Interesting Open Access Hidradenitis Suppurativa (HS) Reads – December 2024
In the busiest year-to-date for HS publications, December witnessed the most HS-related publications in a single month (69). Of these, approx. 57% (39/69) were open access.
1. Hidradenitis Suppurativa: Embracing Progress
The world’s most widely read dermatology journal, the Journal of the American Academy of Dermatology (JAAD) published a free HS supplement in December. Featuring 12 chapters over 63 pages from many key opinion leaders, this is an excellent addition to the HS literature. More details here.
2. European S2k Guidelines for Hidradenitis Suppurative/Acne Inversa Part 2: Treatment
Part of the new (HS) European S2k guidelines, focusing on #treatment options for HS, have been published, in a collaboration involving #dermatologists, #patients, and surgeons from all over Europe.
Link: https://onlinelibrary.wiley.com/doi/10.1111/jdv.20472
Citation: Zouboulis CC, Bechara FG, Benhadou F, Bettoli V, Bukvić Mokos Z, Del Marmol V, Dolenc-Voljč M, Giamarellos-Bourboulis EJ, Grimstad Ø, Guillem P, Horváth B, Hunger RE, Ingram JR, Ioannidis D, Just E, Kemény L, Kirby B, Liakou AI, McGrath BM, Marzano AV, Matusiak Ł, Molina-Leyva A, Nassif A, Podda M, Prens EP, Prignano F, Raynal H, Romanelli M, Saunte DML, Szegedi A, Szepietowski JC, Tzellos T, Valiukevičienė S, van der Zee HH, van Straalen KR, Villumsen B, Jemec GBE. European S2k guidelines for hidradenitis suppurativa/acne inversa part 2: Treatment. J Eur Acad Dermatol Venereol. 2024 Dec 19. doi: 10.1111/jdv.20472. Epub ahead of print. PMID: 39699926.
3. North American Clinical Practice Guidelines for the Medical Management of Hidradenitis Suppurativa in Special Patient Populations
These timely and much-needed clinical practice guidelines focus on seven patient special populations: i) pregnancy, ii) breastfeeding, iii) paediatrics, iv) malignancy, v) tuberculosis infection, vi) hepatitis B or C infection, and vii) HIV disease.
Link: https://www.jaad.org/article/S0190-9622(24)03395-4/pdf
Citation: Alhusayen R, Dienes S, Lam M, Alavi A, Alikhan A, Aleshin M, Bahashwan E, Daveluy S, Goldfarb N, Garg A, Gulliver W, Jaleel T, Kimball AB, Kirchhof MG, Kirby J, Lenczowski J, Lev-Tov H, Lowes MA, Lara-Corrales I, Micheletti R, Okun M, Orenstein L, Poelman S, Piguet V, Porter M, Resnik B, Sibbald C, Shi V, Sayed C, Wong SM, Zaenglein A, Veillette H, Hsiao JL, Naik HB, North American Clinical Practice Guidelines for the Medical Management of Hidradenitis Suppurativa in Special Patient Populations, Journal of the American Academy of Dermatology (2025), doi: 10.1016/j.jaad.2024.11.071. Epub ahead of print. PMID: 39725212.
4. Systematic Review and Meta-Analysis of Questionnaire-Based Global Prevalence of Hidradenitis Suppurativa
The Global Hidradenitis Suppurativa Atlas (GHiSA) is a nonprofit organisation trying to gain precise and homogenous national prevalence rates by executing explorative, cross-sectional, descriptive studies in more than 58 countries using a simple validated questionnaire (https://www.ghisa.org/en/). In this systematic review and meta-analysis, the GHiSA team aimed to estimate a global HS prevalence based on studies using homogeneous validated questions. Their findings from this review and analysis indicate a higher global prevalence of HS than previously reported.
Link: https://karger.com/drm/article/doi/10.1159/000537920/918463/Questionnaire-Based-Global-Prevalence-of
Citation: Zahid JA, Henning MAS, Bouazzi D, Jemec GBE. Questionnaire-Based Global Prevalence of Hidradenitis Suppurativa: A Systematic Review and Meta-Analysis. Dermatology. 2024 Dec 23:1-10. doi: 10.1159/000537920. Epub ahead of print. PMID: 39715604.
