Post-Transcriptional Regulators of Inflammation: The Role of microRNAs in Acne Inversa Pathogenesis

Acne inversa (AI) or Hidradenitis suppurativa is a chronic, inflammatory disorder characterized by painful nodules, abscesses, and scarring, primarily affecting apocrine gland-rich areas. Despite advances in understanding its clinical features, the molecular mechanisms driving AI remain incompletely defined. Emerging evidence highlights the critical role of microRNAs (miRNAs), small non-coding RNAs that regulate gene expression post-transcriptionally, in modulating inflammatory and immune pathways implicated in AI pathogenesis. Specific miRNAs are dysregulated in AI lesional skin and systemic circulation, influencing cytokine production, immune cell recruitment, and keratinocyte activation. These findings position miRNAs as promising non-invasive biomarkers for early diagnosis and disease monitoring. Furthermore, targeting miRNA expression offers a novel therapeutic strategy to restore immune homeostasis and prevent disease progression. This review synthesizes current knowledge on miRNA involvement in AI, underscoring their potential to revolutionize personalized diagnosis and treatment approaches for this complex inflammatory disease.