Mechanical Stress and the Development of Pseudo-Comedones and Tunnels in Hidradenitis Suppurativa/Acne Inversa

The document discussed the role of mechanical stress in the development of lesions in Hidradenitis suppurativa (HS), a chronic inflammatory skin condition. It highlighted that mechanical stress might contribute to the formation of pseudo-comedones and tunnels in HS, similar to acne inversa. Historical experiments by Plewig on acne comedones suggested that mechanical stress could lead to keratinocyte proliferation and inflammation, resulting in scar formation and pseudo-comedones. The study proposed that IL-17-driven inflammation, exacerbated by mechanical stress, could be a key factor in HS pathogenesis. The findings suggested that mechanical stress might lower the threshold for keratinocyte proliferation in HS, providing a potential target for understanding and managing the disease.