Hidradenitis suppurativa is a chronic autoinflammatory skin condition with significant comorbidities. Advances in our understanding of its pathogenesis are leading to new potential treatments.
- Hidradenitis suppurativa (HS) is an autoinflammatory skin condition involving the innate immune system.
- The pathogenesis of HS is not fully understood; inflammation has been regarded as secondary to follicular occlusion but is now considered the likely initial event.
- Genetics, the skin and gut microbiome and biofilms are also likely to play significant roles in HS pathogenesis.
- HS is part of the follicular occlusion tetrad, and evidence is emerging that the other members (acne conglobata, dissecting cellulitis of the scalp and pilonidal sinus) are anatomical variants of HS.
- Biologics such as interleukin-23 and interleukin-1 are emerging off-label treatments for patients with HS, although large-scale randomised clinical trials are lacking.