Viewpoint 6

Hidradenitis suppurativa (HS), also known as acne inversa, was identified as a chronic inflammatory disease linked to the pilosebaceous unit, with tobacco smoking being a significant trigger. The document highlighted that 80-90% of HS patients were smokers, suggesting a strong association between smoking and HS. Nicotine, a key component of cigarette smoke, was found in high concentrations in axillary sweat, potentially contributing to HS lesions due to its pharmacological effects. Nicotine promoted the growth of Staphylococcus aureus, a bacterium commonly found in HS patients, and influenced inflammatory processes by affecting immune cells and cytokine production. The study proposed that nicotine's interaction with nicotinic acetylcholine receptors (nAChR) played a crucial role in HS pathogenesis, leading to follicular obstruction and inflammation. The document suggested that further research was needed to explore the potential of anticholinergic agents as a therapeutic strategy for HS.