We conclude that TNF-α antagonists may be beneficial in the management of DCS by reducing inflammation, pain and discharge. If used early in the disease course, they may prevent or decrease chronic sequelae such as scarring with permanent destruction of hair follicles.
Their use may be beneficial prior to surgical resection by reducing the extent of involvement.[4] TNF-α inhibitors do not alter structural disease and are not curative, but they provide an alternative management option of this challenging disease, and should be considered in refractory cases. In order to gain accurate assessment of the efficacy of biological agents in DCS, validated scoring systems need to be established and studied in randomized controlled trials.