Ultrasound-guided Percutaneous Galvanic Current Compared to Ultrasound-guided Intralesional Corticosteroid Infiltration in Tunnels of Hidradenitis Suppurativa

Abstract

BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory condition primarily affecting pilosebaceous units in areas with apocrine sweat glands. Although treatment options vary, intralesional therapies are often necessary, even under systemic treatment, but have limitations such as variable efficacy and inability to eliminate persistent tunnels. Percutaneous galvanic current may constitute an alternative intralesional therapy in HS. OBJECTIVE: This study aimed to compare the efficacy and safety of ultrasound-guided percutaneous galvanic current (GC) with ultrasound-guided intralesional triamcinolone acetonide (AT) in treating inflammatory or draining HS tunnels. Additionally, the study sought to analyze the ability of both therapies to physically eliminate treated HS tunnels. METHODS: Ambispective observational study including patients treated with GC and AT for HS tunnels. Efficacy and safety were assessed 12 weeks post-treatment, complete response to treatment was defined as the absence of spontaneous suppuration or upon vigorous digital pressure during physical examination, coupled with the absence of Doppler signal suggestive of inflammatory activity on ultrasound. RESULTS: Sixty-six patients were included, with 26 receiving GC and 40 receiving AT. Both groups showed comparable socio-demographic and clinical characteristics. At 12 weeks, complete response was observed in 77.6% of GC-treated patients compared to 55% of AT-treated patients. Ultrasound evaluations revealed that GC treatment resulted in fibrosis formation in 38.46% of treated tunnels. GC demonstrated a significant reduction in pain intensity compared to AT. Safety profiles were favorable for both treatments. CONCLUSION: Ultrasound-guided percutaneous galvanic current may constitute an intralesional treatment alternative in inflammatory and draining HS tunnels, with the potential to physically eliminate the treated lesion and with an acceptable safety profile.