Management of patients with hidradenitis suppurativa during the COVID-19 pandemic: Risk and benefit of immunomodulatory therapy

Dermatol Ther. 2020 Nov;33(6):e14256. doi: 10.1111/dth.14256. Epub 2020 Sep 14.

Abstract

Coronavirus disease 2019 (COVID-19) is a clinical syndrome caused by a new coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Italy has been the first nation affected by the coronavirus pandemic and is the second in the number of reported deaths in the European Union. In the United Hospital of Ancona, a specialist outpatient clinic dealing with diagnosis and treatment of immunomediated skin diseases has been operating since 1985, and 291 patients with hidradenitis suppurativa (HS) are currently being treated. Several cutaneous immunomediated diseases, including HS, are treated with biologic and nonbiologic immunosuppressive and immunomodulatory drugs. Since the end of February 2020, when the SARS-CoV-2 pandemic had already spread in most of Italy, a task force comprised of seven specialists has been set up with the aim of addressing problems relating to the specific risk for this class of patients in relation to SARS-CoV-2 infection and immunosuppressive ongoing therapy. In this article, the management of HS disease during the COVID-19 pandemic is discussed. The main goal was to evaluate the risk/benefit in modulating treatment taking into consideration patients' risk of exposure to SARS-CoV-2 virus.

Keywords: COVID-19; SARS-CoV-2; adalimumab; biologic therapy; coronavirus; dermatology; hidradenitis suppurativa; skin diseases.

MeSH terms

  • Adult
  • Biological Products / adverse effects
  • Biological Products / therapeutic use*
  • COVID-19 / diagnosis
  • COVID-19 / epidemiology
  • COVID-19 / immunology*
  • COVID-19 / virology
  • Comorbidity
  • Female
  • Hidradenitis Suppurativa / diagnosis
  • Hidradenitis Suppurativa / drug therapy*
  • Hidradenitis Suppurativa / epidemiology
  • Hidradenitis Suppurativa / immunology
  • Host-Pathogen Interactions
  • Humans
  • Immunocompromised Host
  • Immunologic Factors / adverse effects
  • Immunologic Factors / therapeutic use*
  • Male
  • Middle Aged
  • Patient Safety
  • Risk Assessment
  • Risk Factors
  • SARS-CoV-2 / immunology*
  • SARS-CoV-2 / pathogenicity
  • Treatment Outcome
  • Young Adult

Substances

  • Biological Products
  • Immunologic Factors