Hidradenitis Suppurativa: From Physiopathologies to Targeted Therapeutics

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder with a global prevalence of about 1.0%, primarily affecting areas where skin surfaces rub together, such as the armpits, buttocks, and groin. It is associated with systemic complications, including metabolic and cardiovascular diseases, which can reduce patient longevity. The disease is linked to genetic factors, smoking, obesity, and hormonal influences, and involves immune system abnormalities around hair follicles. Inflammatory mediators like TNF, IL-1β, and IL-17 play a role in its pathophysiology. HS typically emerges after puberty and is often diagnosed around age 30, persisting into older age. Treatment varies by disease stage, with antibiotics for early nodular lesions, long-term antibacterials, zinc salts, and anti-TNF medications for severe cases. Surgical interventions are necessary for advanced disease, with total wide excision being the only curative option.