Comprehensive Overview of Hidradenitis Suppurativa

The document from December 2015 provides a comprehensive overview of Hidradenitis Suppurativa (HS), a chronic inflammatory skin condition, emphasizing its significant impact on patients' quality of life. It highlights the disease's prevalence, estimated between 0.1% and 4.1%, and its onset typically after puberty, with a higher incidence in females. The pathogenesis of HS is not fully understood but is thought to involve immunologic factors, genetic predisposition, obesity, and smoking. The document outlines an evidence-based management algorithm for HS, recommending lifestyle modifications such as smoking cessation and weight loss, which can lead to a 35% decrease in symptoms. Various medical treatments are discussed, including antibiotics, hormonal therapies, and biologics like TNF inhibitors, with infliximab showing an 80-89% response rate. Surgical intervention is advised for improved outcomes, and a maintenance regimen of topical clindamycin is recommended for all patients. The document also notes the association of HS with metabolic syndrome and insulin resistance and calls for more research to evaluate treatment effectiveness and understand the disease better.