Acne inversa or hidradenitis suppurativa

Known trigger factors are smoking, increased sweating, mechanical stimuli and obesity.

Diagnostics

Some patients have a hereditary predisposition, but many do not. Depending on the data collected, between 0.05 % and 2.10 % of the population are affected by this disease. Known trigger factors are smoking, increased sweating, mechanical stimuli and obesity.

Treatment

In summary, the severity of the disease is classified into three stages according to Hurley.

Almost all patients who smoke notice a significant improvement in their skin condition after they quit smoking. Reducing the other triggers mentioned above also leads to an improvement in symptoms.

Overall, the most effective treatment is the extensive surgical removal of abscesses and fistulas from the affected areas of the body.

Antiseptic and antibiotic creams and solutions, as well as antibiotics in tablet form, can reduce the number of germs on the skin and thus significantly improve patients’ quality of life.

Adalimumab (Humira®), a tumor necrosis factor-α inhibitor, has been approved since 2016 for the treatment of acne inversa in patients with moderate-to-severe disease.

Several off-label therapies—such as zinc gluconate, botulinum toxin, low-dose doxycycline, and many others—show promise but are not (yet) approved for the treatment of hidradenitis suppurativa.