Acne inversa treated with Infliximab: different outcome in 2 patients.

Sir, Acne inversa, also known as Verneuil’s disease or hidradenitis suppurativa, is a common disorder resulting in a chronic, recurrent and debilitating disease. This condition usually presents with painful, inflamed lesions in the apocrine-gland-bearing areas of the body, most commonly the axillary, inguinal and anogenital areas. The disease usually occurs after puberty and before the age of 40 years, suggesting a hormonal influence on the pathogenesis of the disease. Occlusion of the apocrine duct by a keratinous plug and defects of the follicular epithelium have usually been considered the aetiology of acne inversa. Contributing factors include friction from axillary adiposity, sweat, heat, stress, tight clothing and genetic and hormonal components (1). Acne inversa can be treated with antibiotics, retinoids, corticosteroids, cyclosporine, incision and drainage, local wound care, local excision, radiation and laser therapy. Although there are a wide range of therapies suggested for the treatment of acne inversa, the disease is often resistant and the psychological impact on the patient can be great (2), encompassing social, personal and occupational challenges. We describe here 2 case reports of patients affected by acne inversa resistant to traditional therapies, who were treated with infliximab.