For Immediate Release: December 17, 2025
Media contact: Katelyn Deckelbaum, katelyn [dot] deckelbaum
gwu [dot] edu (katelyn[dot]deckelbaum[at]gwu[dot]edu)
Researchers from the George Washington University School of Medicine and Health Sciences report encouraging early results using topical roflumilast 0.3% cream for the management of mild hidradenitis suppurativa (HS), a chronic inflammatory skin condition with limited targeted treatment options in early disease. The prospective case series was published in JAAD Case Reports.
Hidradenitis suppurativa is a long-lasting inflammatory skin condition that causes painful lumps, draining tunnels under the skin, and scarring, usually in areas like the armpits, groin, and under the breasts. It has traditionally been treated with repeated courses of antibiotics or steroids, which can lead to antibiotic resistance and side effects, especially in sensitive skin folds. Although biologic drugs have improved treatment for more severe cases, there are still limited options for people with mild HS.
In this prospective case series, three patients with Hurley stage I HS were treated with once-daily off-label topical roflumilast 0.3% cream and followed over a 60-day period. Investigators assessed both objective lesion counts and patient-reported symptoms, including pain, itch, odor, and drainage.
Key Findings:
- Reduction in inflammatory lesions: All three patients experienced a decrease in nodule count by 30 days, with complete clearance achieved by 60 days
- Rapid symptom improvement: Pain, itch, odor, and drainage improved within the first month and were sustained through two months
- Consistent benefit across disease burden: Improvement was observed even in the patient with the highest baseline lesion count and symptom severity
- Favorable tolerability: No local or systemic adverse events were reported, including burning, stinging, or gastrointestinal symptoms
“Patients with mild hidradenitis suppurativa are often missed, caught in a cycle of antibiotics and corticosteroids.” said Adam J. Friedman, Professor and Chair of Dermatology at George Washington University. “These early findings suggest that topical roflumilast may offer a targeted, well-tolerated approach that addresses inflammation without many of the drawbacks of our current therapies.”
Topical roflumilast is a phosphodiesterase-4 (PDE-4) inhibitor approved for plaque psoriasis and is known to modulate inflammatory pathways implicated in HS, including Th1 and Th17 cytokine signaling.
“Our goal was to explore whether a medication already familiar to dermatologists could be repurposed thoughtfully for patients with early disease,” said Nagasai C. Adusumilli, chief resident at GW Dermatology and lead author of the study. “The rapid improvement in both objective findings and patient-reported symptoms was clinically meaningful and reinforces the importance of studying targeted topicals in hidradenitis suppurativa.”
While limited by small sample size and short duration, the authors emphasize that these results support further investigation of topical PDE-4 inhibition in HS, particularly as an early intervention or adjunctive therapy.
“Treating HS earlier and more precisely has the potential to alter disease trajectory,” Friedman added. “This study underscores the need for larger, controlled trials to better define where topical roflumilast may fit in our treatment algorithm.”
-GW-