Hidradenitis suppurativa: epidemiology, clinical features, associated comorbidities and treatment

Hidradenitis suppurativa (HS) is a chronic relapsing suppurativa skin disease localized in the apocrine-gland-bearing areas of the body, predominantly in the axillae and groin. Although important risk factors have been identified, the pathomechanisms of the disease have not been fully understood. In the absence of proper treatment, chronic inflammation results in debilitating, and sometimes life-threatening complications. This severe and chronic disease can have detrimental effects on self-esteem and quality of life and is associated with high comorbidity, such as the metabolic syndrome and its components. Early detection and treatment in patients with HS may prevent late direct complications, such as severe scarring, and indirect complications, i.e. cardio-vascular disease. Thus appropriate screening and treatment should be prompt. No definitive treatment has been recognized, but several therapies have been found to reduce lesion severity and improve symptoms of HS. Additional research is needed for evaluation of the comparative effectiveness of topical and systemic treatments and for better understanding of the pathogenesis, natural history, and subtypes of HS.