Table 2.
Treatment algorithm based on the IGM-TCC
| Initial treatment option | Alternative treatment option1 | |
|---|---|---|
| Pregnancy/lactation | OBS | ILS/TOPS |
| Type 1 disease | OBS | ILS/TOPS |
| Type 2 disease | ILS/TOPS2 | |
| Type 3 disease | SS | IMT/COMB |
| Type 4 disease | ||
| Resistant | IMT | COMB |
| Recurrent | According to reclassification | |
| Follow-up | During treatment, follow-up should be scheduled every month | |
| Decision to discontinue treatment | When a CCR is achieved in both physical examinations and radiological assessments | |
In all types, abscesses should be drained: deep abscesses under ultrasound guidance and superficial abscesses via skin incisions.
OBS, observation – regular monitoring without active intervention, except for drainage when necessary; ILS, intralesional steroid – steroid injection administered directly into the lesion; TOPS, topical steroid – steroid applied to the skin surface; SS, systemic steroids – steroids taken orally or intravenously; IMT, immunosuppressive therapy – treatment that suppresses immune system activity (e.g., methotrexate, azathioprine); COMB, combination therapy – use of multiple treatment modalities together (e.g., SS + SURG/IMT/TOPS/ILS/ABX, IMT + SURG, etc.); CCR, complete clinical response.
Consensus is indicated in bold text.
1If necessary, this may be considered a subsequent or additional treatment to the initial therapy.
2In our study, the consensus threshold was set at 80%; however, since a high level of agreement was achieved in the 70–80% range, it was recommended as the first-line treatment for Type 2 disease.