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Dermatopathology
Volume 12
Issue 3
10.3390/dermatopathology12030025
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Immunohistochemical Characterisation of the Interstitial Inflammatory Environment: T-Cell- and B-Cell-Dominant Subtypes of Hidradenitis Suppurativa

by
Nessr Abu Rached
1,2,*,
Stefanie Bruckmüller
1,2,
Martin Doerler
1,2,
Hanna Telkemeyer
1,2,
Lennart Ocker
1,2,
Yannik Haven
1,2,
Daniel Myszkowski
1,2,
Markus Stücker
1,2,
Eggert Stockfleth
1,2 and
Falk G. Bechara
1,2
1
International Centre for Hidradenitis Suppurativa/Acne Inversa (ICH), Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, 44791 Bochum, Germany
2
Skin Cancer Center, Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, 44791 Bochum, Germany
*
Author to whom correspondence should be addressed.
Dermatopathology 2025, 12(3), 25; https://doi.org/10.3390/dermatopathology12030025 (registering DOI)
Submission received: 2 June 2025 / Revised: 12 July 2025 / Accepted: 19 August 2025 / Published: 25 August 2025
(This article belongs to the Section Clinico-Pathological Correlation in Dermatopathology)
Versions Notes

Abstract

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory disease with a complex immune response. Given the considerable heterogeneity of the clinical phenotype of HS, this study aimed to analyse the immunohistochemical pattern of interstitial inflammation. Methods: Immunohistochemical analysis was performed on skin samples from 49 patients with HS. The immunohistochemical markers CD3, CD4 and CD8 for T-cells, CD20 for B-cells, CD138 for plasma cells and CD30, CD56, Bcl-2 and Bcl-6 were stained on lesional skin. Results: The analysis of immune cell dominance in patients with HS revealed that 33.3% of the cohort exhibited B-cell dominance, defined as a ratio of the sum of CD20+ and CD138+ cells to CD3+ cells greater than 1, while the majority (66.7%) demonstrated T-cell dominance, defined as a ratio of CD3+ cells to the sum of CD20+ and CD138+ cells greater than 1. B-cell-dominant HS is associated with a significantly elevated probability of mammary involvement (13.3% vs. 0%; p = 0.041). T-cell-dominant HS patients tended to demonstrate a higher mean tobacco consumption, but not significantly (20 vs. 5 tobacco pack-years; p = 0.06). CD4-dominant HS patients exhibited a significantly greater involvement of the mons pubis (62.5% vs. 28.6%, p = 0.023) compared to CD8-dominant patients, who demonstrated a significantly higher number of abscesses (p = 0.027). Conclusions: For the first time, we describe the clinical and immunohistochemical characteristics of T-cell- and B-cell-dominant HS. Although HS seems to be more dominated by T-cells, a B-cell dominance was found in 33% of cases.
Keywords: hidradenitis suppurativa; lymphocytes; inflammation; inflammatory environment; T-cells; B-cells; plasma cells hidradenitis suppurativa; lymphocytes; inflammation; inflammatory environment; T-cells; B-cells; plasma cells

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MDPI and ACS Style

Abu Rached, N.; Bruckmüller, S.; Doerler, M.; Telkemeyer, H.; Ocker, L.; Haven, Y.; Myszkowski, D.; Stücker, M.; Stockfleth, E.; Bechara, F.G. Immunohistochemical Characterisation of the Interstitial Inflammatory Environment: T-Cell- and B-Cell-Dominant Subtypes of Hidradenitis Suppurativa. Dermatopathology 2025, 12, 25. https://doi.org/10.3390/dermatopathology12030025

AMA Style

Abu Rached N, Bruckmüller S, Doerler M, Telkemeyer H, Ocker L, Haven Y, Myszkowski D, Stücker M, Stockfleth E, Bechara FG. Immunohistochemical Characterisation of the Interstitial Inflammatory Environment: T-Cell- and B-Cell-Dominant Subtypes of Hidradenitis Suppurativa. Dermatopathology. 2025; 12(3):25. https://doi.org/10.3390/dermatopathology12030025

Chicago/Turabian Style

Abu Rached, Nessr, Stefanie Bruckmüller, Martin Doerler, Hanna Telkemeyer, Lennart Ocker, Yannik Haven, Daniel Myszkowski, Markus Stücker, Eggert Stockfleth, and Falk G. Bechara. 2025. "Immunohistochemical Characterisation of the Interstitial Inflammatory Environment: T-Cell- and B-Cell-Dominant Subtypes of Hidradenitis Suppurativa" Dermatopathology 12, no. 3: 25. https://doi.org/10.3390/dermatopathology12030025

APA Style

Abu Rached, N., Bruckmüller, S., Doerler, M., Telkemeyer, H., Ocker, L., Haven, Y., Myszkowski, D., Stücker, M., Stockfleth, E., & Bechara, F. G. (2025). Immunohistochemical Characterisation of the Interstitial Inflammatory Environment: T-Cell- and B-Cell-Dominant Subtypes of Hidradenitis Suppurativa. Dermatopathology, 12(3), 25. https://doi.org/10.3390/dermatopathology12030025

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