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Hidradenitis suppurativa.

Robert Sabat1, Afsaneh Alavi2, Kerstin Wolk3

  • 1Psoriasis Research and Treatment Center, Department of Dermatology, Venereology and Allergology and Institute of Medical Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.

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Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease affecting 1% globally. New systemic therapies targeting TNF and IL-17 offer improved management for moderate-to-severe cases.

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Area of Science:

  • Dermatology
  • Immunology
  • Chronic Inflammatory Diseases

Background:

  • Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition causing painful nodules and tunnels.
  • It affects approximately 1% of the global population, typically starting in early adulthood.
  • HS significantly impacts quality of life and is linked to systemic comorbidities due to chronic inflammation.

Purpose of the Study:

  • To review the advancements in understanding HS pathogenesis and treatment.
  • To highlight the impact of HS on patients and society.
  • To discuss current and emerging therapeutic strategies for HS.

Main Methods:

  • Review of recent scientific literature on HS.
  • Analysis of disease pathogenesis, including immune mechanisms (innate, T-cell, B-cell).
  • Evaluation of current treatment modalities and pipeline drugs.

Main Results:

  • HS pathogenesis involves complex immune dysregulation, including IL-1β, TNF, IL-17, and IFN-γ.
  • Chronic inflammation leads to irreversible skin damage like scarring and tunnels.
  • New systemic therapies targeting TNF (adalimumab) and IL-17 (secukinumab, bimekizumab) are now available for moderate-to-severe HS.

Conclusions:

  • Early diagnosis and intervention are crucial to prevent irreversible skin damage in HS.
  • Management requires an interdisciplinary, holistic, and personalized approach.
  • Advances in understanding immune pathways have led to targeted therapies, with more in development.