Control of hidradenitis suppurativa in women using combined antiandrogen (cyproterone acetate) and oestrogen therapy

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Abstract
The effects of combined treatment with the antiandrogen, cyproterone acetate, and ethinyl oestradiol on four women with long-standing hidradenitis suppurativa have been investigated. The condition was controlled successfully in all patients with 100 mg/day cyproterone acetate using the reversed sequential regimen; lowering the antiandrogen to 50 mg/day caused deterioration. Before treatment, plasma testosterone levels were within the normal range, but plasma androstenedione values were raised and sex hormone binding globulin levels were low. On treatment, the androstenedione concentration fell and sex hormone-binding globulin values were raised. However, since these levels were unaltered by reducing the antiandrogen dosage, the main action of the therapy is probably that of the antiandrogen within the target cells.