Hidradenitis suppurativa
Open accessAbstract
Hidradenitis suppurativa is a chronic disease characterized by recurrent, painful, deep-seated, rounded nodules and abscesses of apocrine gland-bearing skin. Subsequent suppuration, sinus tracts and hypertrophic scarring are its main features. Onset is usually after puberty, although it is most common during the third decade and may persist in old age. The disease tends to be chronic and may develop to subcutaneous extension leading to indurations, sinus, and fistula having a profound impact on the quality of life. The prevalence is 1% in several studies. Axillary and inguinal involvement is more common in females; peri-anal and buttocks localizations are prevalent in males. The exact aetiology remains unknown. The primary event is a follicular occlusion with secondary inflammation, infection and destruction of the pilo-sebaceo-apocrine apparatus and extension to the adjacent sub-cutaneous tissue. Infection is common. Smoking may be a triggering factor. Obesity aggravates the discomfort. Differential diagnostic includes Crohn's disease, nodular acne and furonculosis. The main complications are arthropathy, carcinoma. Treatment depends upon the stage of the disease. Early nodular lesions may be treated by antibiotics for acute stage; long-term antibiotics, zinc salts may be useful as maintenance treatment; anti-TNF drugs have been used in severe cases; systemic steroids, estrogens, anti-androgens, retinoids have been used as options with limited success. Surgical treatment includes incision with or without drainage for limited abscesses; limited excisions are used for locally recurring draining sinuses. Total wide excision and healing with secondary intention or flaps and grafts is the only curative procedure in case of advanced disease.
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Comorbidity with Crohn's disease and other Th17-induced autoinflammatory diseases, bacterial colonization, and response to anti-TNFα factors strongly suggest immune system involvement in hidradenitis suppurativa.
“Comorbidity with Crohn’s disease and other autoinflammatory Th17-induced diseases [238], subsequent bacterial colonization of the lesions [245, 246] and the response of HS patients to anti-TNFα factors strongly suggest involvement of the immune system.”
From Steroidogenesis in the skin: Implications for local immune functions (2013) · cites this paper as [245]
Altered serum androgen levels are rare in hidradenitis suppurativa patients.
“Altered serum androgen levels [244] are rare in HS patients.”
From Steroidogenesis in the skin: Implications for local immune functions (2013) · cites this paper as [244]
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Cites
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Hidradenitis Suppurativa: Where We Are and Where We Are Going
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- Authors
- Revuz, J.
- Corresponding author
- Revuz, J
- Venue
- Journal of the European Academy of Dermatology and Venereology
- Publisher
- Wiley
- Published
- 2009-09
- Volume
- 23
- Issue
- 9
- Pages
- 985-998
- ISSN
- 0926-9959 (ISSN-L)
- 1468-3083
- OpenAlex
- W4238611516
- Cited by
- 336
- References
- 75
- Citations by year
- 2026: 9 · 2025: 17 · 2024: 20 · 2023: 23 · 2022: 14 · 2021: 18 · 2020: 26 · 2019: 17 · 2018: 25 · 2017: 31 · 2016: 26 · 2015: 35 · 2014: 14 · 2013: 13 · 2012: 17
- FWCI
- 19.55
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of the European Academy of Dermatology and Venereology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Dermatology › Hidradenitis Suppurativa and Treatments
- Health Sciences › Medicine › Epidemiology › Autoimmune and Inflammatory Disorders
- Health Sciences › Medicine › Rheumatology › Osteomyelitis and Bone Disorders Research
- Keywords
- hidradenitis suppurativa, apocrine glands, sinus tract, abscess, follicular occlusion, smoking, obesity, differential diagnosis, Crohn's disease, nodular acne, furunculosis, anti-TNF therapy, antibiotics, zinc therapy, surgical excision, quality of life
- MeSH terms
- Anti-Bacterial Agents, Diagnosis, Differential, Humans, Quality of Life, Radiotherapy, Risk Factors, Severity of Illness Index, Skin, Steroids, Tumor Necrosis Factor-alpha, Hidradenitis Suppurativa, Laser Therapy
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Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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