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Hidradenitis Suppurativa

Useful link: http://www.pcds.org.uk/clinical-guidance/hidradenitis-suppurativa

 

Management options in primary care:

 

Step 1:

Topical clindamycin 1% bd for 3 months + tetracycline 500mg bd for 4 months

 

Step 2:

Consider,

Oral clindamycin 300mg bd + rifampicin 300mg bd for 10 weeks

 

Referral criteria

 

Refer patients where there has been an unsatisfactory response to step 1 +/- step 2 for consideration of biologic therapy.

 

Important notes

 

Rifampicin

  • Can colour urine/contact lenses
  • Monitoring of LFTs required as per BNF.
  • Additional contraceptive measures required, see BNF chapter, ‘Contraceptives, interactions’ for guidance.

 

Clindamycin

  • Stop if diarrhoea develops – predisposes to C. diff. infection.

 

Tetracycline

  • Contraindicated in pregnancy