Abstract
Purpose
Hidradenitis suppurativa (HS) is a benign, chronic inflammatory condition involving painful lesions that can progress to abscesses, skin tunnels, and fibrotic scars. Treatment of recalcitrant disease often involves immunomodulatory agents or surgery, but these often result in modest improvement. This study’s objective was to determine the effectiveness of external beam low-dose radiation therapy (LD-RT) as an adjunct treatment for recalcitrant HS.
Methods and Materials
HS patients receiving LD-RT at a single institution from 2017 to 2024 were retrospectively identified. LD-RT dose included 750 cGy in 3 fractions or 800 cGy in 4 fractions. Patient demographics and comorbidities were recorded. Treatment response was categorized as excellent, partial, or no response, and site-specific symptoms were recorded based on available records.
Results
Thirteen patients with HS underwent LD-RT to 38 sites were identified with a median follow-up period of 1.45 years from completion of LD-RT (range, 0.4-7 years). The majority of sites were Hurley stage III (34/38). At the patient level, all had been previously treated with antibiotics, 9 with prednisone, 12 with biologic agents, and 7 with a surgical procedure. Clinical response per site included 4 of 38 (10.5%) excellent, 26 of 38 (68.4%) partial, and 8 of 38 (21.1%) nonresponders. Four patients reported a reduction in pain score at first radiation oncology follow-up. For those with a response, median time from LD-RT to next rescue intervention was 2.2 months (range, 0.6-23.1 months). Three sites underwent surgery at a median time of 9.3 months from LD-RT completion. Two patients with 5 sites were retreated without response 1 year after LD-RT.
Conclusion
LD-RT for HS demonstrates high rates of response, with the majority of treated areas having some subjective improvement in disease burden, although most only have partial improvement. Need for rescue intervention shortly after this treatment is common.
Introduction
Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition characterized by painful deep-seated nodules and sterile abscesses that can progress to form cutaneous sinus tracts and fibrotic scars. Lesions typically occur in intertriginous areas such as the axilla, groin, or buttock but can occur anywhere on the body.1 The Hurley staging system classifies HS into 3 stages: stage I (abscesses or nodules without sinus tracts), stage II (recurrent abscesses or nodules with discrete sinus tracts and scarring), and stage III (extensive interconnected sinus tracts and abscesses) (Fig. 1).2 Although the pathophysiology is complex and poorly understood, it is thought to be driven by hyperkeratosis of the pilosebaceous unit, followed by follicular rupture and release of proinflammatory keratin and bacteria into the subcutaneous space, thereby resulting in a positive feedback loop of progressive tissue destruction. The treatment approach for HS is stepwise, escalating as disease severity increases.3 Mild stage I cases can be treated with topical antiseptics (chlorhexidine wash, benzoyl peroxide wash, and clindamycin lotion) and androgen antagonists (eg, spironolactone and combination oral contraceptive pills).4 Flare-ups can be controlled with intralesional corticosteroid injections, systemic glucocorticoids, punch debridement, and oral antibiotics.4, 5, 6 Moderate-to-severe stage II-III HS is often treated with chronic immunosuppression with biologics in the tumor necrosis factor-α and interleukin-17–inhibitor class.3,4 Efficacy of these biologic agents and surgery, however, remains limited.7,8 A phase 3 multicenter, double-blinded, placebo-controlled study found that less than half of adalimumab-treated patients achieved the primary endpoint of Hidradenitis Suppurativa Clinical Response (HiSCR)50 (50% reduction in active nodules and abscesses).9 For very severe disease, surgical interventions can be considered but these often result in significant morbidity, prolonged recovery, and recurrent disease following resection.10,11 Despite a variety of treatment modalities for HS, success remains inadequate.
Figure 1.
Three-stage Hurley staging system. (A) stage I – abscesses or nodules without sinus tracts. (B) stage II – recurrent abscesses or nodules with discrete sinus tracts and scarring. (C) stage III – extensive interconnected sinus tracts and abscesses.
