Over the last several years, new treatments called biologics have been available for the treatment of a variety of inflammatory conditions. These treatments are called biologics because, unlike chemical medications, they are made out of materials found in nature, and are designed to mimic chemicals found naturally in the body . Biologics are antibodies grown in the laboratory that stop certain proteins in the body from causing inflammation, and are isolated from a variety of natural sources - human, animal, or microorganism.
Biological products often represent the cutting-edge of biomedical research and, in time, may offer the most effective means to treat a variety of medical illnesses and conditions that presently have no other treatments available. The National Institute for Clinical Excellence (NICE) has approved the use of Humira (Adalimumab) for patients with moderate to severe HS, that have not responded to alternative therapies.
Humira is currently the only drug that is licensed for the treatment of moderate to severe HS. This biologic treatment is a tumor necrosis factor-alpha (TNFα) inhibitor. The TNFα protein is partly responsible for the regulation of immune cells, induction of inflammation. By inhibiting this protein, Humira reduces the inflammatory response of the immune system. It is administered via a syringe or self-injecting pen every 1-2 weeks.
Infliximab (Remicade) is another biologic often used for HS, and is commonly used to treat Crohn's disease, psoriasis, rheumatoid arthritis and ulcerative colitis. It is normally administered by intravenous infusion, typically at 6-8 week intervals, and at a clinic or hospital. Infliximab it is not licensed for the treatment of HS, but can be used "off-label" in certain circumstances.
Since the most common non-surgical treatments do not always result in lasting remission, surgical treatment is often an option to help restore patient quality of life and mobility. The type of surgery used is dependant of the location and severity of the disease.
Incision and draining (lancing)
This is probably one of the most common forms of surgery, with the abscess being cut open and allowed to drain. This will reduce pain and pressure in the affected area, however this will not stop the abscess from returning.
Deroofing is a tissue-saving technique, whereby the "roof" of an abscess, cyst, or sinus tract is electro- surgically removed. The deroofing technique is an effective, simple, minimally invasive, surgical intervention for the treatment of mild to moderate HS lesions.
Wide scale excision
Often regarded as a last option, the entire area is surgically removed. Normally performed by a general or plastic surgeon under a general anesthetic. After the excision is made, the wound will be either left open to heal on its own (secondary intention healing) or closed using stitches, staples, grafting, or flap repair.