Hidradenitis Suppurativa — SCE Dermatology MCQ

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ModerateInflammatory DermatosesHidradenitis SuppurativaSCE Dermatology

A 32-year-old woman with severe hidradenitis suppurativa (Hurley stage III) has failed combination Clindamycin/Rifampicin and is not a surgical candidate. Which biologic therapy is specifically NICE-approved for HS?

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Correct answer: C — Adalimumab

Adalimumab (anti-TNF-alpha) is the only biologic currently NICE-approved (TA392) specifically for moderate-to-severe hidradenitis suppurativa in adults who have not responded to conventional systemic therapy. The dosing regimen for HS differs from psoriasis: 160 mg at week 0, 80 mg at week 2, then 40 mg weekly. Response should be assessed at 12 weeks. Infliximab has evidence from trials but lacks specific NICE approval for HS. Secukinumab (IL-17A inhibitor) received MHRA approval for HS in 2023 but UK NICE approval status differs.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/skin-conditions