Review Article Dermatology Intralesional Treatments in Hidradenitis Suppurativa: A Systematic Review Carlos Cuenca-Barrales a, b Trinidad Montero-Vílchez a, b Manuel Sánchez-Díaz a Antonio Martínez-López a, b Juan Ángel Rodríguez-Pozo a Pablo Díaz-Calvillo a Salvador Arias-Santiago a, b, c Alejandro Molina-Leyva a, b a Hidradenitis Suppurativa Clinic, Dermatology Department of Hospital Universitario Virgen de las Nieves, Granada, Spain; b TECe19-Dermatología Clínica y Traslacional Investigation Group, Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; c University of Granada, Granada, Spain Received: September 23, 2021 Accepted: March 13, 2022 Published online: April 27, 2022 Correspondence to: Salvador Arias-Santiago, salvadorarias @ugr.es © 2022 S. Karger AG, Basel Karger@karger.com www.karger.com/drm DOI: 10.1159/000524121 Keywords Hidradenitis suppurativa · Systematic review (publication type) · Injections · Intralesional treatment · Triamcinolone acetonide · Photochemotherapy Abstract Hidradenitis suppurativa (HS) is an inflammatory chronic dis- ease with difficult management. In some scenarios, intrale- sional (IL) treatments could be useful. However, the scien- tific evidence available is limited and heterogeneous. We aimed to synthesize the available scientific evidence on IL treatments in HS. We conducted a systematic review in July 2021. The clinical databases reviewed included MEDLINE and Embase. All types of epidemiological studies and case series with at least 10 patients were included; reviews, guide- lines, protocols, conference abstracts, case series with less than 10 patients, and case reports were excluded. Fifteen ar- ticles representing 599 patients and 1,032 lesions were in- cluded for review. Corticosteroid injections were the most reported treatment. They showed effectiveness for the treat- ment of acute inflammatory lesions and fistulas in terms of reduction of lesion counts, symptoms, and signs of inflam- mation and were safe in general terms. Light-based thera- pies were the other main treatment group, including photo- dynamic therapy and 1,064-nm diode laser. They were also effective, but more local and systemic adverse events were reported. Other treatments included botulinum toxin type B and punch-trocar-assisted cryoinsufflation (cryopunch). They were effective and safe, although were reported anec- dotally. The main limitation of the systematic review was the general quality of the articles included. In conclusion, IL treatments such as corticosteroid injections and light-based therapies seem to be effective and safe for both acute in- flammatory lesions and fistulas, although more prospective studies, with higher sample sizes and with standardized out- comes are needed to provide more scientific evidence on the subject. © 2022 S. Karger AG, Basel Introduction Hidradenitis suppurativa (HS) is a chronic, inflamma- tory, recurrent, debilitating skin disease of the hair follicle that usually presents after puberty with painful, deep- seated, inflamed lesions in the apocrine gland-bearing ar- eas of the body [1]. HS management is difficult and chal- The first two authors, Carlos Cuenca-Barrales and Trinidad Montero- Vílchez, equally contributed to the manuscript.