Low-dose radiation therapy (LD-RT) has demonstrated efficacy in a variety of benign conditions mediated through inflammatory pathways, including osteoarthritis, ankylosing spondylosis, and Grave’s ophthalmopathy. Historically, radiation therapy (RT) has been used for HS but robust clinical data reporting is limited.12, 13, 14, 15, 16, 17, 18 Published data is mostly limited to case reports and retrospective series, with most reporting clinical response rates of 50% to 90% but without granular detail about degree of response or data regarding durability of response.13,17 There are several case reports demonstrating very dramatic clinical responses to low doses of RT, but little literature to support whether these responses are typical.15,17 Although published doses range dramatically from 50 Gy in 5 fractions with custom brachytherapy patches to 3 Gy in 6 fractions using external beam RT, the majority of experiences report using lower doses.12,13,15,17, 18, 19, 20, 21, 22, 23, 24
This case series aims to evaluate our single institutional experience with low-dose external beam radiation as a treatment for refractory moderate-to-severe HS.
Methods and Materials
Study design
With institutional review board approval, electronic medical records were retrospectively reviewed from 2017 to 2024. Patients were included for analysis if they met the following criteria: (1) a diagnosis of HS treated with radiation and (2) at least one pre-RT and one post-RT follow-up appointment with dermatology or radiation oncology.
Radiation therapy
RT was delivered at the discretion of the treating radiation oncologist. Dosing schemes consisted of 750 cGy in 3 fractions or 800 cGy in 4 fractions. RT techniques varied but included en face electrons, 2-field (anteroposterior and posteroanterior), and 3-dimensional conformal. Retreatment was offered for recurrent or refractory disease at physician discretion.
Data collection and treatment response
Baseline demographics, comorbidities, HS severity, pre- and post-RT treatments, RT treatment details, patient-reported pain scores at radiation consultation and first posttreatment clinic visit, and site-specific symptoms (swelling, pruritus, drainage, and malodor) were recorded. Length of follow-up was calculated from completion of RT to last HS-specific follow-up with dermatology or radiation oncology. Overall response to RT was determined based on documentation of pain, drainage, physical exam findings, and need for rescue treatment as assessed by chart review of dermatology or radiation oncology progress notes. Treatment response was categorized as excellent if all of the following criteria were met: (1) decreased pain rating; (2) decreased HS activity on physical exam (number of lesions with active erythema, swelling, drainage, and tenderness to palpation); and (3) no rescue interventions (incision and drainage, intralesional corticosteroid injection) in the treated region or need for systemic treatment initiation or escalation (biologics, prednisone, and antibiotics) within 3 months of RT completion. Those who met at least one of these criteria were defined as partial responders, provided they had either reduction in disease activity or subjective improvement in symptoms; others were defined as nonresponders. Treated sites with partial or excellent responses were also assessed for duration of efficacy, as determined by time from RT completion to first local HS flare requiring rescue intervention or site-driven systemic medication change. The response or lack thereof for individual site-specific symptoms (swelling, pruritus, drainage, and malodor) was recorded based on subjective assessment of clinic notes when available.
Results
Patient characteristics
Patient demographics are listed in Table 1. Thirteen patients (7 females and 6 males) with a total of 38 symptomatic radiation–naïve HS sites (10 left groin, 10 right groin, 3 left axilla, 2 right axilla, 9 buttock/hip, 3 perineum/genitals, and 1 lower abdomen) were retrospectively identified at our multicenter single institution. Seven patients were African American and 6 were Caucasian. Median follow-up from completion of RT to last HS-specific visit was 1.45 years (range, 0.4-7 years). The vast majority (34/38) of these sites were Hurley stage III. The median age at treatment was 45 years (range, 33-63 years) with median body mass index of 29.9 (range, 24.6-45.7). Notable comorbidities included 1 patient with psoriasis, 1 with multiple sclerosis treated with anti-CD20 monoclonal antibody, 1 with dissecting cellulitis, 5 with active tobacco use, 2 with psychiatric disease, and 4 with type 2 diabetes. Systemic treatment failures prior to RT included prolonged antibiotics in all 13 patients, biologics in 12, prednisone in 9, retinoids in 3, and surgery (partial debridement or wide local excision) in 7.
Table 1.
