Hidradenitis suppurativa: a comprehensive review

Area of Science:

• Dermatology
• Pathophysiology

Background:

• Hidradenitis suppurativa (HS), or acne inversa, is a chronic skin condition affecting specific body areas.
• Estimated prevalence reaches up to 4% globally.
• Historically misclassified, HS is now understood as a follicular occlusion disease.

Purpose of the Study:

• To provide an updated overview of hidradenitis suppurativa.
• To discuss the evolving understanding of its pathophysiology.
• To highlight current and emerging therapeutic options.

Main Methods:

• Literature review of hidradenitis suppurativa.
• Analysis of current pathophysiological concepts.
• Summary of therapeutic interventions.

Main Results:

• HS presents clinically with nodules, abscesses, and sinus tracts, often starting at puberty.
• Pathogenesis is now viewed as follicular occlusion, not apocrine gland inflammation.
• Treatment has advanced from antibiotics and surgery to include biologics like TNF-α inhibitors.

Conclusions:

• Hidradenitis suppurativa requires a shift in understanding towards follicular occlusion.
• The disease's impact on quality of life necessitates effective management.
• Novel therapies offer improved outcomes for patients with this challenging condition.