Cryoinsufflation for Hurley Stage II Hidradenitis Suppurativa

Report of a Case A woman in her 30s presented with hidradenitis suppurativa (HS), Hurley stage II. She was treated with oral contraceptives (drospirenone/ethinyl estradiol), spironolactone (50 mg/d), topical clindamycin, andmonthly intralesional corticosteroids (triamcinolone acetonide, 10 mg/mL). Previously, she had received rifampicin (600 mg/d), first with minocycline (100 mg/d), then with clindamycin (300 mg/d), and finally with moxifloxacin (400mg/d). After these treatments failed, she received isotretinoin (0.5 mg/kg/d) for 2 more years to achieve remission, but without success. Because shehaddecided tobecomepregnant, shewas searching for an alternative treatment, devoid of teratogenic effects, to safely replace oral contraceptives. Effective therapy was paramount because theHS seriously interferedwith sexual intercourse and indirectly with her planned pregnancy. Surgical treatmentwas offered (local incision anddrainage, deroofing, limited local orwide excision), which she declined.