Hidradenitis suppurativa treated with finasteride.
BACKGROUND
Hidradenitis suppurativa (HS) is a distressing condition for which no satisfactory treatment is available. Studies on hormonal mechanisms responsible for HS point towards altered end-organ sensitivity, probably related to the enzyme 5a reductase that converts testosterone to dihydrotestosterone. Finasteride, an inhibitor of type II 5a reductase, has been reported to be effective in recalcitrant HS.


OBJECTIVE
To study the effectiveness and tolerability of finasteride in patients with HS in a preliminary trial.


METHODS
Seven patients (five women and two men) with HS that was not responding well to antibiotics were treated with finasteride at a dose of 5 mg/day as monotherapy. Clinical response was assessed at regular intervals. Patients were followed up for periods varying from 8 months to 2 years.


RESULTS
Six patients improved significantly and three of them had complete healing of lesions. Two patients who were followed up for more than 1 year experienced remissions lasting 8-18 months. The drug was generally well tolerated; however, two women complained of breast enlargement.


CONCLUSIONS
The results of this preliminary study suggest that finasteride is an effective therapeutic option in HS.
Joseph
M A
MA
Department of Dermatology, St. John's Medical College Hospital, Bangalore, India. maryjoseph1@rediffmail.com
Jayaseelan
E
E
Ganapathi
B
B
Stephen
John
J
D058891:5-alpha Reductase Inhibitors; D000293:Adolescent; D000328:Adult; D004791:Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D018120:Finasteride / Q000009:adverse effects / Q000627:therapeutic use*; D005500:Follow-Up Studies; D017497:Hidradenitis Suppurativa / Q000188:drug therapy*; D006801:Humans; D008297:Male; D013997:Time Factors; D016896:Treatment Outcome
D058891:5-alpha Reductase Inhibitors; D004791:Enzyme Inhibitors; D018120:Finasteride