Kristen Fajgenbaum1, Lauren Crouse2, Li Dong3, Donglin Zeng3, Christopher Sayed4. 1. University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC. 2. Department of Internal Medicine, Carolinas Medical Center, Chapel Hill, NC. 3. Department of Biostatistics, UNC Gillings School of Global Public Health, Chapel Hill, NC. 4. Department of Dermatology, University of North Carolina School of Medicine, Chapel Hill, NC.
Abstract
BACKGROUND: Hidradenitis suppurativa (HS) is a chronic, inflammatory condition characterized by recurrent nodules, sinus tracts, comedones, and scarring. Hidradenitis suppurativa is often associated with pain and decreased quality of life. Limited clinical trial data exist regarding the management of acute HS lesions, but clinical experience and a prospective case series suggest that intralesional triamcinolone may be useful. OBJECTIVE: To compare the efficacy of intralesional triamcinolone to placebo for the treatment of HS inflammatory lesions. MATERIALS AND METHODS: This is a double-blind, randomized, placebo-controlled trial comparing intralesional triamcinolone 10 mg/mL, triamcinolone 40 mg/mL, and normal saline (NS). Thirty-two subjects at University of North Carolina Dermatology and Skin Cancer Centers were enrolled for a total of 67 lesions. Subjects reported pain scores, days to resolution, and satisfaction on a standardized survey over a 14-day period. RESULTS: When intralesional injections of triamcinolone 10 mg/mL, triamcinolone 40 mg/mL, and NS were compared, no significant difference was found for days to HS inflammatory lesion clearance, pain reduction at Day 5, or patient satisfaction. CONCLUSION: No statistically significant difference was found between varying concentrations of triamcinolone and NS for the treatment of HS lesions. Steroid injections may be less effective for the management of acute HS than typically presumed.
RCT Entities:
BACKGROUND:Hidradenitis suppurativa (HS) is a chronic, inflammatory condition characterized by recurrent nodules, sinus tracts, comedones, and scarring. Hidradenitis suppurativa is often associated with pain and decreased quality of life. Limited clinical trial data exist regarding the management of acute HS lesions, but clinical experience and a prospective case series suggest that intralesional triamcinolone may be useful. OBJECTIVE: To compare the efficacy of intralesional triamcinolone to placebo for the treatment of HS inflammatory lesions. MATERIALS AND METHODS: This is a double-blind, randomized, placebo-controlled trial comparing intralesional triamcinolone 10 mg/mL, triamcinolone 40 mg/mL, and normal saline (NS). Thirty-two subjects at University of North Carolina Dermatology and Skin Cancer Centers were enrolled for a total of 67 lesions. Subjects reported pain scores, days to resolution, and satisfaction on a standardized survey over a 14-day period. RESULTS: When intralesional injections of triamcinolone 10 mg/mL, triamcinolone 40 mg/mL, and NS were compared, no significant difference was found for days to HS inflammatory lesion clearance, pain reduction at Day 5, or patient satisfaction. CONCLUSION: No statistically significant difference was found between varying concentrations of triamcinolone and NS for the treatment of HS lesions. Steroid injections may be less effective for the management of acute HS than typically presumed.
Authors: Kevin T Savage; Vinita Singh; Zarine S Patel; Christine A Yannuzzi; Anne Marie McKenzie-Brown; Michelle A Lowes; Lauren A V Orenstein Journal: J Am Acad Dermatol Date: 2020-09-17 Impact factor: 15.487