Follicular Neutrophilic Inflammation in Hidradenitis Suppurativa

The document from January 1, 2018, provides a comprehensive overview of Hidradenitis Suppurativa (HS), a chronic inflammatory skin condition affecting hair follicles, with a prevalence ranging from less than 0.1% to 4% and a higher incidence in women aged 20-29. It outlines the clinical features, diagnosis, and treatment options for HS, including antibiotics, biologic agents like adalimumab, and surgical excision. The pathogenesis of HS is described as involving follicular occlusion, genetic factors, and an autoinflammatory component, with mutations in genes such as those of the y-secretase complex. The document also discusses the role of the immune system, particularly TNF-α inhibitors, in the treatment of HS. Adalimumab was effective in about 80% of patients, while infliximab resulted in a ≥50% decrease in disease severity in 26% of patients. Other treatments and their varying success rates are mentioned, as well as the association of HS with comorbidities like obesity, metabolic syndrome, and an increased risk for skin cancer. Smoking is noted as an aggravating factor. The document concludes that HS may be considered an autoinflammatory disease, and understanding its pathogenesis could lead to more effective treatments. However, the document does not provide the number of people involved in the studies, limiting the assessment of the strength of the evidence presented.