Pathophysiology of hidradenitis suppurativa: An update

Area of Science:

• Dermatology
• Immunology
• Genetics

Background:

• The precise pathogenesis of hidradenitis suppurativa (HS), also known as acne inversa, remains incompletely understood.
• Current understanding points to the hair follicle as the primary site of the defect in HS pathophysiology.
• Genetic and environmental factors significantly influence the HS phenotype.

Purpose of the Study:

• To elucidate the key mechanisms underlying hidradenitis suppurativa (HS) pathogenesis.
• To identify the necessary conditions for the development of clinical HS.
• To highlight the need for translational research in HS.

Main Methods:

• Review of recent research on HS pathophysiology.
• Analysis of the role of the hair follicle in HS.
• Examination of contributing genetic and environmental factors.

Main Results:

• Follicular occlusion and rupture are critical initial events in HS development.
• A foreign body-type immune response is essential for clinical manifestations of HS.
• Factors such as smoking, microbial colonization, and obesity contribute to HS.

Conclusions:

• Understanding HS pathogenesis requires focusing on the hair follicle and subsequent immune responses.
• Genetic predisposition and environmental triggers play a significant role in HS.
• Translational research targeting inflammatory pathways is vital for advancing HS therapeutics.