European Hidradenitis Suppurativa Foundation e.V.

12th Conference of the European Hidradenitis Suppurativa Foundation e.V. (EHSF)

Join us for the 12th Conference of the European Hidradenitis Suppurativa Foundation e.V. (EHSF). Next year we will bring the annual conference to each of you in the form of a hybrid experience. EHSF 2023 brings together scientists and healthcare professionals involved with hidradenitis suppurativa / acne inversa from all around the world. We will put together an outstanding scientific program designed to provide significant information to the scientific and lay community.

www.ehsf2023.com »

Systemic Therapy for Patients with Hidradenitis suppurativa/Acne inversa during the pandemic phase of SARS-CoV-2 (Coronavirus)

Dear colleagues,

the ongoing coronavirus (COVID-19) pandemic is a serious public health concern. It  is not known to what extent the coronavirus impacts Hidradenitis suppurativa/Acne inversa and its treatment. The European Hidradenitis Supurativa Foundation (EHSF) e.V. advises physicians to be alert to the potentially harmful effects of COVID-19 infection on patients with Hidradenitis suppurativa/Acne inversa and counsel all their patients on how to prevent transmission of the virus.

It is recommended that patients with symptoms, initially consult their doctor by email, fax or telephone. For Hidradenitis suppurativa/Acne inversa patients diagnosed with COVID-19 disease, the EHSF recommends physicians to discontinue the use of immunosuppressant medications. This is in accordance with established psoriasis treatment guidelines for psoriasis (for example, the European Dermatology Forum and the American Academy of Dermatology), which recommend the discontinuation of immunosuppressive treatments in patients with active infections.

As of now, there is insufficient evidence to determine how COVID-19 will impact Hidradenitis suppurativa/Acne inversa patients on systemic treatment. Patients using TNF-alpha blockers (adalimumab, infliximab, etanercept) may have a slightly increased risk of upper repiratory tract infections, especially for infliximab. Particular caution is, therefore, recommended for individuals generally at risk of developing a more serious course of COVID-19 disease: Men, age 60+ years and patients with cardiovascular disease, pulmonary diseases or diabetes.

In the event of acute fever or respiratory symptoms and other clinical suspicion of a COVID-19 infection,  it is advised that a diagnosis is carried out following the current recommendations of the respective authorities. If medication is imminent, it is recommended that it is postponed until a diagnosis is made.The EHSF will continue to provide updates to the global dermatology community.

For the latest information on the coronavirus (COVID-19) outbreak, including prevention and signs and symptoms of the disease, please refer to the World Health Organization (WHO) website.

Prof. Dr. Veronique del Marmol, Brussels, Belgium
Prof. Dr. Gregor B.E. Jemec, Roskilde, Denmark
Prof. Dr. Christos C. Zouboulis, Dessau, Germany
Prof. Dr. Errol Prens, Rotterdam, The Netherlands
Prof. Dr. Thrasyvoulos Tzellos, Harstad, Norway

CONSENSUS FOR ANTI- COVID-19 MEASUREMENTS IN HS PATIENTS

Giamarellos-Bourboulis EJ, Bettoli V, Jemec GBE, et al. Anti-COVID-19 measurements for hidradenitis suppurativa patients. Exp Dermatol 2021;30(suppl 1):18–22

Taking into consideration the available data, the experts of the symposium “Anti-COVID-19 measurements in HS patients”, which took place during the 10th International Conference of the EHSF e.V. reached unanimously a consensus on behalf of the European Hidradenitis Suppurativa Foundation e.V., which includes the following measures:

• The prevalence of COVID-19 in patients with HS is apparently lower than that of the general population. This may be due to HS patients having been especially careful with social shielding. However, underestimation is also possible.
• HS appears not to be associated with a more severe course of COVID-19.
• Treatment of HS with antibiotics and the TNF-α inhibitor adalimumab seems not to increase the risk for COVID-19 or induce a more severe course.
• Treatment initiation of HS patients with other therapeutic compounds should be carefully evaluated at individual level.
• Even if we do not yet know what effect—if any—vaccination has on HS (and vice versa), anti-SARS-CoV2 vaccination is recommended. Benefits versus risks should be considered at an individual level.
• Treatment with adalimumab appears to be compatible with anti-SARS-CoV2 vaccination and should not be interrupted, especially in moderate-to-severe HS. It might be suspended around the time point of anti-SARS-CoV2 vaccination.
• It is still unclear if biologics may compromise SARS-CoV2 vaccination. Serological confirmation of successful vaccination by ELISA is still not recommended as routine practice.
• National self-protection and hygiene measurements should be adhered to. Self-protection with masks is recommended even despite vaccination.
• This consensus is based on expert opinion and literature evidence, and complements the recommendations already published by other scientific societies.

Based on the available knowledge, HS patients may be vaccinated and the group of them, affected with metabolic syndrome, at the soonest possible time. HS patients on adalimumab treatment can be vaccinated with non-living virus anti-SARS-CoV2 vaccines. A possible suboptimal effect of the vaccine may be suspected. The management of the biological treatment in HS patients is at the discretion of the dermatologist / responsible physician.