Patient demographics
| Total patients | 13 |
|---|---|
| Females | 7 (53.8%) |
| Males | 6 (46.2%) |
| African American | 7 (53.8%) |
| Caucasian | 6 (46.2%) |
| Median age at RT (range), y | 45 (33-63) |
| Median BMI at RT (range), kg/m2 | 29.9 (24.6-45.7) |
| Median follow-up (range), y | 1.45 (0.4-7) |
| Comorbidities | |
| Type 2 diabetes mellitus | 4 (30.7%) |
| Active tobacco use | 5 (38.4%) |
| Psychiatric disease | 2 (15.3%) |
| Psoriasis | 1 (7.7%) |
| Multiple sclerosis | 1 (7.7%) |
| Dissecting cellulitis | 1 (7.7%) |
| Hurley stage (site-specific) | |
| Stage II | 4 (10.5%) |
| Stage III | 34 (89.5%) |
| Median pain score, pre-RT (range) | 6 (0-10) |
| Previous systemic treatments | |
| Antibiotics | 100% (13/13) |
| Biologics | 92.3% (12/13) |
| Retinoids | 23.1% (3/13) |
| Prednisone | 69.2% (9/13) |
| Surgical interventions (site-specific) | 28.9% (11/38) |
| RT naïve sites | 38 |
| Groin left/right | 10 (26.3%)/10 (26.3%) |
| Axilla left/right | 3 (7.9%)/2 (5.3%) |
| Buttock/hip | 9 (23.7%) |
| Perineum/genitalia | 3 (7.9%) |
| Lower abdomen | 1 (2.6%) |
| Retreated sites | 5 |
| Groin left/right | 2/2 |
| Buttock | 1 |
Abbreviations: BMI = body mass index; RT = radiation therapy.
Values are n (%) or % (n/N) unless otherwise specified.
Radiation technique
Radiation technique included 3-dimensional conformal (18 sites), anteroposterior/posteroanterior (10 sites), and en face electrons (10 sites) (Table 2). The majority were treated with 750 cGy in 3 fractions (36 sites), whereas the remainder were treated with 800 cGy in 4 fractions (2 sites).
Table 2.
Radiation technique and dose
| Radiation Technique | Number of Lesions |
|---|---|
| AP/PA | 10 |
| En face electrons | 10 |
| 3D conformal | 18 |
| RT dose and fractionation per site | |
| 750 cGy in 3 fractions | 36 |
| 800 cGy in 4 fractions | 2 |
Abbreviations: 3D = 3-dimensional; AP/PA = anteroposterior and posteroanterior; RT, radiation therapy.
Values are the number of sites.
Clinical outcomes
Based on our predefined criteria, an excellent response to RT was observed in 3 patients across 4 sites (10.5%), partial response in 10 patients across 26 sites (68.4%), and no response in 3 patients across 8 sites (21.1%). Differing results by treated area were seen within 3 patients who received RT at multiple sites (Table 3). Four patients had a reduction in reported pain score at first radiation oncology follow-up. Objective reductions in HS activity and/or drainage on physical exam were noted in 9 patients across 21 treated sites (Table E1).
Table 3.
Site-specific LD-RT response
| Patient | Treated sites | Hurley stage | Response type | Response grade | Time to first rescue intervention or last follow-up (mo) | First rescue treatment |
|---|---|---|---|---|---|---|
| 1 | Lower abdomen | II | Responder | Partial | 23.1 | ILK |
| Buttock | III | Nonresponder | Poor | 0.6 | ILK, I&D | |
| Right groin | III | Nonresponder | Poor | 2.8 | ILK | |
| Left groin | III | Nonresponder | Poor | 2.8 | ILK | |
| 2 | Right groin | III | Responder | Partial | 3.2 | Steroids, secunkinumab, doxycycline |
| Left groin | III | Responder | Partial | 3.2 | ||
| Perineum/scrotum | III | Responder | Partial | 3.2 | ||
| Left axilla | III | Responder | Excellent | 13.3* | - | |
| Right axilla | III | Responder | Excellent | 13.3* | - | |
| 3 | Right groin | III | Responder | Partial | 7.87 | Apremilast |
| Left groin | III | Responder | Partial | 7.84 | Apremilast | |
| Buttock | III | Responder | Excellent | 7.87 | Apremilast | |
| 4 | Right groin | III | Responder | Partial | 9.2 | ILK, LD-RT |
| Left groin | III | Responder | Partial | 1.77 | ILK, IFX increase | |
| Buttock | III | Responder | Partial | 3.5 | ||
