Significant clinical response in severe hidradenitis suppurativa to oral rifampicin and methylprednisolone therapy: A case report

Abstract

Hidradenitis suppurativa (HS) is a chronic, relapsing inflammatory disorder of the apocrine glands characterized by nodules, abscesses, fistulas, and scarring in intertriginous areas. The condition is also known as apocrinitis, axillary hidradenitis, apocrine gland abscess, and acne inversa. The prevalence of HS ranges from 0.4% to 4% worldwide. Women are affected more frequently than men. HS typically involves intertriginous regions such as the axillae, breasts, groin, and anogenital area, and it is often bilateral. In men, HS is more commonly found in the anogenital region. HS significantly reduces patients’ self-confidence and quality of life. Appropriate management, including antibiotic or surgical therapy is essentials depending on the disease severity, comorbidity control, and patient education.We report a case of a 50-year-old man with Hurley stage III hidradenitis suppurativa involving atypical sites for males, namely the axilla, back, and left knee. Although standard therapy for severe HS usually requires surgical intervention, the patient refused the procedure. As an alternative, a combination of systemic antibiotics and corticosteroids was administered, resulting in a marked clinical improvement. This case is reported to highlight the successful non-surgical treatment of severe HS with an atypical lesion distribution, a condition rarely documented in the literature.