Phosphodiesterase-4 Inhibitors in the Treatment of Hidradenitis Suppurativa: A Systematic Review Publisher



Vahabi S M ; Pourgholi E ; Lasalle C ; Gainer H ; Wang Y ; Amber K T
Source: Archives of Dermatological Research Published:2026

Abstract

Current treatments for HS are limited in their efficacy, and severe manifestations of the condition can have debilitating effects on affected patients. This review aims to evaluate the use of phosphodiesterase-4 inhibitors (PDE4i) in the treatment of Hidradenitis Suppurativa (HS), a chronic inflammatory skin condition. A comprehensive literature review was conducted in PubMed/Medline, Scopus, Web of Science, and Embase. This review included studies of patients with HS who received at least one PDE4i, and quality of articles was evaluated by two authors using National Heart, Lung, and Blood Institute (NHLBI) quality assessment tools. Results demonstrated an overall efficacy of 53.4% of patients receiving at least one PDE4i achieving HiSCR, with major side effects including gastrointestinal symptoms, weight loss, and headache experienced by 20.9% of patients across all PDE4i. Thus, PDE4is may offer a well-tolerated option for HS with modest HiSCR. Further high-quality randomized controlled trials are needed to confirm their efficacy, define optimal dosing strategies, and establish their place in clinical practice. © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2026.