Hidradenitis suppurativa: Review of the pathogenesis and treatment

Hidradenitis suppurativa (HS) is a chronic inflammatory disease characterized by significant morbidity. The clinical course of HS ranges from relatively mild cases characterized by recurrent tender, subcutaneous, inflammatory nodules to severe cases demonstrating painful, deep dermal abscesses, fibrosis, draining sinuses, and hypertrophic scars. Conventional treatment options for management of HS include topical and systemic antibiotics, antiandrogens, fumarates, biguanides, retinoids, immunosuppressive drugs, laser and phototherapy, and surgical excision. Given its association with pro-inflammatory cytokines, there has been interest in the use of novel biological agents. Recently, available treatment options have expanded to include tumor necrosis factor alpha inhibitors (TNF-ai), interleukin-1 inhibitors (IL-1i), and interleukin-12/23 inhibitors (IL-12/23i), but the management of HS is still very challenging. In this review, the authors will discuss new therapies for HS.