Intralesional secukinumab for localized, recalcitrant hidradenitis suppurativa: a case series of rapid symptom relief

PURPOSE: Hidradenitis suppurativa (HS) is a debilitating, chronic, inflammatory disease. While secukinumab (an IL-17A inhibitor) demonstrates systemic efficacy, specific lesions often remain resistant to systemic therapy, representing a significant unmet clinical need. This case series aimed to evaluate the efficacy and safety of intralesional secukinumab for localized HS lesions. MATERIALS AND METHODS: We retrospectively analyzed five patients treated with this modality after failing conventional therapies, including oral tetracyclines and oral/intralesional corticosteroids. RESULTS: Post-treatment, all targeted lesions showed marked reduction in inflammation and nodule size. Notably, patient-reported Visual Analogue Scale (VAS) and Dermatology Life Quality Index (DLQI) scores decreased rapidly in the short term. No severe local adverse events or systemic side effects were observed. CONCLUSIONS: These preliminary findings suggest that intralesional secukinumab may serve as an effective, well-tolerated adjunctive strategy, particularly for localized, recalcitrant lesions, offering a new perspective in HS management.