Table 2.
Treatment of hidradenitis suppurativa IN pregnancy.
| Medication | Comments/precautions | |
|---|---|---|
| Safe IN pregnancy | Topical clindamycin 1% BID | |
| Clindamycin 300 mg BID + rifampin 600 mg qd | Clindamycin is a pregnancy category B drug and considered safe in pregnancy; rifampin is pregnancy class C and has not been associated with increased birth defects (evidence is limited) | |
| Dapsone 50–200 mg qd | Presumed safe in pregnancy (evidence is limited) | |
| Adalimumab 40 mg qd | No increased risk of adverse birth outcomes | |
| Infliximab 5 mg/kg at weeks 0, 2, and 6 | No increased risk of adverse birth outcomes | |
| Contraindicated in pregnancy | Oral tetracyclines | Pregnancy class D; can cause dental staining and enamel hypoplasia in developing fetus |
| Spironolactone | Antiandrogen effects can cause feminization of a male fetus | |
| Retinoids | Absolutely contraindicated in pregnancy due to severe birth defects | |
| Surgical management | Although not completely contraindicated, surgical management of lesions should be addressed after pregnancy. | |
BID, twice daily; qd, one a day.