5. Polygenic Score: A Tool for Evaluating the Genetic Background of Sporadic Hidradenitis Suppurativa
Sporadic hidradenitis suppurativa (spHS) is a multifactorial disease in which genetic predisposition is intertwined with environmental factors. Polygenic scores (PGS) estimate an individual’s genetic liability to a trait or disease, calculated according to their genotype profile and relevant genome-wide association study (GWAS) data. In this report, researchers from six centres studied the genetic underpinnings that contribute to spHS within the European demographic by comparing data from 256 patients with spHS and 1686 unaffected controls and calculating PGS. The authors developed a polygenic model associated with spHS, which has the potential to serve as a valuable tool for predicting spHS states in future studies.
Link: https://www.jidonline.org/article/S0022-202X(24)03042-2/fulltext
Citation: Moltrasio C, Moura R, Conti A, Fania L, Jaschke W, Caposiena Caro RD, Chersi K, Margiotta FM, Di Cesare A, Rosi E, Regensberger F, Boeckle B, Frischhut N, Cappellani S, Del Vecchio C, Nardacchione EM, Zalaudek I, von Stebut E, Berti I, Boniotto M, Pio d’Adamo A, Schmuth M, Dini V, Prignano F, Abeni D, Chiricozzi A, Marzano AV, Crovella S, Tricarico PM. Polygenic Score: A Tool for Evaluating the Genetic Background of Sporadic Hidradenitis Suppurativa. J Invest Dermatol. 2024 Dec 28:S0022-202X(24)03042-2. doi: 10.1016/j.jid.2024.11.019. Epub ahead of print. PMID: 39736307.
6. A Genome-Wide Association Meta-Analysis Links Hidradenitis Suppurativa to Common and Rare Sequence Variants Causing Disruption of the Notch and Wnt/Β-Catenin Signaling Pathways
The authors of this report sought to identify sequence variants that associate with HS and determine the contribution of environmental risk factors and inflammatory diseases to HS pathogenesis. They conducted a genome-wide association meta-analysis of 4814 HS cases (Denmark: 1977; Iceland: 1266; Finland: 800; UK: 569; and US: 202) and 1.2 million controls, searching for sequence variants associated with HS. The team found eight independent sequence variants associating with HS, six common and two rare (frequency <1%), demonstrating that genes and pathways involved in epidermal keratinization are the genetic backbone of HS pathology.
Link: https://www.jaad.org/article/S0190-9622(24)03292-4/fulltext
Citation: Kjærsgaard Andersen R, Stefansdottir L, Riis PT, Halldorsson G, Ferkingstad E, Oddsson A, Walters B, Olafsdottir TA, Rutsdottir G, Zachariae C, Thomsen SF, Brodersen T, Dinh KM, Knowlton KU, Knight S, Nadauld LD, Banasik K, Brunak S, Hansen TF, Hjalgrim H, Sørensen E, Mikkelsen C, Ullum H, Nyegaard M, Bruun MT, Erikstrup C, Ostrowski SR, Eidsmo L, Saunte DML, Sigurgeirsson B, Orvar KB, Saemundsdottir J, Melsted P, Norddahl GL, Sulem P, Stefansson H, Holm H, Gudbjartsson D, Thorleifsson G, Jonsdottir I, Pedersen OBV, Jemec GBE, Stefansson K. A genome-wide association meta-analysis links hidradenitis suppurativa to common and rare sequence variants causing disruption of the Notch and Wnt/β-catenin signaling pathways. J Am Acad Dermatol. 2024 Dec 5:S0190-9622(24)03292-4. doi: 10.1016/j.jaad.2024.11.050. Epub ahead of print. PMID: 39645042.
7. Cost-Utility Analysis of Clinic-Based Deroofing Versus Local Excision for Hidradenitis Suppurativa
Deroofing and local excision are common clinic-based surgical options for HS and are recommended in HS guidelines. This cost-utility analysis evaluated the economic and health-related impacts of clinic-based deroofing versus excision for HS, comparing direct medical costs and quality-adjusted life-years. The team conclude that when clinically appropriate, deroofing is more cost-effective than excision for clinic-based procedural management of HS, offering improved quality of life at a modest incremental cost.