| 5 | Left axilla | III | Responder | Excellent | 3.33 | IFX, prednisone |
| 6 | Left groin | II | Responder | Partial | 1.8 | ILK |
| Right groin | II | Responder | Partial | 1.8 | ILK | |
| Buttock | II | Responder | Partial | 1.8 | ILK | |
| 7 | Right groin | III | Responder | Partial | 2.5 | IFX |
| Left groin | III | Responder | Partial | 2.5 | IFX | |
| Scrotum | III | Responder | Partial | 2.5 | IFX | |
| 8 | Left axilla | III | Responder | Partial | 4.8* | - |
| Right axilla | III | Responder | Partial | 4.8* | - | |
| 9 | Buttock | III | Responder | Partial | 1.1 | Ertapenem |
| Left groin | III | Responder | Partial | 1.1 | Ertapenem | |
| Right groin | III | Responder | Partial | 1.1 | Ertapenem | |
| 10 | Right groin | III | Responder | Partial | 1.1 | ILK |
| Left groin | III | Responder | Partial | 1.1 | ILK | |
| 11 | Buttock | III | Nonresponder | Poor | 13.6* | - |
| Right hip | III | Nonresponder | Poor | 13.6* | - | |
| 12 | Right buttock | III | Nonresponder | Poor | 17.4* | - |
| Right groin | III | Nonresponder | Poor | 17.4* | - | |
| Left groin | III | Nonresponder | Poor | 17.4* | - | |
| 13 | Vulva | III | Responder | Partial | 2.2 | Prednisone, IFX increase |
| Buttock | III | Responder | Partial | 2.2 | ||
| Right groin | III | Responder | Partial | 2.2 | ||
| Left groin | III | Responder | Partial | 2.2 |
Abbreviations: I&D = incision and drainage; IFX = infliximab; ILK = intralesional kenalog injection; LD-RT, low-dose radiation therapy.
No documented rescue intervention at last follow-up.
Median time from LD-RT to rescue intervention for those with a clinical response was 2.2 months (range, 0.6-23.1 months). Rescue interventions required within 3 months of completion of RT for 5 patients (12 lesions). Two patients with 4 sites had not required rescue intervention at last disease-specific follow-up at 4.9 and 13.3 months. First rescue intervention after LD-RT included intralesional corticosteroid injections, biologic initiation or dose escalation, prednisone, antibiotics, and incision and drainage. Three sites underwent wide local excision after LD-RT at a median time of 9.3 months from RT completion.
Symptom-specific response rates for malodor, drainage, pruritus, and swelling with subjective degrees of improvement are listed in Table 4. Most treated sites had at least some improvement in site-specific symptoms including malodor (80%), drainage (65.2%), swelling (42.9%), or pruritus (28.6%).
Table 4.
Clinical outcomes after radiation therapy
| Overall radiation response (sites) | ||||
|---|---|---|---|---|
| Excellent response | 10.5% (4/38) | |||
| Partial response | 68.4% (26/38) | |||
| No response | 21.1% (8/38) | |||
| Patients with reduction in pain score | 30.7% (4/13) | |||
| Median time to rescue HS intervention (range), mo | 2.2 (0.6-23.1) | |||
| Median time to surgery, mo | 9.3 (3 sites) | |||
| Improvement in site symptomatic complaint | Initial | ER | PR | NR |
| Malodor | 10 | 6 | 2 | 2 |
| Swelling | 7 | 3 | 0 | 4 |
| Pruritus | 7 | 1 | 1 | 5 |
| Drainage | 23 | 3 | 12 | 8 |
Abbreviations: ER = excellent response; HS = hidradenitis suppurativa; NR = no response; PR = partial response.
Retreatment with second course of RT
Two patients with 5 sites of active disease were offered retreatment with a second course of RT. For those patients that underwent repeat LD-RT, infliximab was the first rescue drug used. The time between treatments for these patients was approximately 1 year for both patients. None of these sites had a response to repeated LD-RT.
Adverse side effects after radiation
No unexpected adverse events occurred as a result of treatment, and no documented grade 2+ acute or late adverse events were reported. No secondary malignancies were reported in this patient cohort.
