The most recent advances in understanding and managing hidradenitis suppurativa

Abstract

Hidradenitis suppurativa (HS) is a chronic, inflammatory, recurrent, and debilitating skin disease of the hair follicle unit that typically develops after puberty. HS has a significant negative impact on both the quality of life (QOL) of patients affected by this disease as well as family members and caregivers. However, the pathogenesis of HS is multifactorial and still remains to be fully elucidated, which makes the development of treatments difficult. The last 10 years have seen a surge in HS research, and many new findings have come to light, yet much more remains to be elucidated. Physicians must employ a multidisciplinary approach to maximally address all facets of HS. Clinical characteristics of the disease that differ between females and males as well as across different races and ethnic groups must be considered. Targeted topical, oral, and injectable therapies continue to be developed for HS as a greater understanding of the pathogenesis is reached. However, randomized controlled trials regarding dietary factors that may contribute to HS are needed to meet our patients’ growing concerns and questions about the role of diet in HS pathogenesis. Finally, improved outcome measures are needed to standardize HS severity and grading between physicians and clinical trials, and a more diverse representation of HS populations is needed in clinical trials.

Hidradenitis suppurativa in skin of colour

“…A more in‐depth understanding of HS in skin of colour patients in the USA and outside of the USA is of major interest 5 . In light of this lack of knowledge, simple measurements are initially required to inform and support physicians in countries with skin of colour, especially in Africa for HS diagnosis and treatment, such as simple HS recommendations for diagnosis 24 (Table 1) and clinical care 1,35 …”

“…Understanding HS among African American patients in the USA is an ongoing concern 1–5 . A population‐based prevalence of 0.13% 6 and a mean HS incidence of 6.0 per 100 000 person‐years with a 2.5‐fold increase between the years 1968 and 2008 has been reported from Rochester, Minnesota, USA 7 .…”

Ectopic Hidradenitis Suppurativa: Case Report and Review of Literature

“…Other suspected inflammatory markers in the pathogenesis of hidradenitis suppurativa include IL-1, IL-6, IL-12, and IL-23. Based on the identification of numerous cytokines, agents that block these inflammatory markers have been reported in the management of hidradenitis suppurativa [ 2 , 17 ].…”

“…Biologic agents targeting IL-17 (secukinumab) and IL-12/IL-23 (guselkumab) have also been used by individual patients with varying efficacy to treat hidradenitis suppurativa; however, multi-center, randomized, double-blind studies of these medications are currently ongoing to assess efficacy over a larger population with hidradenitis suppurativa. To date, drug trials with concurrent use of adalimumab with either secukinumab or guselkumab have not been performed [ 1 , 17 - 19 ].…”

“…To date, drug trials with concurrent use of adalimumab with either secukinumab or guselkumab have not been performed [1,[17][18][19].…”