{"title":"Improving the patient care pathway and multidisciplinary management are major challenges in Hidradenitis suppurativa treatment.","authors":"Ziad Reguiaï","doi":"10.1684/ejd.2025.4859","DOIUrl":"https://doi.org/10.1684/ejd.2025.4859","url":null,"abstract":"<p><p>Hidradenitis suppurativa (HS) is a chronic inflammatory disease resulting from the close interplay between genetic predisposition, dysregulation of the mechanisms involved in autoinflammatory pathways, dysfunctional response to bacterial biofilm changes, and environmental factors that potentially exacerbate the disease. Its cutaneous manifestations may represent just the tip of the iceberg, as numerous comorbidities may be associated with the disease. The risk of occurrence of inflammatory bowel disease is three times higher than that in the general population. At least 5% of patients also have spondylarthritis, and the risk of cardiovascular events and death from myocardial infarction is significantly increased. Psychiatric co-morbidities, ranging from severe anxiety to depression and suicidal risk, also contribute greatly to the disease burden. The painful and chronic nature of the flares and the highly conspicuous appearance of HS lesions, whether inflammatory or permanent scarring, can lead to social isolation and addiction, particularly to analgesics. Despite its high frequency, easy diagnosis, severe impact on patients' daily lives, and the discovery of new treatments, many patients still experience prolonged diagnostic delays, therapeutic inertia, and chaotic, inappropriate management. For HS and the prevention of associated major complications, the identification of the points of rupture in its management, an improved care pathway and a multidisciplinary therapeutic approach are a societal concern and a major public health challenge.</p>","PeriodicalId":11968,"journal":{"name":"European Journal of Dermatology","volume":"35 S1","pages":"8-13"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hidradenitis suppurativa: pathogenesis.","authors":"Axel Villani","doi":"10.1684/ejd.2025.4860","DOIUrl":"https://doi.org/10.1684/ejd.2025.4860","url":null,"abstract":"<p><p>Hidradenitis suppurativa (HS) is a complex immune-mediated disorder, initially presenting as folliculitis, and progressively worsening in some patients to advanced lesions, such as fistulas, that may require extensive surgical interventions. In a subset of HS patients, genetic mutations affecting the gamma-secretase complex or keratinocyte dysfunction (pro-inflammatory and hyperproliferative keratinocytes) are implicated. The microbiota is thought to play a crucial role in the development of HS lesions, with dysbiosis observed in both lesional and non-lesional skin, suggesting preclinical alterations. However, the precise role of bacteria in HS remains unclear: Are they contaminants, co-inflammatory agents, or potential disease triggers? A mixed inflammatory response has been observed in lesional skin, involving both innate (macrophages, neutrophils, unconventional lymphocytes) and adaptive (T-and B-cell) immune pathways. However, the dynamics of this immune response remain poorly understood. Because of the unclear nature of HS inflammation, current treatments primarily are based on TNF or IL-17 inhibition. A better understanding of the complexity of HS is critical for the development of more effective treatments.</p>","PeriodicalId":11968,"journal":{"name":"European Journal of Dermatology","volume":"35 S1","pages":"4-7"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Surgical treatments of hidradenitis suppurativa.","authors":"Philippe Guillem","doi":"10.1684/ejd.2025.4858","DOIUrl":"https://doi.org/10.1684/ejd.2025.4858","url":null,"abstract":"<p><p>The treatment of hidradenitis suppurativa (Verneuil's disease) is considered to be both medical and surgical. While this recognises the importance of surgery, the place of surgery among the other treatments (antibiotics and biologics) remains difficult to define: for dermatologists (whose aim is to avoid surgery, sometimes excessively so) and for surgeons (who have a poor understanding of the disease). Emergency surgery is a different matter. Its goal is to incise a collected, highly painful lesion, and serves only a palliative purpose (pain relief); it does not aim to provide definitive treatment of the lesion. Apart from emergencies, the choice between surgery and other treatments is based on an evaluation of the advantages and disadvantages of each modality, and therefore their complementarity: the physical invasiveness, complexity and focal nature of surgery versus the relative simplicity and systemic action of antibiotic/biological therapy. The definitive cure of excisional surgery versus temporary control and dependence on treatment with antibiotic/biological therapy. The intersection between surgery and other treatments must therefore be the considered outcome of a dialogue between the dermatologist and the surgeon.</p>","PeriodicalId":11968,"journal":{"name":"European Journal of Dermatology","volume":"35 S1","pages":"22-30"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"An update on the medical treatments of hidradenitis suppurativa.","authors":"Pierre-Andre Becherel","doi":"10.1684/ejd.2025.4881","DOIUrl":"https://doi.org/10.1684/ejd.2025.4881","url":null,"abstract":"<p><p>Hidradenitis suppurativa has emerged from therapeutic obscurity only in the last few years. Initially, the purulent and infectious nature of the lesions naturally lead to first-line treatment with antibiotics, some of which are indeed highly effective, particularly for moderate forms, or when used to overcome a highly inflammatory acute flare. Subsequent advances in physiopathology have emphasised the significant value of immunomodulatory therapies, mainly via the blockade of the TNF-α and IL-17 cytokine pathways. Modulation of these nonspecific immune and inflammatory signalling pathways is thus becoming increasingly important in numerous on-going therapeutic trials: JAK pathway and complement inhibition, IL-1 blockade, and even inhibition of B-lymphocyte activation pathways. In this article we detail the currently available data and drugs, and their indications in relation to disease stage, while being constantly aware that presently optimal results require multidisciplinary collaboration and often the use of combination therapies.</p>","PeriodicalId":11968,"journal":{"name":"European Journal of Dermatology","volume":"35 S1","pages":"14-21"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A paediatric case of severe atopic dermatitis with prurigo nodularis successfully treated with nemolizumab as second-line therapy.","authors":"Masaya Kato, Ken Igawa, Yusuke Ando, Manabu Miyamoto, Yuji Fujita, Hideaki Shiraishi, Shigemi Yoshihara","doi":"10.1684/ejd.2025.4844","DOIUrl":"https://doi.org/10.1684/ejd.2025.4844","url":null,"abstract":"","PeriodicalId":11968,"journal":{"name":"European Journal of Dermatology","volume":"35 2","pages":"131-132"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chiara Assorgi, Maria Concetta Fargnoli, Norma Cameli, Annunziata Dattola, Diego Orsini
{"title":"Successful treatment of severe acrodermatitis continua of Hallopeau (ACH) coexisting with plaque psoriasis and non-pustular palmoplantar psoriasis in an elderly patient with bimekizumab.","authors":"Chiara Assorgi, Maria Concetta Fargnoli, Norma Cameli, Annunziata Dattola, Diego Orsini","doi":"10.1684/ejd.2025.4868","DOIUrl":"https://doi.org/10.1684/ejd.2025.4868","url":null,"abstract":"","PeriodicalId":11968,"journal":{"name":"European Journal of Dermatology","volume":"35 2","pages":"146-148"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The administrative burden in outpatient dermatology practice.","authors":"Isabel Gradaille, Manuel Ginarte","doi":"10.1684/ejd.2025.4869","DOIUrl":"https://doi.org/10.1684/ejd.2025.4869","url":null,"abstract":"","PeriodicalId":11968,"journal":{"name":"European Journal of Dermatology","volume":"35 2","pages":"148-150"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}