Dear colleagues

Hidradenitis suppurativa/acne inversa is a chronic, inflammatory, recurrent, debilitating skin disease (of the terminal hair follicle) that usually presents after puberty with painful, deep-seated, inflamed lesions in the apocrine gland-bearing areas of the body, most commonly the axillary, inguinal, and anogenital regions (Dessauer definition).¹

¹ Kurzen H, Kurokawa I, Jemec GBE, Emtestam L, Sellheyer K, Giamarellos-Bourboulis EJ, Nagy I, Bechara FG, Sartorius K, Lapins J, Krahl D, Altmeyer P, Revuz J, Zouboulis CC. What causes hidradenitis suppurativa? Exp Dermatol 17:455–472, 2008

Diagnostic procedure

You can find information on the diagnostic procedure and criteria of hidradenitis suppuratina under:

  • Zouboulis CC, del Marmol V, Mrowietz U, Prens E, Tzellos T, Jemec GBE. Hidradenitis suppurativa/acne inversa: Criteria for diagnosis, severity assessment, classification and disease evaluation. Dermatology 231:184-190, 2015

Photographic documentation

A guide for photographic documentation can be seen in:

  • Zouboulis CC, Nogueira da Costa A. Standardized photographic documentation of hidradenitis suppurativa/acne inversa. Dermatology 235:51-54, 2019

Guidelines for treatment

Guidelines for treatment are published under:

  • Zouboulis CC, Desai N, Emtestam L, Hunger RE, Ioannides D, Juhász I, Lapins J, Matusiak L, Prens EP, Revuz J, Schneider-Burrus S, Szepietowski JC, van der Zee HH, Jemec GBE. European S1 guideline for the treatment of hidradenitis suppurativa / acne inversa. J Eur Acad Dermatol Venereol 29:619-644, 2015
  • Gulliver W, Zouboulis CC, Prens E, Jemec GB, Tzellos T. Evidence-based approach to the treatment of hidradenitis suppurativa/acne inversa, based on the European guidelines for hidradenitis suppurativa. Rev Endocr Metab Disord 17:443-451, 2016
  • Zouboulis CC, Bechara FG, Dickinson-Blok JL, Gulliver W, Horváth B, Hughes R, Kimball AB, Kirby B, Martorell A, Podda M, Prens EP, Ring HC, Tzellos T, van der Zee HH, van Straalen KR, Vossen ARJV, Jemec GBE. Hidradenitis suppurativa/acne inversa: A practical framework for treatment optimization – systematic review and recommendations from the HS ALLIANCE working group. J Eur Acad Dermatol Venereol 33:19-31, 2019

Severity classification system

A severity classification system and outcome measure for treatment effectiveness is published under:

  • Zouboulis CC, Tzellos T, Kyrgidis A, Jemec GBE, Bechara FG, Giamarellos-Bourboulis EJ, Ingram JR, Kanni T, Karagiannidis I, Martorell A, Matusiak L, Pinter A, Prens EP, Presser D, Schneider-Burrus S, von Stebut E, Szepietowski JC, van der Zee HH, Wilden SM, Sabat R, on behalf of the EHSF Investigator Group. Development and validation of IHS4, a novel dynamic scoring system to assess hidradenitis suppurativa/acne inversa severity. Br J Dermatol 177:1401-1409, 2017

Information on comorbid disorders

Information on comorbid disorders can be found in:

  • Fimmel S, Zouboulis CC. Comorbidities of hidradenitis suppurativa (acne inversa). Dermatoendocrinol 2:9-16, 2010
  • Tzellos T, Zouboulis CC, Gulliver W, Cohen AD, Wolkenstein P, Jemec GB. Cardiovascular disease risk factors in patients with hidradenitis suppurativa: a systematic review and meta-analysis of observational studies. Br J Dermatol 173:1142-1155, 2015
  • Tzellos T, Zouboulis CC. Review of comorbidities of hidradenitis suppurativa: Implications for daily clinical practice. Dermatol Ther (Heidelb) 10:63-71, 2020

Concepts on disease etiology

Theoretical and experimental concepts on disease etiology can be found under:

  • Tricarico P, Boniotto M, Genovese G, Zouboulis CC, Marzano AV, Crovella S. Skin-OMICS: an integrated approach to unravel hidradenitis suppurativa etiopathogenesis. Front Immunol 10:892, 2019
  • Jenei A, Dajnoki Z, Medgyesi B, Gáspár K, Béke G, Kinyó Á, Méhes G, Hendrik Z, Dinya T, Törőcsik D, Zouboulis CC, Prens EP, Bíró T, Szegedi A, Kapitány A. Apocrine gland-rich skin has a non-inflammatory IL-17 related immune milieu, which turns to inflammatory IL-17 mediated disease in hidradenitis suppurativa. J Invest Dermatol 139:964-968, 2019
  • Zouboulis CC, Nogueira da Costa A, Makrantonaki E, Hou XX, Almansouri D, Dudley JT, Edwards H, Readhead B, Balthasar O, Jemec GBE, Bonitsis NG, Nikolakis G, Trebing D, Zouboulis KC, Hossini AM. Alterations in innate immunity and epithelial cell differentiation are the molecular pillars of hidradenitis suppurativa. J Eur Acad Dermatol Venereol [Epub ahead of print], 2019

Information on quality of life:

Information on quality of life can be found under:

  • Chernyshov PV, Zouboulis CC, Tomas-Aragones L, Jemec G, Manolache L, Tzellos T, Sampogna F, Evers AWM, Dessinioti C, Marron SE, Bettoli V, van Cranenburgh O, Svensson A, Liakou A, Poot F, Szepietowski JC, Salek MS, Finlay AY. Quality of life measurement in acne. Position paper of the European Academy of Dermatology and Venereology Task Forces on Quality of Life and Patient Oriented Outcomes and Acne, Rosacea and Hidradenitis Suppurativa. J Eur Acad Dermatol Venereol 32:194-208, 2018
  • Chernyshov PV, Zouboulis CC, Tomas-Aragones L, Jemec GB, Svensson A, Manolache L, Tzellos T, Sampogna F, Pustisek N, van der Zee HH, Marron SE, Spillekom-van Koulil S, Bewley A, Linder D, Abeni D, Szepietowski JC, Augustin M, Finlay AY. Quality of life measurement in hidradenitis suppurativa: position statement of the European Academy of Dermatology and Venereology task forces on Quality of Life and Patient-Oriented Outcomes and Acne, Rosacea and Hidradenitis Suppurativa. J Eur Acad Dermatol Venereol 33:1633-1643, 2019