Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland.
Department of Dermatology, Hospital de Manises, Valencia, Spain.
Dermatology. 2023;239(3):323-327. doi: 10.1159/000529848. Epub 2023 Feb 23.
Hidradenitis suppurativa (HS) is a chronic, inflammatory, debilitating disorder of the pilosebaceous unit. Dermal tunnels, sinus tracts, or fistulas are unique features of HS. One may hypothesize that HS tunnels remain active and may contribute to inflammation and disease severity.
Increased inflammatory infiltrate with an increased number and densities of immune cells was reported in HS tunnels. Moreover, significantly higher levels of IL-36, Il-17A, IL-17C, IL-17F, and CXCL8 mRNA compared to non-tunnel HS skin were found. Furthermore, in the lumen, a proliferative gelatinous mass consisting of inflammatory cells with similar cytokine levels as inflammatory HS lesions was found. It was also proven that HS sinus tracts are often colonized by Porphyromonas spp. and Prevotella spp. with a tendency to biofilm creation. The genetic profile of HS tunnels varies from non-tunnel HS skin, with upregulation of pro-inflammatory and downregulation of anti-inflammatory genes. Lastly, treatment with newly developed drugs targeting different subunits of IL-17 seems promising in decreasing dermal tunnel drainage and in the resolution of sinus tracts. Moreover, a higher percentage of patients treated with these drugs achieved HiSCR75 and HiSCR90.
化脓性汗腺炎（HS）是一种慢性、炎症性、使人虚弱的毛囊皮脂腺单位疾病。皮肤隧道、窦道或瘘管是 HS 的独特特征。人们可能假设 HS 隧道仍然活跃，并可能导致炎症和疾病严重程度增加。
研究报告称，HS 隧道中存在更多数量和密度的免疫细胞，炎症浸润增加。此外，与非隧道 HS 皮肤相比，隧道 HS 皮肤中发现的 IL-36、Il-17A、IL-17C、IL-17F 和 CXCL8mRNA 水平显著更高。此外，在管腔中，发现了由具有与炎症性 HS 病变相似细胞因子水平的炎症细胞组成的增生胶状物质。还证明 HS 窦道通常被卟啉单胞菌属和普雷沃菌属定植，且具有生物膜形成的趋势。HS 隧道的遗传特征与非隧道 HS 皮肤不同，促炎基因上调，抗炎基因下调。最后，针对不同 IL-17 亚单位开发的新型药物治疗在减少皮肤隧道引流和窦道消退方面似乎很有前景。此外，用这些药物治疗的患者中，有更高比例的患者达到了 HiSCR75 和 HiSCR90。
