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Background: Hidradenitis suppurativa (HS) is a chronic, recurrent and disabling inflammatory skin condition, clinically characterized by nodules, bullae, abscesses, fistulae, and draining sinus tracts mainly located in axillae, inguinal folds, inframammary region and buttocks, often leading to pain, scarring, disfigurement and decreased quality of life. Due to its complex nature, with still no completely elucidated etiology and pathogenesis, the management of HS can be challenging. In fact, many patients do not respond to the traditionally available systemic treatments, including anti-inflammatories, antibiotics and surgery. Research has provided new insights into the mechanisms of HS, mainly investigating on the inflammatory cytokine pathways underlying the disease. Methods: We review the current knowledge on newer therapeutic approaches and targets for the treatment of HS, through a PubMed-based literature search. Results: In this setting, studies on tumor necrosis factor-α, IL-1β, IL-10, and the IL-23/T-helper (Th) 17 and IL12/Th1 axes in immune dysregulation in HS have helped in developing new regimens. Inhibitor of phosphodiesterase 4 and laser treatments have shown clinically meaningful efficacy with good short-term safety and tolerability. Conclusion: Target therapy has revolutionized the treatment of moderate to severe HS, basing on the inhibition of specific molecular or cellular targets, directly involved in the pathogenesis of the condition.

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Many clinical studies reported the safety and efficacy of PDT in the treatment of VWs. Chong and Kang reported complete healing of a recalcitrant acral VW after three PDT sessions. 5 Recently, Huang et al. reported that, compared with cryotherapy, the combination of superficial shaving and PDT results in a better healing and a lower recurrence rate of warts. 4 In our case, clearance of warts was achieved after only two sessions, with minimal side effects and no recurrence at one-year follow-up. In conclusion, PDT may represent a relatively new therapeutic modality for some patients with warts, especially where other treatments have shown no or minimal improvement, or in whom invasive therapies should be avoided or not well tolerated.

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