical clindamycin versus systemic tetracycline in the treatment of hidradenitis suppurativa

J Am Acad Dermatol. 1998 Dec;39(6):971-4. doi: 10.1016/s0190-9622(98)70272-5.

Abstract

Background: Antibiotics are often used to treat hidradenitis, but only topical clindamycin has been shown to be effective in a randomized controlled trial. The paucity of these trials may be the result of difficulties in disease assessment.

Objective: We compare topical clindamycin with systemic tetracycline in the treatment of hidradenitis suppurativa, and study clinical disease assessment.

Methods: A total of 46 patients with stage 1 or 2 hidradenitis suppurativa were treated in a double-blind, double dummy controlled trial.

Results: No significant difference was found between the two types of treatment. Patients' global assessment of disease was significantly worse than physician's assessment in 3 of 5 evaluations (P = .0096 to .015), but the correlation between patients' and physicians' assessments was satisfactory after only one visit (rs = .761 to .895). Soreness was the key factor in patients' overall assessment of the disease.

Conclusion: Systemic therapy with tetracyclines did not show better results than topical therapy with clindamycin. Subjective factors, particularly soreness, appear to be a key factor in patients' assessment of the disease and should, therefore, be included as an outcome variable in future therapy studies.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Administration, Cutaneous
  • Administration, Oral
  • Adult
  • Anti-Bacterial Agents / therapeutic use*
  • Clindamycin / therapeutic use*
  • Double-Blind Method
  • Female
  • Hidradenitis Suppurativa / drug therapy*
  • Humans
  • Male
  • Tetracycline / therapeutic use*
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Clindamycin
  • Tetracycline