Place des antibiotiques à diffusion systémique dans la prise en charge de la maladie de Verneuil

Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition characterized by inflammatory nodules, abscesses, and persistent drainage, primarily affecting the major skin folds. Affecting 0.5-1% of the general population, it significantly impacts quality of life. In the age of biological treatments, antibiotics continue to be an important therapeutic option for managing HS. However, they are not curative, as relapses or the development of new lesions are common after discontinuation. Given the disease's high prevalence, antibiotic use should be carefully limited, tailored to the clinical severity, and aligned with specific therapeutic goals, as part of a comprehensive multidisciplinary treatment plan. Currently, antibiotics are typically used to manage mild cases (Hurley stage 1), acute flare-ups, and severe cases before a biologic or for patients that are resistant to biologic therapies (Hurley stages 2 and 3). The role of antibiotics in the preoperative management of severe lesions is still under investigation.