Hidradenitis Suppurativa

Hidradenitis suppurativa (HS) is a chronic, relapsing inflammatory skin disease that is characterised by painful, recurrent, deep-seated nodules and abscesses in the skin. Over time, this can result in a chronic inflammatory state with fistula formation, odorous discharge, scarring, fibrosis and contractures with resultant disability.

The prevalence rate of HS is estimated to be between 0.05 and 4% of the population. Typically, patients first notice symptoms after puberty or their twenties. Women are more commonly affected than men. It is a very distressing disease and has a significant impact on a patient's quality of life.

The sites most commonly affected include the axilla, mammary, perineal and anogenital areas. The exact pathophysiology of HS remains unknown but is thought to involve follicular occlusion followed by immune mediated inflammation of the pilosebaceous unit.

HS remains a difficult condition to manage. Current treatments strategies include lifestyle modification, smoking cessation and weight loss, topical and systemic antibiotics, antiandrogens, systemic retanoids, laser treatment, localised surgery and immunosuppressive agents.

In UCD Charles Institute, we aim to further investigate the underlying pathophysiology of HS. Using novel sampling techniques such as microdialysis, we hope to identify key cytokines, chemokines and signalling pathways in patients with HS, and compare these markers in early and late stages of disease development.

We will also examine the genetic profiles of patients who fail to respond to current treatments in an effort to identify alternative disease pathways in these individuals and potentially novel therapeutic targets.