Extract

Conflict of interest: the authors declare that they have no conflicts of interest.

Hidradenitis suppurativa (HS) is a common, chronic, inflammatory skin disorder. Its name is as much a source of controversy as its actual pathogenesis. Once thought to be an apocrinitis, it is now considered a disorder of the entire pilosebaceous unit, stemming from an inappropriate inflammatory response to skin microbiota in the presence of genetic and environmental susceptibility.1

There is a lack of a definitive ‘gold standard’ for the treatment of HS. A review in 20122 showed fair evidence to support the use of antibacterials as first‐line therapy, with infliximab as an alternative for severe (Hurley stage II and III) disease. Other management options include weight loss, smoking cessation, anti‐androgens, acitretin, zinc and dapsone.

We report the successful use of botulinum toxin A (BTXA) for HS, and suggest it as a potential treatment option. This has previously been reported twice in the literature,3  4 and our department has used it successfully in three patients. Our most successful patient asked us to present her case.

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