[Acne inversa/hidradenitis suppurativa: An update]

Area of Science:

• Dermatology
• Immunology
• Internal Medicine

Background:

• Hidradenitis suppurativa (HS), also known as acne inversa, is a chronic, recurrent, immune-mediated skin disease.
• It manifests as inflammatory nodules, abscesses, fistulas, and scars in apocrine gland-bearing areas.
• Beyond skin issues, HS patients often experience metabolic changes, spondyloarthritis, and depression, significantly impacting quality of life.

Purpose of the Study:

• To provide a comprehensive overview of hidradenitis suppurativa (HS).
• To summarize essential information regarding the pathophysiology, clinical manifestations, and associated comorbidities of HS.
• To propose a straightforward therapeutic algorithm for managing HS.

Main Methods:

• Literature review and synthesis of current knowledge on HS.
• Analysis of clinical characteristics, immune mechanisms, and extra-cutaneous manifestations.
• Development of a simplified treatment guideline based on evidence.

Main Results:

• HS is a complex dermatosis with significant systemic involvement and profound effects on patients' lives.
• Associated conditions include metabolic disturbances, spondyloarthritis, and psychological comorbidities like depression.
• The disease frequently leads to reduced quality of life, social stigmatization, and unemployment.

Conclusions:

• Hidradenitis suppurativa requires a multidisciplinary approach due to its chronic nature and systemic impact.
• Effective management involves understanding the immune basis and associated comorbidities.
• A proposed therapeutic algorithm aims to guide clinicians in treating HS patients effectively.