Hidradenitis suppurativa: an emerging debilitating disease with new and effective therapeutic options

Hidradenitis suppurativa (HS) is a chronic inflammatory disease manifesting with painful, deep abscesses and chronic, draining sinus tracts typically in young patients. HS remains widely unrecognized and difficult to treat, resulting in significant diagnostic delay and inconsistent treatment process. HS is associated with metabolic changes including obesity, metabolic syndrome and diabetes. HS is the results of an inappropriate inflammatory response following hair follicle occlusion and rupture, and can be part of the clinical spectrum of pyogenic auto-inflammatory syndromes. Treatments used in the management of this condition remain off-label. Traditional therapies, such as systemic antibiotics, retinoids, immunosuppressants, and antiandrogens all have been used with limited success. Among biological treatments, adalimumab given weekly and infliximab are effective for HS. Surgery is an important option but recurrence or disfiguring results are common