Discussion
HS is a severely debilitating chronic inflammatory disease that significantly impacts quality of life and frequently leads to psychiatric comorbidities. Although biologic therapies have advanced moderate-to-severe HS management, they carry substantial financial burden, require frequent administration, and have limited efficacy. Adalimumab, the first approved biologic, demonstrated efficacy in the PIONEER (Phase III study to determine the pItential Of adalimumab iN Early sEverRe hidradenitis suppurativa) I and II trials, with Hidradenitis Suppurativa Clinical Response rates reaching 41.8% and 58.9% at week 12, respectively, modestly outperforming placebo.25 Long-term efficacy is limited, with only 30.5% of patients at 24 months remaining on adalimumab, primarily due to ineffectiveness or adverse effects. Novel agents modulating IL-17 have demonstrated similarly unimpressive overall response rates.3 Although surgical intervention can be considered, it carries significant morbidity including scarring, pain, and wound complications, which can result in severe impact to quality of life.10,11
Our study saw an overall 78.9% sites achieving an excellent or partial response (Fig. 2), which is comparable to previously published literature14,15 and favorable when compared to the response rates generally seen with biologic agents, although lack of formalized assessment and concurrent systemic treatments makes comparison fraught with potential confounding factors. In addition to the reduction in appearance of lesions and inflammatory nodules, many patients had symptomatic improvement in pain, drainage, malodor, and other subjective symptoms. Given the median time of 2.2 months to first rescue treatment, the benefits for this heavily pretreated cohort were generally transient, although some patients remained without rescue treatment at last follow-up.
Figure 2.
A Hurley stage II lesion involving the bilateral gluteal folds in the same patient demonstrating an excellent response to low-dose radiation. (A) Target lesions (arrows) treated with radiation with 750 cGy in 3 fractions (250 cGy per fraction). (B) Two years after radiation, there is a dramatic resolution of draining abscess and sinus tracts. Of note, the patient underwent a deroofing procedure on the left buttock for a hidradenitis suppurativa flare adjacent to previous area of flare (demarcated by *) 7.2 months after being treated with low-dose radiation therapy.
The efficacy of LD-RT in HS is generally understood to stem from its anti-inflammatory and immunomodulatory properties, which may target the inflammatory cascades and follicular units central to HS pathophysiology.26 Although this heavily pretreated cohort had impressive overall response rates, most had only a partial response to therapy, with only a minority of sites achieving an excellent response. Despite the historical use of lower doses of RT for HS, a consensus on the optimal dose and fractionation scheme remains poorly defined. Given that the key driver of HS is the pilosebaceous unit, it is possible higher doses of RT may be more effective as it can result in permanent alopecia and loss of sebaceous function.26 Experiences with higher doses have been reported, and it is possible that higher doses may result in more dramatic and durable changes, although side effects and overall risk may be higher with such an approach.27 Given the low dose used in these patients, the risk of acute or long-term side effects from this treatment is expected to be minimal. A significant concern associated with RT is the potential for secondary malignancies. However, it is imperative to contextualize this risk within the specific patient population and the severity of this condition. Given the low doses employed and exposed tissues, this treatment is generally considered to carry a very low risk of inducing secondary malignancies.28 Although malignancy risk is an important consideration of RT, biologic agents also have the potential to induce malignancy. Given their already widespread use, clinicians and patients alike have already accepted this rare event as an acceptable risk to help achieve better disease control and improve quality of life.
Limitations
The present study is characterized by a retrospective design and a small sample size, involving only 13 patients with relatively short follow-up. Lack of a formalized and prospective evaluation protocol is also another major limitation as is the inherently subjective nature of our criteria for treatment response. The presence, absence, or response of some site-specific symptoms were not always available in the medical record, so these are likely underreported. The absence of a control group (eg, patients receiving standard care without RT) is another notable limitation. Any observed improvements could potentially be attributed to other concurrent treatments that patients received or to the natural fluctuations in disease activity. Given that patients were referred for LD-RT because of inadequate disease control on other pre-existing concurrent treatments coupled with the modest efficacy of these agents, we still suspect LD-RT was causative for disease improvements observed in this patient cohort.
