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Current treatment strategies, including topical antibiotics, often yield limited efficacy and pose risks of antibiotic resistance. Photodynamic therapy has emerged as a potential option, with RLP068\/Cl (ELKOFAST\u00ae, non-sterile formulation) showing promising efficacy due to its broad-spectrum bactericidal activity. We conducted a pilot study assessing the therapeutic response to photodynamic therapy with RLP068\/Cl versus topical clindamycin gel in patients affected by hidradenitis suppurativa of Hurley score I, II, and III. Results revealed higher efficacy of photodynamic therapy in combination with RLP068\/Cl, particularly in mild cases. Its efficacy remains reliable even in more severe cases when combined with adalimumab. The observed faster lesion improvement and pain relief were ascribed to the bactericidal effects of RLP068\/Cl against Gram<jats:sup>+<\/jats:sup> and Gram<jats:sup>\u2212<\/jats:sup> bacteria. Furthermore, photoactivated RLP068\/Cl was well tolerated with no adverse events reported. Therefore, photodynamic therapy following RLP068\/Cl application represents a novel therapeutic option for hidradenitis suppurativa with potential implications for antibiotic stewardship in dermatology.<\/jats:p>\n                <jats:p><jats:bold>Graphical abstract<\/jats:bold><\/jats:p>","DOI":"10.1007\/s43630-024-00656-w","type":"journal-article","created":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T18:50:50Z","timestamp":1731351050000},"page":"2123-2132","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Assessment of therapeutic response to photodynamic therapy with the Zn-Phthalocyanine RLP068\/Cl versus topical Clindamycin in patients affected by Hidradenitis Suppurativa: a comparative clinical pilot study"],"prefix":"10.1007","volume":"23","author":[{"given":"E.","family":"Rosi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Prignano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Viola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Venturini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Pimpinelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Calzavara-Pinton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,11,11]]},"reference":[{"issue":"1","key":"656_CR1","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1111\/jdv.16677","volume":"35","author":"TV Nguyen","year":"2021","unstructured":"Nguyen, T. V., Damiani, G., Orenstein, L. A. V., Hamzavi, I., & Jemec, G. B. (2021). Hidradenitis suppurativa: an update on epidemiology, phenotypes, diagnosis, pathogenesis, comorbidities and quality of life. Journal of the European Academy of Dermatology and Venereology., 35(1), 50\u201361.","journal-title":"Journal of the European Academy of Dermatology and Venereology."},{"issue":"5","key":"656_CR2","doi-asserted-by":"publisher","first-page":"1045","DOI":"10.1016\/j.jaad.2019.08.090","volume":"82","author":"SR Goldburg","year":"2020","unstructured":"Goldburg, S. R., Strober, B. E., & Payette, M. J. (2020). Hidradenitis suppurativa. Journal of the American Academy of Dermatology, 82(5), 1045\u20131058.","journal-title":"Journal of the American Academy of Dermatology"},{"issue":"12","key":"656_CR3","doi-asserted-by":"publisher","first-page":"1154","DOI":"10.1111\/exd.14214","volume":"29","author":"CC Zouboulis","year":"2020","unstructured":"Zouboulis, C. C., Benhadou, F., Byrd, A. S., Chandran, N. S., Giamarellos-Bourboulis, E. J., Fabbrocini, G., et al. (2020). What causes hidradenitis suppurativa\u202f?\u201415 years after. Experimental Dermatology, 29(12), 1154\u20131170.","journal-title":"Experimental Dermatology"},{"issue":"4","key":"656_CR4","doi-asserted-by":"publisher","first-page":"922","DOI":"10.1016\/j.jid.2019.08.445","volume":"140","author":"HB Naik","year":"2020","unstructured":"Naik, H. B., Jo, J. H., Paul, M., & Kong, H. H. (2020). Skin microbiota perturbations are distinct and disease severity-dependent in hidradenitis suppurativa. Journal of Investigative Dermatology., 140(4), 922-925.e3.","journal-title":"Journal of Investigative Dermatology."},{"key":"656_CR5","first-page":"10","volume":"1","author":"JW Frew","year":"2019","unstructured":"Frew, J. W., Hawkes, J. E., & Krueger, J. G. (2019). Topical, systemic and biologic therapies in hidradenitis suppurativa: pathogenic insights by examining therapeutic mechanisms. 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