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Surgical Treatment in Hidradenitis Suppurativa

Itch in Hidradenitis Suppurativa/Acne Inversa: A Systematic Review

Department of Dermatology, SMS Medical College and Hospital, Jaipur 302004, Rajasthan, India
Department of Dermatology, Venereology and Leprosy, Bharati Vidyapeeth (DTU) Medical College and Hospital, Pune 411043, Maharashtra, India
Department of Dermatology, Bangalore Medical College and Research Institute, Bangalore 560002, Karnataka, India
Department of Dermatology, Wayne State University, Detroit, MI 48202, USA
Department of Dermatology, Oregon Health and Science University, Portland, OR 97239, USA
Department of Dermatology, NLSH University Hospital, 8092 Bodø, Norway
European Hidradenitis Suppurativa Foundation e.V., 06847 Dessau, Germany
Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-367 Wroclaw, Poland
Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, 06847 Dessau, Germany
Department of Dermatology, University Medical Center Mainz, 55131 Mainz, Germany
Authors to whom correspondence should be addressed.
Academic Editors: Hei Sung Kim and Masutaka Furue
J. Clin. Med. 2022, 11(13), 3813;
Received: 26 April 2022 / Revised: 23 June 2022 / Accepted: 24 June 2022 / Published: 30 June 2022
(This article belongs to the Special Issue 10th Anniversary of JCM – New Era in Dermatology)
Hidradenitis suppurativa/acne inversa (HS) is a chronic inflammatory disease of the pilosebaceous unit leading to formation of painful, inflammatory nodules, abscesses and tunnels in apocrine gland-bearing areas of the skin. Pain and drainage are the most important symptoms associated with reduction of quality of life in HS. On the other hand, an overlooked symptom in quality of life studies is itch, despite the fact that several studies have reported its importance. Various theories have tried to explain the pathogenesis of itch in HS, such as the presence of mast cells in the cell infiltrates and elevated Ig E levels in the lesional skin. Smoking and advanced stage of disease have been found to be associated with increased intensity of itch. A PUBMED search was conducted to perform a systematic literature review using the term “hidradenitis suppurativa” [all fields], the keywords “pruritus”, “itching”, “itch” [all fields] and with “AND” as operator. Mast cells and mTor signaling were found to be raised in both lesional and perilesional skin. Itch as a presenting symptom has been found in 35–82.6% of patients across multiple studies. It often co-presents with pain and may be misinterpreted as burning, stinging, tickling, tweaking, prickling, etc. The presence of itch is associated with reduced quality of life, depression and impairment of social life. Brodalumab, a monoclonal antibody against IL-17A receptor, produced significant improvements in itch, pain, QoL and depression in patients with moderate to severe HS. Statins have shown some reduction in itch intensity score. Further studies are required to gain a better understanding of the etiopathogenesis and optimal therapeutic modalities for itch in HS that will allow clinicians to better address issue and reduce its impact on quality of life. View Full-Text
Keywords: hidradenitis suppurativa; acne inversa; pruritus; itch; itching; systematic review hidradenitis suppurativa; acne inversa; pruritus; itch; itching; systematic review
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MDPI and ACS Style

Agarwal, P.; Lunge, S.B.; Shetty, N.S.; Karagaiah, P.; Daveluy, S.; Ortega-Loayza, A.G.; Tzellos, T.; Szepietowski, J.C.; Zouboulis, C.C.; Grabbe, S.; Goldust, M. Itch in Hidradenitis Suppurativa/Acne Inversa: A Systematic Review. J. Clin. Med. 2022, 11, 3813.

AMA Style

Agarwal P, Lunge SB, Shetty NS, Karagaiah P, Daveluy S, Ortega-Loayza AG, Tzellos T, Szepietowski JC, Zouboulis CC, Grabbe S, Goldust M. Itch in Hidradenitis Suppurativa/Acne Inversa: A Systematic Review. Journal of Clinical Medicine. 2022; 11(13):3813.

Chicago/Turabian Style

Agarwal, Puneet, Snehal Balvant Lunge, Nandini Sundar Shetty, Priyanka Karagaiah, Steven Daveluy, Alex G. Ortega-Loayza, Thrasyvoulos Tzellos, Jacek C. Szepietowski, Christos C. Zouboulis, Stephan Grabbe, and Mohamad Goldust. 2022. "Itch in Hidradenitis Suppurativa/Acne Inversa: A Systematic Review" Journal of Clinical Medicine 11, no. 13: 3813.

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