Combination Therapy of Oral LDN and Topical Pentoxifylline, Rifampin, Clindamycin for Hidradenitis Suppurativa

Int J Pharm Compd. 2024 Jul-Aug;28(4):271-277.

Abstract

Hidradenitis Suppurativa (HS) is a chronic inflammatory skin disease that may have profound effects on the patient's quality of life. A personalized HS combination therapy treatment was prescribed to a 54-year-old female suffering from multiple painful sores, as follows: naltrexone capsules titrated from 0.5 mg up to 4.5 mg; pentoxifylline 5%, rifampin 2%, clindamycin 1%, and glycolic acid topical cream. Clinical improvements were observed using two disease-specific outcome measures: Hurley Staging System and HS Score. The patient's HS improved from Stage II (moderate) to Stage I (mild), and the HS score decreased from 103 points with five anatomical regions reported, to 19 points with only three regions affected. Furthermore, the before and after treatment photographs showed a visible reduction in the number of boils/skin abscesses and an overall recovery. Improvements were also observed across all domains of the patient's self-reported quality of life (Hidradenitis Suppurativa Quality of Life Assessment). The patient did not experience any undesirable effects. Compounded medications may be customized to meet the patient's special needs and may be adjusted throughout the course of treatment to match the patient's individual progress. Although further studies are necessary, this personalized, combination therapy may be a key treatment option in HS.

Publication types

  • Case Reports

MeSH terms

  • Administration, Oral
  • Administration, Topical
  • Anti-Bacterial Agents / administration & dosage
  • Clindamycin* / administration & dosage
  • Clindamycin* / therapeutic use
  • Drug Combinations
  • Drug Therapy, Combination*
  • Female
  • Hidradenitis Suppurativa* / drug therapy
  • Humans
  • Middle Aged
  • Pentoxifylline* / administration & dosage
  • Pentoxifylline* / therapeutic use
  • Quality of Life
  • Rifampin* / administration & dosage
  • Treatment Outcome

Substances

  • Clindamycin
  • Pentoxifylline
  • Rifampin
  • Anti-Bacterial Agents
  • Drug Combinations