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Hidradenitis Suppurativa (HS): Research Advances in Pathogenesis, Diagnosis and Treatment

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Dermatology".

Deadline for manuscript submissions: closed (20 November 2021) | Viewed by 11326

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Special Issue Editor

Dr. Michele Boniotto

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Guest Editor

Univ Paris Est Creteil, INSERM, IMRB, F-94010 Creteil, France
Interests: genetics of skin diseases; induced pluripotent stem cells; Crispr/Cas9; organoids

Special Issue Information

Dear Colleagues,

Hidradenitis suppurativa (HS) is increasingly recognized as one of the main dermatological disorders in western countries affecting 1% of the general population, mainly vulnerable individuals with a low socioeconomic status. The diagnosis is far from simple, as dermatologists have to look for the presence of chronic and unremitting nodules, abscesses, and sinus tracts in skin folds as the only criteria to diagnose HS. To make the diagnosis even more difficult, most patients often conceal HS as typical malodorous lesions in genital areas are associated with strong feelings of shame. As a result, HS diagnosis takes, in median, 7 years to be made, the patients moved from one treatment to another without obtaining any improvement, thus losing faith in the medical follow-up and frequently falling in to depression and, in the most severe cases, suicidal attempts.

The situation does not improve after diagnosis is finally established. Poor knowledge of HS pathogenesis reflects the lack of an effective treatment. Most patients receive a first treatment combining analgesics and topical and systemic antibiotics with HS often mistaken for folliculitis. Some dermatologists prescribe sulfonamides, immunosuppressants or isotreonin, used to treat acne. Adalimumab (an anti-TNF-a) is currently used off-label for severe to moderate cases, although not all patients respond to the treatment. Medical treatments seldom result in a cure, and the aggravation of lesions often leads to surgical resection of the skin of affected areas.

Over the last few years, however, research into HS pathogenesis has sensibly increased, giving new hopes for a faster diagnosis and effective treatments. The present Special Issue aims to present the last findings in HS pathogenesis that can improve its diagnosis and treatment.

Dr. Michele Boniotto
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

hidradenitis suppurativa
genetics
omics
hair follicle
Th17
neutrophils
plasma cells
biologics

Published Papers (5 papers)

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Research

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9 pages, 261 KiB

Open AccessArticle

The Use of HSQoL-24 in an Assessment of Quality-of-Life Impairment among Hidradenitis Suppurativa Patients: First Look at Real-Life Data

by Piotr K. Krajewski, Servando E. Marrón, Manuel Gomez-Barrera, Lucía Tomas-Aragones, Yolanda Gilaberte-Calzada and Jacek C. Szepietowski

J. Clin. Med. 2021, 10(22), 5446; https://doi.org/10.3390/jcm10225446 - 22 Nov 2021

Cited by 2 | Viewed by 1776

Abstract

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder with well-documented effects on patients’ quality of life (QoL). The aim of this study was to evaluate the QoL of patients with HS via the use of a newly developed questionnaire: Hidradenitis Suppurativa Quality of Life-24 (HSQoL-24). This study was performed on a population of 342 HS patients. Their QoL was assessed via the HSQoL-24 questionnaire. The perceived impairment of QoL due to HS in the studied group was considered to be serious (mean HSQoL-24 score: 58.3 ± 21.0 points). Women tended to experience a significantly higher impact from the disease than men (61.6 ± 19.2 points vs. 51.1 ± 23.1 points, p < 0.001). The HS severity had an effect on the perceived QoL, with statistically significant differences being evident between the self-assessed HS severity groups. The level of QoL impairment correlated positively with the number of affected body areas (r = 0.285, p < 0.001) and the duration of the disease (r = 0.173, p = 0.001), while the patients’ age at disease onset correlated negatively with the HSQoL-24 global score (r = −0.182, p = 0.001). Patients living in their family house scored higher than other groups. The least affected were patients who lived alone. The study shows that the HSQoL-24 questionnaire is a reliable, HS-specific tool for measuring the QoL among patients with HS in real-life clinical settings. Full article

(This article belongs to the Special Issue Hidradenitis Suppurativa (HS): Research Advances in Pathogenesis, Diagnosis and Treatment)

10 pages, 1341 KiB

Open AccessArticle

Increased Serum Levels of S100A4 and S100A15 in Individuals Suffering from Hidradenitis Suppurativa

by Aleksandra Batycka-Baran, Łukasz Matusiak, Danuta Nowicka-Suszko, Jacek C. Szepietowski and Wojciech Baran

J. Clin. Med. 2021, 10(22), 5320; https://doi.org/10.3390/jcm10225320 - 15 Nov 2021

Cited by 6 | Viewed by 1887

Abstract

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease. Recently, some S100 proteins have been suggested to play an important role in the pathogenesis of chronic immune-mediated inflammatory diseases and they may constitute valuable biomarkers for these diseases’ diagnosis and monitoring. The objective of the current study was to investigate, for the first time, serum levels of S100A4 and S100A15 in individuals suffering from HS. Furthermore, we assessed the associations between S100A4 and S100A15 serum levels and the severity of disease, CRP serum concentration and some demographic and clinical data. Serum levels of S100A4 and S100A15 were evaluated with the commercially available ELISA kit according to the manufacturer’s instructions. The serum level of S100A4 in individuals with HS was significantly elevated as compared to controls, with the highest level found in the individuals in Hurley stage II. The S100A15 serum level was positively correlated with the CRP concentration and was associated with the severity of the disease. The serum level of S100A15 in the individuals in Hurley stage III was significantly elevated compared to that of the controls and the individuals with HS in Hurley stages I and II. S100A4 and S100A15 may be considered as new serum biomarkers for the monitoring of HS progression, and they may play a role in the pathogenesis of HS by promoting inflammatory process and fibrosis. Full article

