Hidradenitis Suppurativa, Acne Inversa, Dissecting Terminal Hair Folliculitis

The document from January 1, 2019, discusses Dissecting Terminal Hair Folliculitis (DTHF), a chronic inflammatory skin condition affecting terminal hair follicles, more common in women and associated with obesity, smoking, and genetic factors. The condition is linked to autoimmune diseases and characterized by an increased Th17 cell/regulatory T-cell ratio, suggesting a proinflammatory predisposition. Genetic mutations in the y-secretase gene complex and impaired Treg-hair follicle stem cell interactions are implicated in hereditary cases. Treatments include antibiotics, anti-inflammatory drugs, and biologics like TNF-α blockers, but these often result in relapse. A combination of clindamycin and rifampicin showed a satisfactory response in 70-80% of patients with moderate disease, but 60% relapsed after 4 months. Surgical excision is the only curative treatment, with a much lower long-term recurrence rate (13-27%). Early diagnosis and surgical intervention are crucial for better outcomes, and the disease has a significant psychosocial impact on patients.