Recalcitrant severe hidradenitis suppurativa successfully treated with cyclosporine A.

Hidradenitis suppurativa therapy is usually complex and unsatisfactory. Systemic antibiotics, isotretinoin and tumor necrosis factor-alfa are used with relapses following discontinuation. The use of CyA in hidradenitis suppurativa, effective and well tolerated, has rarely been reported in the literature. A 52-year-old male, with an 8-year history of recurrent inflammatory nodular and cystic lesions, discharging sebaceous and seropurulent material associated with sinus and fistula occurrence of the anogenital region, groins, and right axilla, is reported. Several antibiotic therapies, oral isotretinoin, infliximab and etanercept had been ineffective or temporarily effective. The Dermatology Life Quality Index showed a severe impairment of life quality. Oral cyclosporine A was started and after 2 months an improvement of lesions was observed. During the last 2 years cyclosporine A has been well tolerated, with marked reduction in inflammation and suppuration and significant improvement in the quality of life of the patient.