Preliminary Findings Suggest Hidradenitis Suppurativa May Be Due to Defective Follicular Support

Preliminary findings suggested that hidradenitis suppurativa (HS) might have been due to defective follicular support rather than apocrine gland occlusion. Initially thought to result from apocrine gland occlusion, later studies by Plewig and Steger proposed that infundibular occlusion of the hair follicle was the primary cause. Histological evidence supported this, showing follicular occlusion as a key feature. Further studies revealed a lack or reduction of sebaceous glands in HS, differentiating it from acne vulgaris and explaining the ineffectiveness of isotretinoin in treating HS. New histological features, such as psoriasiform hyperplasia and keratin fibers from ruptured follicles, were identified, contributing to inflammation in HS lesions.