Local Control of Hidradenitis Suppurativa After Combination Deroofing and Long-Pulsed 1064-nm Nd:YAG Laser
试验速览
- 阶段
- 不适用
- 入组人数
- 6
- 主要终点
- Disease Activity Changes as Assessed by the International Hidradenitis Suppurativa Severity Score System
研究概览
简要总结
The purpose of the study is to determine whether a series of laser hair removal treatments can improve participant outcomes after deroofing procedures. A deroofing procedure is a surgery where larger hidradenitis suppurativa bumps (called nodules) and hidradenitis suppurativa tunnels (called sinus tracts) are removed and left to heal open without stitches.
详细描述
Hidradenitis Suppurativa (HS) is a chronic inflammatory disorder characterized by follicular occlusion and rupture which leads to scar and sinus tract formation. Given that medical treatments for HS primarily target inflammation, a multifaceted approach to therapy incorporating procedural techniques is thought to lead to better disease control. Deroofing of nodules and sinus tracts has shown to be beneficial in the treatment of recalcitrant areas that do not respond fully to medical therapy alone. In addition, multiple studies demonstrate the efficacy of long-pulsed 1064-nm Nd:YAG laser in the treatment of HS. To date, no study has evaluated the efficacy of combining surgical deroofing and laser treatment.
In this study, participants with Hurley stage II disease of bilateral axillae who meet the study criteria will be treated. Deroofing will be performed to all nodules and sinus tracts in a randomly selected axilla of each participant. Immediately prior to deroofing, participants will have their initial Nd:YAG laser treatment to the selected axilla. Participants will then be treated every four weeks with a series of additional laser treatments. The opposite (untreated) axilla will serve as a control for monitoring baseline disease activity.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •18 years of age or older
- •Diagnosis of hidradenitis suppurativa Hurley stage II with bilateral axillary involvement
- •Must be under the care of a board certified dermatologist and planning to undergo a deroofing procedure of one axilla for the treatment of their HS
- •Disease must be active in the bilateral axillae
- •Activity to be defined as having had at least one flare in the last six months
- •Flare to be defined as patient reported worsening of disease beyond baseline or clinical evidence of active inflammation (i.e. erythema, edema, drainage, tenderness)
排除标准
- •Pregnancy
- •Clinical evidence of active superinfection
- •Previous deroofing surgery in any axilla
- •Previous laser therapy in any axilla
- •Patients on the following medical therapies:
- •Any systemic immunomodulating agent that has been started within 3 months of initial deroofing and laser treatment
- •Patients on immunomodulators >3 months with no change in therapy are eligible for participation
- •Use of topical antibiotics, antiseptics, oral antibiotics, oral steroids, intralesional steroids
- •Patients must have stopped all of these agents at least 2 weeks prior to surgical deroofing
- •Use of intramuscular steroids
- •It must be at least 4 weeks since administration of intramuscular steroids before deroofing for a patient to be eligible for participation
结局指标
主要结局
Disease Activity Changes as Assessed by the International Hidradenitis Suppurativa Severity Score System
时间窗: 12 months
International Hidradenitis Suppurativa Severity Score System (IHS4) changes over the study period will be reported. At each study visit the number of nodules, abscesses, and draining tunnels will be counted in each axilla. The IHS4 score is the number of nodules + abscess count (multiplied by 2) + number of draining tunnels (multiplied by 4). The score can range from 0 lesions and the maximum value is dependent on how many lesions the participant has. The score is used to assess disease severity and can be used to assess how disease severity changes after an intervention. A higher score indicates more active or severe disease, while a lower score indicates less active or less severe disease. Scores throughout the study visits will be reported as well as how these scores change.
Disease Recurrence after the Intervention as Assessed by Clinical Exam
时间窗: 12 months
During study visits, a study team member will count the number of nodules, abscesses, and tunnels in each axilla. A higher count indicates more active or severe disease, whereas a lower count indicates less active or less severe disease. Scores can range from 0 lesions to as many as the participant has. Differences between the counts throughout the study visits will be reported.
Disease Activity Changes as Assessed by the Hidradenitis Suppurativa Clinical Response
时间窗: 12 months
The Hidradenitis Suppurativa Clinical Response (HiSCR) is a validated score defined as a 50% or greater reduction in abscesses and inflammatory nodule counts with no increase in abscesses and draining sinus tracts at the end of the study period, as compared to baseline. A participant will be considered either positive, or achieving HiSCR, which indicates that the study intervention significantly improved the participant's disease, or the patient will be negative, or did not achieve HiSCR, indicating that the intervention did not significantly impact the participant's disease. Study researchers will calculate this score based on clinical assessment and lesion counts assessed at the first study visit and the last two study visits. The percent of participants who achieve HiSCR at the last two study visits will be reported.
次要结局
- Quality of Life Changes as Assessed by the Dermatology Quality of Life Index(12 months)
- Pain as assessed by the Visual Analog Scale(12 months)