Management of Hidradenitis Suppurativa and Associated Comorbidities

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder characterised by recurrent nodules, abscesses, draining sinus tracts and progressive fibrosis in flexural areas. Management combines medical therapies, procedural interventions and lifestyle measures to address both cutaneous lesions and systemic health. Medical options include antibiotic regimens for infection control, anti-inflammatory biologics targeting TNF-α and interleukin pathways, and off-label small-molecule inhibitors. Surgical approaches range from local excision to wide deroofing of sinus tracts, often complemented by laser therapy to reduce scarring and recurrence. Adjunctive measures such as weight reduction, smoking cessation and psychological support are integral, given the high burden of pain, disfigurement and impact on quality of life. HS is commonly associated with metabolic, cardiovascular and psychiatric comorbidities, including obesity, dyslipidaemia, diabetes, depression and inflammatory bowel disease. Early recognition and systematic screening for these conditions enable a multidisciplinary strategy that can mitigate long-term morbidity and optimise patient outcomes.

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Management of Hidradenitis Suppurativa and Associated Comorbidities publication trend

The graph below shows the total number of articles in management of hidradenitis suppurativa and associated comorbidities across all publications each year (not limited to Nature Index journals).

Technical terms

Comorbidity: a distinct medical condition coexisting with the primary disease.

Metabolic syndrome: a cluster of risk factors including central obesity, hypertension, insulin resistance and dyslipidaemia.

Fibrosis: excessive formation of fibrous connective tissue during chronic inflammation.

Single-cell RNA sequencing: technique for profiling gene expression in individual cells.

Sinus tract: an abnormal channel that extends from a deep lesion to the skin surface.

References

1. Single cell sequencing reveals Hippo signaling as a driver of fibrosis in hidradenitis suppurativa. Journal of Clinical Investigation (2024).
2. Population‐based Clinical Practice Research Datalink study using algorithm modelling to identify the true burden of hidradenitis suppurativa. British Journal of Dermatology (2018).
3. Comorbidity screening in hidradenitis suppurativa: Evidence-based recommendations from the US and Canadian Hidradenitis Suppurativa Foundations. Journal of the American Academy of Dermatology (2021).