Prolonged disease remission of the chronic immunological skin disorder hidradenitis suppurativa with adjunctive bacteriophage therapy

Hidradenitis suppurativa (HS) is a chronic skin disease in which the acute development of noduli, abscesses and in a later stage fistulas remains difficult to control, despite a wide range of recommended treatment options including immunomodulatory biologicals, surgical intervention and antibiotics. Besides being painful, associated lesions have an extensive impact on the quality of life. While HS is primarily an immune-mediated inflammatory disease, the skin microbiota plays a key role in its pathogenesis with pathogenic bacterial colonization of lesions observed. Bacteriophages, the viruses of bacteria, are used to treat a 52-year-old female HS patient with re-current colonization of lesions with Staphylococcus aureus. Phage therapy results in complete removal of lesions with a flare-free period of six months, along with a substantial improvement in the patient’s quality of life. The deployed experimental framework and the gained clinical experience will be valuable for future HS phage therapy research.