Conclusions
LD-RT is an effective treatment option for patients with recalcitrant HS, with most patients experiencing some improvement in disease severity including notable reductions in disease associated drainage, pain, and malodor. Despite high rates of response, most patients have a partial response to treatment, with many patients continuing to have active disease in the treated area and frequent need for early rescue treatment. Prospective studies with RT to elucidate optimal dosing and patient selection are warranted.
Disclosures
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Footnotes
Sources of support: This work had no specific funding.
Research data are not available at this time.
Supplementary material associated with this article can be found in the online version at doi:10.1016/j.adro.2026.102105.
Appendix. Supplementary materials
References
- 1.Thorlacius L., Cohen A.D., Gislason G.H., Jemec G.B.E., Egeberg A. Increased suicide risk in patients with hidradenitis suppurativa. J Invest Dermatol. 2018;138:52–57. doi: 10.1016/j.jid.2017.09.008. [DOI] [PubMed] [Google Scholar]
- 2.Hurley H. In: Dermatologic Surgery: Principles and Practice. Roenigk R., Roenigk H., editors. Marcel Dekker; 1989. Axillary hyperhidrosis, apocrine bromhidrosis, hidradenitis suppurativa, and familial benign pemphigus: surgical approach; pp. 729–739. [Google Scholar]
- 3.Campbell S.R., Unwala R., Shah C. Hidradenitis suppurativa: Complexity in pathogenesis and management. Lancet. 2025;406:911–912. doi: 10.1016/S0140-6736(25)01444-8. [DOI] [PubMed] [Google Scholar]
- 4.Ocker L., Abu Rached N., Seifert C., Scheel C., Bechara F.G. Current medical and surgical treatment of hidradenitis suppurativa—A comprehensive review. J Clin Med. 2022;11:7240. doi: 10.3390/jcm11237240. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5.Savage K.T., Singh V., Patel Z.S., et al. Pain management in hidradenitis suppurativa and a proposed treatment algorithm. J Am Acad Dermatol. 2021;85:187–199. doi: 10.1016/j.jaad.2020.09.039. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 6.Katoulis A., Efthymiou O., Liakou A., et al. Resorcinol 10% as a promising therapeutic option for mild hidradenitis suppurativa: a prospective, randomized, open study. Skin Appendage Disord. 2023;9:438–443. doi: 10.1159/000531926. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7.Mansour M.R., Rehman R.A., Daveluy S. Punch debridement (mini-deroofing): An in-office surgical option for hidradenitis suppurativa. J Am Acad Dermatol. 2024;90 doi: 10.1016/j.jaad.2023.12.050. [DOI] [PubMed] [Google Scholar]
- 8.Clark S.R., Soti V. Effectiveness of surgical deroofing and carbon dioxide laser in moderate-to-severe hidradenitis suppurativa patients. Cureus. 2024;16 doi: 10.7759/cureus.56959. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 9.Kimball A.B., Okun M.M., Williams D.A., et al. Two phase 3 trials of adalimumab for hidradenitis suppurativa. N Engl J Med. 2016;375:422–434. doi: 10.1056/NEJMoa1504370. [DOI] [PubMed] [Google Scholar]
- 10.Mehdizadeh A., Hazen P.G., Bechara F.G., et al. Recurrence of hidradenitis suppurativa after surgical management: A systematic review and meta-analysis. J Am Acad Dermatol. 2015;73(5 suppl 1):S70–S77. doi: 10.1016/j.jaad.2015.07.044. [DOI] [PubMed] [Google Scholar]
- 11.Madan V., Hindle E., Hussain W., August P.J. Outcomes of treatment of nine cases of recalcitrant severe hidradenitis suppurativa with carbon dioxide laser. Br J Dermatol. 2008;159:1309–1314. doi: 10.1111/j.1365-2133.2008.08932.x. [DOI] [PubMed] [Google Scholar]
