Efficacy of Nd:YAG Laser for the Treatment of Hidradenitis Suppurativa

Neda Nosrati, Lindsey Hunter, Erica Kelly

Department of Dermatology, University of Texas Medical Branch, Galveston, USA.

DOI: 10.4236/jcdsa.2012.22019                

Abstract

Hidradenitis suppurativa (HS) is an inflammatory skin disease that involves sebaceous glands and hair follicles of intertriginous areas, including axillary and inguinal regions. It is often chronic, painful, disabling, and can worsen over time. Besides surgically excising affected areas, effective treatments are currently lacking. The long-pulsed neodymium:yttrium-aluminium-garnet (Nd:YAG) laser is a device that has traditionally been used for hair removal, but has recently shown promise in clearing old lesions of HS and preventing new eruptions. In accordance with studies in the current literature, we hypothesize that the Nd:YAG laser will significantly improve subjects with hidradenitis suppurativa compared to standard, uninvasive treatment with topical antibiotics [1,2]. Study aims include: to treat subjects with hidradenitis suppurativa with Nd:YAG laser therapy once monthly for 3 consecutive months, with a one month follow-up; to compare the effectiveness of Nd:YAG treatment on one side of the subject (e.g., right) to treatment with topical antibiotics on the subject’s other side (e.g., left); to assess treatment response using a visual analogue scale; to assess subject satisfaction with treatment using a questionnaire; and to photodocument treatment response at each visit.

Keywords

Hidradenitis Suppurativa; Nd:YAG Laser; Acne Inverse; Follicular Disease

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	L. Y. Xu, D. R. Wright, B. H. Mahmoud, D. M. Ozog, D. A. Mehregan and I. H. Hamzavi, “Histopathologic Study of Hidradenitis Suppurativa Following Long-Pulsed 1064 nm Nd: YAG Laser Treatment,” Archives of Dermatology, Vol. 147, No. 1, 2011, pp. 21-28. doi:10.1001/archdermatol.2010.245
[2]	A. Alikhan, P. J. Lynch and D. B. Eisen, “Hidradenitis Suppurativa: A Comprehensive Review,” Journal of the American Academy of Dermatology, Vol. 62, No. 4, 2009, pp. 706-708.
[3]	B. H. Mahmoud, E. Tierney, C. L. Hexsel, J. Pui, D. M. Ozog and I. H. Hamzavi, “Prospective Controlled Clinical and Histopathologic Study of Hidradenitis Suppurativa Treated with the Long Pulsed Neodymium: YttriumAluminium-Garnet Laser,” Journal of the American Academy of Dermatology, Vol. 62, No. 4, 2010, pp. 637-645. doi:10.1016/j.jaad.2009.07.048
[4]	P. V. Rambhatla, H. W. Lim and I. Hamzavi, “A Systematic Review of Treatments for Hidradenitis Suppurativa,” Archives of Dermatology, Vol. 148, No. 4, 2011, pp. 439-446. doi:10.1001/archdermatol.2011.1950
[5]	H. Hurley, “Dermatologic Surgery, Principles and Practice,” Marcel Dekker, New York, 1989.
[6]	K. Sartorius, J. Lapins, L. Emtestam and G. B. Jemec, “Suggestions for Uniform Outcome Variables When Reporting Treatment Effects in Hidradenitis Suppurativa,” British Journal of Dermatology, Vol. 149, No. 1, 2003, pp. 211-213. doi:10.1046/j.1365-2133.2003.05390.x
[7]	S. Kamp, A. M. Fiehn, K. Stenderup, C. Rosada, B. Parkkenberg, K. Kemp, T. N. Dam and G. B. Jemec, “Hidradenitis Suppurativa: A Disease of the Absent Sebaceous Gland? Sebaceous Gland Number and Volume Are Significantly Reduced in Uninvolved Hair Follicles from Patients with Hidradenitis Suppurativa,” British Journal of Dermatology, Vol. 164, No. 5, 2011, pp. 1017-1022. doi:10.1111/j.1365-2133.2011.10224.x
[8]	J. Boer and E. F. Weltevreden, “Hidradenitis Suppurativa or Acne Inversa: A Clinicopathologic Study of Early Lesions,” British Journal of Dermatology, Vol. 135, No. 5, 1996, pp. 721-725. doi:10.1111/j.1365-2133.1996.tb03880.x
[9]	R. E. Hunger, A. M. Surovy, A. S. Hassan, L. R. Braathen and N. Yawalkar, “Toll-Like Receptor 2 Is Highly Expressed in Lesions of Acne Inversa and Colocalizes with C-Type Lectin Receptor,” British Journal of Dermatology, Vol. 158, No. 4, 2008, pp. 691-697. doi:10.1111/j.1365-2133.2007.08425.x
[10]	H. Kurzen, I. Kurokawa, G. B. Jemec, L. Emtestam, K. Sellhever, E. J. Giamarellos-Bourboulis, I. Nagy, F. G. Bechara, K. Sartorius, J. Lapins, D. Krahl, P. Altmeyer, J. Revuz and C. C. Zouboulis, “What Causes Hidradenitis Suppurativa?” Experimental Dermatology, Vol. 17, No. 5, 2008, pp. 455-456. doi:10.1111/j.1600-0625.2008.00712.x
[11]	T. S. Alster, H. Bryan and C. M. William, “Long Pulsed Nd:Yag Laser-Assisted Hair Removal in Pigmented Skin: Clinical and Histological Evaluation,” Archives of Dermatology, Vol. 13, No. 7, 2001, pp. 885-889.