Zuzanna Świerczewska

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by recurrent nodules, abscesses, draining tunnels, and scarring. Dysregulated IL-1 and inflammasome-associated pathways have been implicated in its pathogenesis, but their spatial distribution beyond clinically apparent lesions remains incompletely characterized. To assess topographic expression of NLRP3, caspase-1, IL-1β, and IL-18 across lesional, perilesional, and distant HS skin. Skin samples were obtained from eight biologic-untreated patients with HS, six patients receiving adalimumab, and five healthy controls. In HS, matched 6 mm full-thickness biopsies were obtained from the same axilla at an active inflammatory lesion (0 cm), clinically normal-appearing skin 2 cm from the visible lesion edge, and clinically uninvolved skin 10 cm from the lesion edge. Protein abundance was assessed by Western blot. Primary topographic effects were evaluated using mixed-design ANOVA with Benjamini–Hochberg FDR correction, supplemented by non-parametric and exploratory contrast analyses. No protein showed an FDR (false discovery rate)-significant overall site effect or cohort × site interaction in the primary analysis. In biologic-untreated HS, IL-18 showed an FDR-significant topographic effect (q = 0.0444), with higher expression at 0 cm than at 10 cm (q = 0.0469). An exploratory post hoc 2-versus-10 cm analysis identified a highly concordant IL-1β pattern: expression was higher at 2 cm in 7/8 biologic-untreated and 6/6 adalimumab-treated patients. Fisher’s combined probability remained significant after BH correction across the four proteins evaluated for this contrast (p = 0.00421, q4 = 0.0168), whereas comprehensive correction across all 12 protein × contrast combinations yielded q12 = 0.0505 and did not meet q < 0.05. Overall, 13/14 patients showed the same direction (92.9%; exact 95% CI 66.1–99.8%). IL-18 provided the clearest FDR-supported secondary topographic finding. IL-1β showed a highly concordant but hypothesis-generating perilesional-to-distant spatial pattern, whereas total NLRP3 and caspase-1 did not show robust FDR-adjusted spatial variation.

Background/Objectives: Hidradenitis suppurativa is an inflammatory skin condition of the pilosebaceous unit of a chronic, painful, and progressive nature. It affects intertriginous parts of the body, including the axillae, groin, submammary region, and anogenital region. The risk of infection in HS patients is not well understood. Thus, presenting the most recent findings in the study of bacterial infections in relation to hidradenitis suppurativa was the objective of this review. Methods: The presented article is a narrative review. The PubMed and Scopus databases were searched for articles applicable to this review. All types of study design were included in this review. Results: Among reported infections in patients with HS, Fournier’s gangrene, osteomyelitis, Clostridium difficile infection, and biofilm were significant. Attention should also be paid to post-procedural infections. Conclusions: A wide range of bacterial infections, from localized purulent infections to serious systemic consequences, can affect patients with HS. Comorbid diseases like diabetes mellitus and obesity change the cutaneous microbiota and produce a pro-inflammatory systemic milieu, which makes the disease more severe and makes HS patients more susceptible to infections. Additionally, those with untreated or unmanaged HS are more likely to experience infectious complications.

Purpose Body dysmorphic disorder (BDD) is characterized by a preoccupation with a non-existing or minimal defect in appearance. It affects around 2% of the population, causes distress in daily functioning and reduces the quality of life. The aim of this study was to evaluate the usefulness and...

Recently, interest in the microbiome of cutaneous diseases has increased tremendously. Of particular interest is the gut-brain-skin axis proposed by Stokes and Pillsbury in 1930. The microbiome has been suggested in the pathogenesis of hidradenitis suppurativa, however the link between the commensals and the host is yet to be established. Across all studies, the increased abundance of Porphyromonas, Peptoniphilus, and Prevotella spp., and a loss of skin commensal species, such as Cutibacterium in HS lesions, is a consistent finding. The role of gut and blood microbiome in hidradenitis suppurativa has not been fully elucidated. According to studies, the main link with the intestine is based on the increased risk of developing Crohn’s disease and ulcerative colitis, however, further research is highly needed in this area. Lifestyle, dietary approaches, and probiotics all seem to influence the microbiome, hence being a promising modality as adjuvant therapy. The aim of this review was to present the latest reports in the field of research on skin, blood, and gut microbiome in terms of hidradenitis suppurativa.

Hidradenitis suppurativa, also known as acne inversa, is a chronic, progressive, debilitating, recurrent inflammatory skin disease characterized by the occurrence of very severe, persistent, painful nodules, abscesses, and fistulas, most commonly found in the skin folds of the axilla, groin, gluteal, and perianal areas. Treatment is rather difficult and typically requires the use of multiple modalities. Regardless of the presence of several therapeutic options, treatment often turns out to be ineffective or poorly selected concerning the clinical picture of the disease. Thus, the search for new biologics and other target treatments of hidradenitis suppurativa is ongoing. The safety and efficacy of adalimumab, still the only U.S. Food and Drug Administration approved biologic in the hidradenitis suppurativa treatment, paved the way for new drugs to be compared with it. Several more drugs with new immunological targets are currently under investigation for the treatment of acne inversa. The aim of the article was to present the current and future targets of acne inversa treatment, simultaneously providing insights into the molecular pathomechanisms of the disease.