Link: https://www.jaad.org/article/S0190-9622(24)03362-0/fulltext
Citation: Hundal S, Cappelli J, Croitoru D, Drucker AM, Ingram JR, Goldberg SR, Netchiporouk E. Cost-utility analysis of clinic-based deroofing versus local excision for hidradenitis suppurativa. J Am Acad Dermatol. 2024 Dec 8:S0190-9622(24)03362-0. doi: 10.1016/j.jaad.2024.11.057. Epub ahead of print. PMID: 39657847.
8. Unlocking the Mechanisms of Hidradenitis Suppurativa: Inflammation and miRNA Insights
While much has been learned about HS in recent years, the precise mechanisms driving HS remain elusive. Recent advances have highlighted the role of certain pathways in initiating and perpetuating HS. Specific microRNAs (miRNAs; a type of non-coding ribonucleic acid [RNA] that play important roles in controlling the expression of genes) have been implicated in these pathways. This narrative review hypothesizes that miRNA dysregulation triggers unusual expression in specific inflammatory pathways, contributing to the clinical manifestations and progression of HS. This review also discusses future research directions to enhance the clinical management of HS.
Link: https://pmc.ncbi.nlm.nih.gov/articles/PMC11646389/pdf/ccid-17-2829.pdf
Citation: Ames E, Sanders M, Jacobs M, Vida TA. Unlocking the Mechanisms of Hidradenitis Suppurativa: Inflammation and miRNA Insights. Clin Cosmet Investig Dermatol. 2024 Dec 11;17:2829-2846. doi: 10.2147/CCID.S483871. PMID: 39677852.
9. Hidradenitis Suppurativa Is Associated with Cardiometabolic Comorbidities in a Racially and Ethnically Diverse Safety Net Population: A Cross-Sectional Analysis
Previous studies have identified associations between HS and the cardiometabolic comorbidities (CMCs) diabetes, hypertension, and hyperlipidemia, but most of these have analysed predominantly White populations, and only some controlled for obesity. Considering this, the authors of this study analysed CMC rates in patients with and without HS among a racially/ethnically diverse safety net population after controlling for obesity. They performed a cross-sectional study of patients with and without HS (38% Black, 34% Hispanic, and 87% publicly insured) matched 1:2 on patient-reported gender, age, and race/ethnicity and compared rates of CMCs (diabetes, hyperlipidemia, hypertension, and obesity). They found that patients with HS had higher rates of obesity, diabetes, and hypertension, but not hyperlipidemia. After controlling for covariates, patients with HS had 2.32 times the odds of diabetes and 1.66 times the odds of hypertension compared with patients without HS.
Link: https://www.jaadinternational.org/article/S2666-3287(24)00165-2/fulltext
Citation: Alba M, Rudd N, Zakaria A, Chang AY, Amerson EH. Hidradenitis suppurativa is associated with cardiometabolic comorbidities in a racially and ethnically diverse safety net population: A cross-sectional analysis. JAAD Int. 2024 Oct 28;18:131-133. doi: 10.1016/j.jdin.2024.10.003. PMID: 39719958.
10. Effectiveness of Anti-Tumor Necrosis Factor Drugs on Hidradenitis Suppurativa: A Systematic Review
The first approved treatment for moderate-to-severe HS, a tumor necrosis factor (TNF) inhibitor, has been in use in clinics for around a decade. This systematic review was conducted to assess the effectiveness of anti-TNF therapies, offering a detailed analysis to inform future research and clinical practice. The reviewers sought to determine whether anti-TNF drugs continue to be a strong treatment option or if newer (other than anti-TNF) therapies might lead to better outcomes for patients.
Link: https://pmc.ncbi.nlm.nih.gov/articles/PMC11663038/pdf/cureus-0016-00000074172.pdf
Citation: Samifanni R, Gatt V, Kabore J, Silva M, Khan M, Kollias TF, Clunes LA. Effectiveness of Anti-tumor Necrosis Factor Drugs on Hidradenitis Suppurativa: A Systematic Review. Cureus. 2024 Nov 21;16(11):e74172. doi: 10.7759/cureus.74172. PMID: 39712699.
