Treating a Life-Altering Skin Disease

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For many individuals, hidradenitis suppurativa (HS) is a life-altering skin disease.  It causes painful, draining bumps under the skin that can become infected, break open and leave scars. It occurs most often in the groin, buttocks, armpits or under the breasts.

“It’s a devastating disease that hits many adults in the prime of life,” said Hadar Lev-Tov, M.D., M.A.S., assistant professor in the Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery at the University of Miami Miller School of Medicine. “Our wound healing group is now conducting clinical trials for HS. We hope that research will bring new therapies and help the many patients who now suffer in silence.”

Dr. Hadar Lev-Tov, right.

Dr. Lev-Tov serves on the board of the Hidradenitis Suppurativa Foundation, a nonprofit dedicated to increasing awareness of HS and providing information and advocacy to individuals with the disease. HS is estimated to affect about 1 percent of the U.S. population, making it about as prevalent as psoriasis – a skin disease that is far more familiar to most clinicians and patients.

“South Florida’s subtropical climate and humidity may increase the severity of HS in our region, but it’s difficult to gauge its prevalence,” said Dr. Lev-Tov. “There can be a long delay in diagnosing the problem, since many patients are reluctant to talk about a skin disease in their private areas. It can also be missed in a physical examination that doesn’t cover the entire body.”

The underlying cause of the disease is not known. In HS patients, the skin lesions are typically caused by inflammation around the hair follicle and sweat glands, creating small lumps under the skin that can enlarge, break down and drain pus. It is more common in women than men, and is more likely to affect women and men who are overweight, smoke and had acne.  There may be a genetic connection as about one-third of HS patients have a relative with the same condition.

Currently, no single perfect treatment exists for HS. Several medications are available that can be helpful during flare-ups of the disease, and surgery can sometimes manage the symptoms of this chronic condition, said Dr. Lev-Tov. Many HS patients also benefit from participating in support groups, since the disease can be socially isolating.

While there are no definitive treatments, Dr. Lev-Tov said the FDA’s 2016 approval of adalimumab (Humira) – an injectable medication for multiple conditions – has given new hope to patients with HS.  “We are also seeing a growing interest among pharmaceutical companies interested in bringing new therapies to the market, with a few drugs already in advanced clinical trials here at UM,” he said. “That gives our HS patients a strong reason for hope.”