Viewpoint 6

The document discussed hidradenitis suppurativa (HS), a chronic inflammatory disease linked to the pilosebaceous unit, and its strong association with tobacco smoking. It highlighted that 80-90% of HS patients were active smokers, suggesting a significant role of nicotine in HS pathogenesis. Nicotine was found to persist in axillary sweat, promoting Staphylococcus aureus colonization and stimulating inflammatory responses. The study proposed that nicotine's interaction with nicotinic acetylcholine receptors (nAChR) contributed to follicular obstruction and infundibulitis, key early events in HS. The document suggested that nicotine might impair macrophage and lymphocyte functions, influencing later stages of HS. It called for further research to explore the potential of anticholinergic agents as a therapeutic strategy for HS.