Hidradenitis Suppurativa/Acne Inversa: An Endocrine Skin Disorder?

    Ioannis Karagiannidis, Georgios Nikolakis, Robert Sabat, Christos C. Zouboulis
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    TLDR Hidradenitis suppurativa may be related to hormones and patients often have metabolic disorders; more research is needed to understand this connection.
    The document from 2016 examines the relationship between Hidradenitis suppurativa/acne inversa (HS), a chronic inflammatory skin disorder, and endocrine as well as metabolic factors. It notes the disease's tendency to manifest after puberty, its higher prevalence in females, and hormonal treatment responses, suggesting hormonal influences. Although studies show conflicting results regarding hormonal dysregulation, with some reporting higher androgen levels and others finding no significant differences, antiandrogen therapy has been effective for some patients. Additionally, a significant link between HS and metabolic syndrome is highlighted, with HS patients showing higher odds for conditions like central obesity and hyperglycemia. The document also discusses the role of adipokines and dietary factors in HS and reviews treatments such as metformin, dietary changes, retinoids, and vitamin D, with varying success. The conclusion emphasizes the need for further research to understand hormonal roles in HS and recommends metabolic disorder screening for HS patients before treatment.
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