Hidradenitis Suppurativa as a Potential Subtype of Autoinflammatory Keratinization Disease

The document discussed the potential classification of Hidradenitis Suppurativa (HS) as a subtype of autoinflammatory keratinization disease (AIKD), highlighting its chronic and recurrent nature with painful nodules, abscesses, and scarring. It emphasized the role of genetic mutations in γ-secretase genes (NCSTN, PSENEN, PSEN1) and the dysregulation of the innate immune system and keratinization processes. The study noted the upregulation of interleukin-1β, interleukin-36, caspase-1, and NLRP3, along with Th17:Treg cell axis dysregulation, suggesting a significant autoinflammatory component. The efficacy of biologics like adalimumab supported the immunological nature of HS, although the exact sequence of inflammatory and hyperkeratotic events remained uncertain. Understanding HS within this framework could lead to better-targeted therapies and improved patient outcomes.