{"title":"Hidradenitis suppurativa: pathogenesis.","authors":"Axel Villani","doi":"10.1684/ejd.2025.4860","DOIUrl":null,"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":2.0000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Dermatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1684/ejd.2025.4860","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"DERMATOLOGY","Score":null,"Total":0}
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.
期刊介绍:
The European Journal of Dermatology is an internationally renowned journal for dermatologists and scientists involved in clinical dermatology and skin biology.
Original articles on clinical dermatology, skin biology, immunology and cell biology are published, along with review articles, which offer readers a broader view of the available literature. Each issue also has an important correspondence section, which contains brief clinical and investigative reports and letters concerning articles previously published in the EJD.
The policy of the EJD is to bring together a large network of specialists from all over the world through a series of editorial offices in France, Germany, Italy, Spain and the USA.