Hidradenitis suppurativa: from pathogenesis to diagnosis and treatment

Abstract

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease primarily affecting apocrine gland-rich areas of the body and presenting with painful nodules, abscesses, sinus tracts, and scarring. HS is a multifactorial disease in which genetic and environmental factors play a key role. The primary defect in HS pathophysiology involves follicular occlusion of the folliculopilosebaceous unit, followed by follicular rupture, and immune responses (perifollicular lympho-histiocytic inflammation), finally leading to the development of clinical HS lesions. HS has a destructive impact on the patient’s quality of life, being a very challenging disease. Available treatments are limited, mostly off-label and with high variability in the reported efficacy. Fortunately, a monoclonal antibody against tumor necrosis factor alpha has been recently approved for treatment of moderate to severe HS, offering patients a promising new option. This review focuses on the main features of HS, including epidemiology, clinical aspects, pathogenesis, severity classifications, comorbidities, and currently available treatments.

Ultrasonography in the pathway to an optimal standard of care of hidradenitis suppurativa: the Italian Ultrasound Working Group experience

“…The current classifications and staging systems of HS are based on the clinical recognition, count and localization of the cutaneous lesions . Although additional clinical information has been suggested, overall simple clinical evaluation may underestimate the real extent and severity of the disease …”

Fluorescent light energy: A new therapeutic approach to effectively treating acne conglobata and hidradenitis suppurativa

“…The pathology of AC resembles hidradenitis suppurativa (HS), which also features large sensitive nodules and draining sinus tracts. In both cases, the active areas are severely inflamed and unstable . Systemic therapy with isotretinoin is the most common treatment choice for severe cystic acne.…”

Homocysteine plasma levels in patients affected by hidradenitis suppurativa: an Italian experience

“…Hidradenitis suppurativa (HS) is a chronic, inflammatory, recurrent and debilitating skin disease, which is frequently associated with other systemic conditions . In particular, several studies have suggested that patients with HS have a higher cardiovascular risk compared with healthy controls (HCs) .…”