Novel injectable cryopreserved human umbilical cord flowable particulate* in hidradenitis suppurativa lesions

Hidradenitis suppurativa (HS) is a disease of the hair follicle unit leading to recurrent inflammatory nodules, abscesses and tunneling sinus tract wounds. Amniotic membrane and placental tissue, specifically Heavy chain-Hyaluronan/Pentraxin 3_(HC-HA/PTX3), have shown to inhibit inflammation, enhance epithelialization and inhibit scarring1-3. To our knowledge HC-HA/PTX3 has not yet been investigated for use in HS wounds. Here we present our experience using an injectable human umbilical cord particulate* in HS lesions.   To prepare the injection, 25mg of the human umbilical cord particulate is suspended in 1mL of normal saline. Up to 1mL of the suspension is then injected into the lesion.   Briefly, a 42 year old woman with a 20 year history of Hurley Stage 1 HS presented with a new left inguinal crease inflammatory nodule with focal 10/10 pain. The lesion was injected per the above protocol. At her 14 day follow up appointment, the lesion was healed.   In a second case, a 39 year old man with HS Hurley Stage 3 presented with a new inflammatory nodule in the right axilla which was tender. The human umbilical cord flowable matrix was injected into the right axillary lesion per the above protocol. Three days post injection, the patient reported complete pain relief. At the two week follow up appointment, the lesion was healed. He has experienced no local recurrence as of seven weeks post injection.   A third case of a 40 year old woman with Hurley Stage 3 HS on adalimumab presented with two chronic gluteal cleft ulcers and 10/10 pain. The umbilical cord particulate was injected per the above protocol and on day 3 her pain was remarkedly decreased to 5/10. At a week 5 follow up appointment, both gluteal ulcers decreased in size.   These cases illustrate the potential of injectable human umbilical cord particulate to enhance HS wound healing. Further controlled trials are needed to understand its true efficacy in healing HS wounds. A discussion of cases and potential mechanisms of action will be presented.