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

The document reviewed the ongoing debate about the pathogenesis of hidradenitis suppurativa (HS), suggesting a shift from the traditional view of it being a disease of the apocrine sweat glands to a potential issue with the hair follicle, particularly the follicular infundibulum. It primarily affected obese women in their 30s to 40s, with factors like shearing forces, hormonal influences, genetic predispositions, and an abnormal immune response to bacteria being considered. Smoking and nicotine were also explored as potential contributors. Despite these insights, there was no consensus on the exact cause, and the terminology "hidradenitis suppurativa" was questioned, highlighting the need for further research to clarify the disease's pathogenesis and improve treatment strategies.