Hidradenitis Suppurativa : Clinical and Translational Studies

Hidradenitis suppurativa (HS) is a chronic, debilitating, autoinflammatory skin disease with a prevalence rate of approximately 1% in Europe. HS usually presents in the adolescence with inflammatory nodules and abscesses, followed by sinus tract formation and scarring in predominantly the inverse body areas such as the axillae and groins. Key symptoms of HS include pain, discomfort, and a purulent, foul-smelling discharge. The physical and psychological consequences of the disease can profoundly reduce several aspects of patient’s quality of life. Although the pathophysiology of HS is not fully understood, follicular occlusion is supposed to be the key triggering event. This is followed by dilatation and subsequent rupture of the hair follicle causing an intense immune response. Exogenous factors such as smoking, obesity, and mechanical friction in addition to genetic predisposition and alterations in the microbiome may contribute to the onset and progression of the disease. Rapidly evolving understanding of pathogenic mechanisms and clinical perspectives are needed to improve disease awareness, disease management, and ultimately improve patient outcomes. Because multiple facets of HS are not yet known, the outline of this thesis was not limited to only one aspect of the disease. This dissertation focused on clinical features and (immuno)pathogenic mechanisms as a rationale for the development of novel treatment strategies.