Pilonidal Cyst Associated With Better Response to Isotretinoin in Patients With Hidradenitis Suppurativa

Data suggest that for patients with HS, having a history of pilonidal cyst is associated with a beneficial response to isotretinoin.

A history of pilonidal cyst is associated with a beneficial response to oral isotretinoin in patients with hidradenitis suppurativa (HS), according to study results published in the Journal of Dermatological Treatment.

As isotretinoin is currently considered a second- or third-line treatment option for patients with HS due to inconsistencies in response rate, researchers performed a retrospective review of patients with HS to identify subgroups of individuals who may respond positively to isotretinoin treatment.

Patient history was collected from 209 patients with HS who presented for outpatient evaluation at the University of California, Los Angeles (UCLA) HS clinic between August 2009 and March 2018. A total of 39 patients (18.7%) reported previous treatment with isotretinoin, with 14 patients (35.9%) reporting a beneficial response. A history of pilonidal cyst was the only factor significantly associated with a beneficial response to isotretinoin treatment (P =.024). There was no significant association found with other factors, including gender or history of acne, despite previous reports.

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The investigators noted the retrospective nature of the study and the small cohort size as study limitations. In addition, isotretinoin dose and duration were not considered.

Based on the results of this study, the researchers conclude that patients with HS with a history of pilonidal cyst may benefit from isotretinoin treatment. These results may suggest a common pathogenic pathway underlying HS and pilonidal cyst, which warrants further investigation.

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Patel N, McKenzie SA, Harview CL, et al. Isotretinoin in the treatment of hidradenitis suppurativa: a retrospective study [published online September 26, 2019]. J Dermatolog Treat. doi:https///doi.org/10.1080/09546634.2019.1670779