Antiandrogen Therapy with Spironolactone for the Treatment of Hidradenitis Suppurativa

The study conducted a single-center chart review of 46 female patients with hidradenitis suppurativa (HS) treated with spironolactone, an antiandrogen therapy, from 2000 to 2017. The average daily dose was 75 mg, and the follow-up period was 7.1 months. Results showed significant improvements in patient-reported pain, inflammatory lesion count, and HS Physician's Global Assessment (HS-PGA) score, with no changes in Hurley stage or fistula count. The efficacy of spironolactone did not differ significantly between doses less than 75 mg daily and those over 100 mg daily. The study concluded that spironolactone effectively reduces lesion count, HS-PGA score, and pain in HS patients, suggesting that lower doses could be beneficial, especially for those with tolerability concerns. However, the study was limited by its retrospective design, small sample size, and inconsistent severity measures.