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Hidradenitis suppurativa (HS) causes acute and chronic abscesses, leading to persistent pain, functional impairment, formation of sinus tracts, scarring, foul-smelling exudates, occlusion and inflammation of hair follicles, and secondary involvement of apocrine follicles. Antibiotics, incision and drainage, marsupialization of sinus tracts, and intralesional injection of triamcinolone acetonide help with signs and symptoms but usually don't prevent new lesions. Despite HS's resemblance to cystic acne, results of systemic isotretinoin treatment are usually unimpressive. Acitretin, another retinoid, seems to work better.
In this trial of acitretin for HS, 12 patients with severe disease received 0.5–1.0 mg/kg of oral acitretin daily for 9–12 m…