Botulinum toxin (BoNT) is a neurotoxin produced by the Clostridium botulinum bacteria. Among seven different isoforms, only BoNT-A and BoNT-B are commercially used. Currently, botulinum toxin has been indicated by the U.S. Food and Drug Administration in several disorders, among others: chronic migraine, hyperhidrosis, urinary incontinence from detrusor overactivity, or cosmetics. However, there are numerous promising reports based on off-label BTX usage, indicating its potential effectiveness in other diseases, which remains unknown to many. Among them, dermatological conditions, such as rosacea, annal fissure, Raynaud phenomenon, hypertrophic scars and keloids, and also hidradenitis suppurativa, are currently being investigated. This article aims to provide a comprehensive update on the off-label use of botulinum toxin in dermatology, based on an analysis and summary of the published literature.

Hidradenitis suppurativa (HS) to przewlekła, postępująca choroba zapalna skóry, charakteryzująca się obecnością uporczywych, bolesnychguzków, ropni i przetok zlokalizowanych najczęściej w okolicach pach, pachwin, pośladków i okolic odbytu. Patofizjologia trądziku odwróconego wciąż nie została całkowicie wyjaśniona, jednak obecnie uważa się, że jej obraz jest związany z okołomieszkowym stanem zapalnym o podłożu immunologicznym. Dobór odpowiedniej terapii jest u tych pacjentów niezwykle istotny ze względu na znaczne pogorszenie jakości ich życia w trakcie trwania choroby oraz odroczone rozpoczęcie leczenia, spowodowane opóźnieniem postawienia właściwej diagnozy. Obecne rekomendacje podkreślają znaczenie wielodyscyplinarnego podejścia do leczenia schorzenia. Terapia biologiczna jest zalecana u tych pacjentów jako leczenie w stopniu umiarkowanym do ciężkiego choroby. Obecnie adalimumab to jedyny lek biologiczny zarejestrowany przez Food and Drug Administration w terapii trądziku odwróconego. Mimo to w zaleceniach oraz badaniach klinicznych opisywane są inne leki biologiczne, takie jak infliksymab, anakinra czy ustekinumab jako potencjalnie skuteczne i bezpieczne opcje terapeutyczne w leczeniu HS. Celem artykułu jest przegląd literatury dotyczącej leczenia biologicznego stosowanego w leczeniu trądziku odwróconego. Hidradenitis suppurativa (HS) to przewlekła, postępująca choroba zapalna skóry, charakteryzująca się obecnością uporczywych, bolesnychguzków, ropni i przetok zlokalizowanych najczęściej w okolicach pach, pachwin, pośladków i okolic odbytu. Patofizjologia trądziku odwróconego wciąż nie została całkowicie wyjaśniona, jednak obecnie uważa się, że jej obraz jest związany z okołomieszkowym stanem zapalnym o podłożu immunologicznym. Dobór odpowiedniej terapii jest u tych pacjentów niezwykle istotny ze względu na znaczne pogorszenie jakości ich życia w trakcie trwania choroby oraz odroczone rozpoczęcie leczenia, spowodowane opóźnieniem postawienia właściwej diagnozy. Obecne rekomendacje podkreślają znaczenie wielodyscyplinarnego podejścia do leczenia schorzenia. Terapia biologiczna jest zalecana u tych pacjentów jako leczenie w stopniu umiarkowanym do ciężkiego choroby. Obecnie adalimumab to jedyny lek biologiczny zarejestrowany przez Food and Drug Administration w terapii trądziku odwróconego. Mimo to w zaleceniach oraz badaniach klinicznych opisywane są inne leki biologiczne, takie jak infliksymab, anakinra czy ustekinumab jako potencjalnie skuteczne i bezpieczne opcje terapeutyczne w leczeniu HS. Celem artykułu jest przegląd literatury dotyczącej leczenia biologicznego stosowanego w leczeniu trądziku odwróconego.

Hidradenitis suppurativa (HS) is a chronic, progressive, debilitating, recurrent inflammatory skin disease characterized by the occurrence of very severe, persistent, painful nodules, abscesses, and fistulas, most commonly found in the skin folds of the axilla, groin, gluteal, and perianal areas. The pathogenesis of HS is still not completely understood; currently, it is considered to be an immune‐mediated inflammatory illness (IMID). Due to the significant decrease in the patients' quality of life and a delayed beginning of a treatment, the selection of the appropriate therapy is extremely important in these patients. Regardless of the fact that there are multiple treatment options for HS, no uniformly effective therapy has been found. All the guidelines underline the need for a multidisciplinary approach to the disease, which enables providers to create the right management of HS. This article aims to provide updates on the current treatment options of acne inversa to raise awareness and improve the management of the disease.

Introduction Hidradenitis suppurativa (HS) is a chronic, recurrent inflammatory skin disease characterized by the occurrence of severe, painful nodules, abscesses, and fistulas, most commonly found in the skin folds of the axilla, groin, gluteal, and perianal areas. The disease is of interest...