What causes acne inversa (or hidradenitis suppurativa)? – the debate continues

The document discussed the ongoing debate regarding the pathogenesis of hidradenitis suppurativa (HS), a chronic skin condition. Historically thought to be a disease of the apocrine sweat glands, recent discussions and studies suggested that it might instead be related to the hair follicle, particularly the follicular infundibulum. The document reviewed various viewpoints from a group of 14 authors, highlighting the lack of consensus on the disease's primary cause. Factors such as obesity, hormonal influences, genetic predisposition, and immune response were considered potential contributors. The role of bacterial colonization and the immune system, including Toll-like receptors and C-type lectin receptors, was also explored. Additionally, the document noted a possible link between smoking and HS due to nicotine's effect on skin acetylcholine receptors. Despite advancements in understanding, the document concluded that more research was needed to achieve a therapeutic breakthrough and improve clinical outcomes for HS patients.