Severe hidradenitis suppurativa responding to treatment with secukinumab: a case report

Br J Dermatol. 2018 Jul;179(1):182-185. doi: 10.1111/bjd.15769. Epub 2018 Mar 25.

Abstract

An inappropriate immunological response to an unknown antigen has been suggested to play a role in the pathogenesis of hidradenitis suppurativa (HS). Studies have identified elevated levels of several proinflammatory cytokines, including interleukin (IL)-17A and tumour necrosis factor-α, nominating these as possible therapeutic targets.1 Secukinumab is an IL-17A monoclonal antibody, which binds to IL-17A and inhibits the cytokine interaction with the IL-17 receptors, inhibiting the inflammatory cascade. Here we report a case of a 47-year-old man, with Hurley stage III lesions on the neck, axillae, breasts, genital skin and buttocks, who had experienced only temporary benefit from different medical treatments over several years. After 12 weeks of treatment with secukinumab, the number of lesions reported by the patient within the period of the last 4 weeks was reduced from 23 to seven, his pain visual analogue scale (VAS) score was reduced from 5 to 3 and pain/utility/handicap VAS score was reduced from 7 to 4. These results may be taken to imply that IL-17 blockade could provide a possible therapeutic approach in the treatment of HS.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Monoclonal / pharmacology
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Humanized
  • Hidradenitis Suppurativa / complications
  • Hidradenitis Suppurativa / drug therapy*
  • Hidradenitis Suppurativa / immunology
  • Humans
  • Interleukin-17 / antagonists & inhibitors
  • Interleukin-17 / immunology
  • Male
  • Middle Aged
  • Pain / diagnosis
  • Pain / drug therapy*
  • Pain / etiology
  • Pain Management / methods
  • Pain Measurement
  • Patient Reported Outcome Measures
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • IL17A protein, human
  • Interleukin-17
  • secukinumab