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. Histopathology studies suggested that keratin plugging and inflammation lead to these formations. The research referenced experiments by Plewig, which showed that open comedones could develop into scar tissue, resembling HS lesions. The study proposed that IL-17-driven inflammation and keratinocyte proliferation, possibly exacerbated by mechanical stress, are key factors in HS pathogenesis. Recent clinical reports supported the hypothesis that mechanical stress is a risk factor for HS, with cases linked to friction from prosthetics and clothing.