Essentials of hidradenitis suppurativa: a comprehensive review of diagnostic and treatment perspectives

Abstract

Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition characterized by recurring inflammatory nodules, abscesses, and subcutaneous sinus tracts and scars, imposing a significant psychological burden and diminishing quality of life for patients. The pathophysiology of HS remains poorly understood, with lifestyle, genetic, and hormonal factors implicated in its development. Until recently, therapeutic options were limited, with adalimumab being the sole FDA-approved biologic drug for HS. However, with the approval of secukinumab, new possibilities have emerged for treating this challenging condition. The complex pathogenesis and wide clinical manifestations of HS make its management challenging, often requiring a combination of treatments tailored to disease severity. While lifestyle modifications, topical treatments, and oral antibiotics suffice for managing mild cases, moderate-to-severe HS presents a significant challenge due to a poor response to traditional approaches. In this comprehensive review, we analyze various evaluation tools and therapy strategies available for the diagnosis and treatment of HS, drawing insights from published literature to guide clinicians in addressing the complexities of this debilitating disease.