- 12.Myers B., Campbell S.R., Shah C. Radiation therapy in the management of hidradenitis suppurativa. Pract Radiat Oncol. 2025;15:326–331. doi: 10.1016/j.prro.2025.01.008. [DOI] [PubMed] [Google Scholar]
- 13.Fröhlich D., Baaske D., Glatzel M. Strahlentherapie der Hidradenitis axillaris–heute noch aktuell? [Radiotherapy of hidradenitis suppurativa – still valid today?] Strahlenther Onkol. 2000;176:286–289. [in German] [PubMed] [Google Scholar]
- 14.Thompson A.M., Seivright J., Atluri S., et al. Radiotherapy for hidradenitis suppurativa: A systematic review. Dermatology. 2021;237:357–364. doi: 10.1159/000514027. [DOI] [PubMed] [Google Scholar]
- 15.Sakyanun P., Vongvanichvathana T., Lertsanguansinchai P. Radiation therapy in chronic hidradenitis suppurativa: case report. Radiat Oncol J. 2022;40:79–85. doi: 10.3857/roj.2021.00570. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 16.Zeligman I. Temporary x-ray epilation therapy of chronic axillary hidradenitis suppurativa. Arch Dermatol. 1965;92:690–694. [PubMed] [Google Scholar]
- 17.Trombetta M., Werts E.D., Parda D. The role of radiotherapy in the treatment of hidradenitis suppurativa: case report and review of the literature. Dermatol Online J. 2010;16:16. [PubMed] [Google Scholar]
- 18.Boer J. Long-term follow-up after radiotherapy of hidradenitis suppurativa. Dermatology. 2022;238:244–250. doi: 10.1159/000517252. [DOI] [PubMed] [Google Scholar]
- 19.Schenck S.G. Hidradenitis suppurativa axillaris; an analysis of 54 cases treated with roentgen rays. Radiology. 1950;54:74–77. doi: 10.1148/54.1.74. [DOI] [PubMed] [Google Scholar]
- 20.Shlyankevich J., Chen A.J., Kim G.E., Kimball A.B. Hidradenitis suppurativa is a systemic disease with substantial comorbidity burden: A chart-verified case-control analysis. J Am Acad Dermatol. 2014;71:1144–1150. doi: 10.1016/j.jaad.2014.09.012. [DOI] [PubMed] [Google Scholar]
- 21.Johnson S.A., Jr, Forbes R.C. Hidradenitis in a patient with AIDS: Palliation with superficial radiation. South Med J. 1994;87:549. doi: 10.1097/00007611-199404000-00028. [DOI] [PubMed] [Google Scholar]
- 22.Garcia-Grande A., Herranz Pinto P., Diaz Diaz R. Radiation therapy for refractory hidradenitis suppurativa. Rep Pract Oncol Radiother. 2013;18(suppl 1):S358. [Google Scholar]
- 23.Patel S.H., Robbins J.R., Hamzavi I. Radiation therapy for chronic hidradenitis suppurativa. J Nucl Med Radiat Ther. 2013;4:2. [Google Scholar]
- 24.Paul S., Bach D., LeBoeuf N.R., Devlin P.M., Lipworth A.D. Successful use of brachytherapy for a severe hidradenitis suppurativa variant. Dermatol Ther. 2016;29:455–458. doi: 10.1111/dth.12393. [DOI] [PubMed] [Google Scholar]
- 25.Kimball A.B., Jemec G.B.E., Alavi A., et al. Secukinumab in moderate-to-severe hidradenitis suppurativa (SUNSHINE and SUNRISE): Week 16 and week 52 results of two identical, multicentre, randomised, placebo-controlled, double-blind phase 3 trials. Lancet. 2023;401:747–761. doi: 10.1016/S0140-6736(23)00022-3. [DOI] [PubMed] [Google Scholar]
- 26.Sabat R., Alavi A., Wolk K., et al. Hidradenitis suppurativa. Lancet. 2025;405:420–438. doi: 10.1016/S0140-6736(24)02475-9. [DOI] [PubMed] [Google Scholar]
- 27.Rozati H., Ferguson F.J., Rashidghamat E., Anand G. Delivery of high-dose radiation for recurrence of breast cancer in a patient with hidradenitis suppurativa. BMJ Case Rep. 2020;13 doi: 10.1136/bcr-2020-238848. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 28.Abu Rached N., Rüth J., Gambichler T., Ocker L., Bechara F.G. A state-of-the-art systematic review of cancer in hidradenitis suppurativa. Ann Med. 2024;56 doi: 10.1080/07853890.2024.2382372. [DOI] [PMC free article] [PubMed] [Google Scholar]
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.