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