Hidradenitis Suppurativa: Current Trends of Treatment in Bangladesh

Abstract

Background: Hidradenitis suppurativa (HS) is a chronic, recurrent, debilitating dermatosis. Management of HS remains a challenge owing to lack of a curative medical treatment, potential resistance of recommended antibiotics and higher cost of biologics.

Objectives: The study aimed to assess the current trends in treatment patterns of Hidradenitis suppurativa in Bangladesh.

Methods: The cross-sectional study was conducted between January 2023 and March 2023 among 76 dermatologists from all over Bangladesh. A pretested, semi-structured questionnaire containing 13 questions targeted mainly prescribing patterns based on their regular clinical practices. The data has been collected through both online and in-person interviews.

Results: The study found that topical+systemic antibiotics were the most frequently used treatment modality for HS in all severity groups. Doxycycline was the most preferred systemic antibiotic, followed by Clindamycin. Most of the dermatologists (79%) did not prescribe the combination therapy of clindamycin + rifampicin as a reason for drug resistance (51.7%) and unavailability (46.6%). However,46% prioritized isotretinoin as non-antibiotic treatment and 78% have never given biologics for HS treatment. When it comes to surgical intervention, almost half (43.4%) of the dermatologists never performed any surgical procedure in clinical practices and they referred the patients to a plastic surgeon (30.2%). The study explored the challenges of HS treatment in Bangladesh, including the chronic nature of the disease (76.3%) and patients not compliant with prescribed treatment (52.6%) as challenges in treating HS treatment.

Conclusion: Identifying and addressing barriers to achieving expertise in the treatment of HS can help provide access to high-quality care for patients with HS.

Keyword: Hidradenitis Suppurativa, combination therapy, non-antibiotic therapy, Biologics.