(This article belongs to the Special Issue Hidradenitis Suppurativa (HS): Research Advances in Pathogenesis, Diagnosis and Treatment)

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7 pages, 710 KiB

Open AccessArticle

Indirect Self-Destructiveness in Hidradenitis Suppurativa Patients

by Amelia Głowaczewska, Radomir Reszke, Jacek C. Szepietowski and Łukasz Matusiak

J. Clin. Med. 2021, 10(18), 4194; https://doi.org/10.3390/jcm10184194 - 16 Sep 2021

Cited by 9 | Viewed by 1890

Abstract

Hidradenitis suppurativa (HS) is a chronic, debilitating skin condition that negatively affects patients’ quality of life. Indirect self-destructiveness refers to activities extended over time, such as addictions, risky behaviors, neglects, resignation, helplessness. These can be an additional factor impeding the achievement of positive clinical effects in the treatment of HS patients, therefore the objective of the study was to assess the indirect self-destructive behaviors in patients suffering from HS. The study group involved 100 adult HS patients with 59 males and 41 females. Indirect self-destructiveness was investigated with the Polish version of the Kelley’s Indirect Self-Destructiveness Scale (CS-DS). The study revealed that the average total score of indirect self-destructiveness in HS population was 130.16 ± 21.3 (median 128 points). The CS-DS scores were significantly higher in smoking patents (p = 0.006). The most expressed class of indirect self-destructiveness was A5 (Helplessness and Passivity). The indicated results pointed out a strong domination of passive forms of indirect self-destructiveness over its active forms. Due to related low self-esteem, social isolation and exclusion, HS patients are more prone to behave in a self-destructive manner, which may lead to poor health maintenance in a form of leaving appointments and non-adherence. Full article

(This article belongs to the Special Issue Hidradenitis Suppurativa (HS): Research Advances in Pathogenesis, Diagnosis and Treatment)

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9 pages, 1038 KiB

Open AccessArticle

Pain as Defining Feature of Health Status and Prominent Therapeutic Target in Patients with Hidradenitis Suppurativa

by Francesca Sampogna, Irene Campana, Luca Fania, Simona Mastroeni, Roberta Fusari, Davide Ciccone, Sabatino Pallotta and Damiano Abeni

J. Clin. Med. 2021, 10(16), 3648; https://doi.org/10.3390/jcm10163648 - 18 Aug 2021

Cited by 5 | Viewed by 1791

Abstract

Background. Pain is one of the main aspects of hidradenitis suppurativa that strongly affects the quality of life of patients. We explored the relationship between pain and clinical severity as well as its role in defining the health status in patients with HS. Methods. Pain was defined by three measures: (a) question 1 (“my skin hurts”) of the Skindex-17; (b) Bodily Pain (BP) scale of the SF-36; and (c) Visual Analog Scale (VAS). Clinical severity of HS was assessed by the Hurley staging, the Sartorius HS Score, and the International HS Severity Score System. Results. The study population included 341 HS patients with complete data for the VAS pain, 316 for question 1 of the Skindex-17, and 294 for BP. Clinical severity was positively associated with pain. This result was observed for all three severity scores and all three pain evaluation methods. In addition, the number of fistulae, abscesses, and nodules were significantly associated with the three severity measures of pain, while the association with scars was not observed for question 1 of the Skindex-17 and BP. Conclusions. Pain may be a good proxy of clinical severity and efficacy of a treatment in HS and therefore a crucial hallmark of patients’ health status. Full article

(This article belongs to the Special Issue Hidradenitis Suppurativa (HS): Research Advances in Pathogenesis, Diagnosis and Treatment)

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Review

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15 pages, 1862 KiB

Open AccessReview

Impact of Psoriasis and Hidradenitis Suppurativa in Pregnancy, a Systematic Review

by Maria-Angeles Ferrer-Alcala, Manuel Sánchez-Díaz, Salvador Arias-Santiago and Alejandro Molina-Leyva

J. Clin. Med. 2021, 10(24), 5894; https://doi.org/10.3390/jcm10245894 - 15 Dec 2021

Cited by 4 | Viewed by 2533

Abstract

Psoriasis and hidradenitis suppurativa (HS) are chronic inflammatory skin diseases that frequently develop in young women. The aim of this study is to evaluate how hidradenitis suppurativa and psoriasis impact women desiring to conceive, and their influence on fertility and gestation. A systematic review of articles dating from January 2015 to April 2021 was performed using the Scopus (Elsevier) database. The search terms were (psoriasis and (birth or pregnancy or fertility)) and ((hidradenitis suppurativa or acne inversa) and (birth or pregnancy or fertility)). The search was limited to human data. Systematic reviews, case reports, clinical practice guidelines, expert consensus and conference papers were excluded. The impact of HS on pregnancy includes an impaired desire for pregnancy, a decrease in fertility, the worsening of the disease during pregnancy and potential adverse events during pregnancy. Moreover, the pregnancy might imply a change on the treatment of HS. The impact of psoriasis on pregnancy includes a decrease in fertility, potential adverse events during pregnancy and an unpredictable evolution of the disease. Moreover, the pregnancy might imply a change on the treatment of psoriasis, although biologic therapies do not appear to increase the risk of adverse events. In conclusion, both HS and psoriasis have an impact on pregnancy. A decrease of fertility has been reported. Moreover, both diseases have an unpredictable evolution during pregnancy. Pregnant women who are under biologic therapy do not seem to have a higher rate of adverse events. Treatment of both conditions is usually halted during pregnancy since scientific evidence about their safety is not conclusive, or teratogenic risk has been proven. Full article

(This article belongs to the Special Issue Hidradenitis Suppurativa (HS): Research Advances in Pathogenesis, Diagnosis and Treatment)

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