Getting Into the DNA of Hidradenitis Suppurativa

This article reflects on the position of HS in dermatology in the past decades, discusses important highlights and status in the field of HS awareness, treatment and research. HS has evolved from a disease with neglible treatment options, rarely seen in dermatology four to five decades ago, to the current situation where dermatologists are in the lead with treatment options giving significant relief to patients. HS surgery, treatment with adalimumab, the anti-IL17s and fostering by the EHSF e.V. has greatly contributed to this positive development. To reach the next level in precision medical treatment, paving the way to disease modification, dissection of the disease 'to the DNA' is necessary. The focus should be on gene discovery, immunology, disease stratification, phenotypes and endotypes based on multi-omics, with special attention for early disease alterations in the hair follicle.