The role of cytokines in hidradenitis suppurativa

Abstract

Introduction: Hidradenitis suppurativa is a chronic, recurrent, inflammatory skin condition. It usually presents with debilitating, deep-seated nodules in areas bearing apocrine-glands. Although numerous causes have been proposed, the exact pathogenesis of hidradenitis suppurativa remains unknown.

Aim: To review the possible role of cytokines in the aetiology and pathogenesis of hidradenitis suppurativa.

Methodology: Papers retrieved from two databases (PubMed and Academic Search Complete [EBSCO]) were reviewed.

Results: Although there seems to be no abnormality with regards to the adaptive immune system, the high comorbidity of hidradenitis suppurativa with immune-deficient diseases such as Crohn’s disease (up to 39%), superimposed with the achievements acquired with anti-tumour necrosis factoralpha (TNF-a)pharmaceuticals may indicate an alteration of the innate immune system. An alteration of the immune system results in the release of a plethora of cytokines. Although initially released as a transient defence mechanism, if persistent, chronic disease may eventually develop. When compared to normal subjects elevated cytokine levels are found not only in lesional but also in perilesional hidradenitis suppurativa, providing a possible reason for the high recurrence rate after surgery. The highly inflammatory nature of hidradenitis suppurativa is highlighted by the fact that these cytokine levels are even more elevated than those in some psoriasis patients. TNF-a, interleukin-10, interleukin-12, interleukin-17, interleukin-20 (IL-20), interleukin-22 (IL-22), interleukin-23, and interleukin-1b are all cytokines which are dysregulated in patients with hidradenitis suppurativa.

Conclusion: Cytokines play a role in the pathogenesis of hidradenitis suppurativa, and thus, modulation of these factors will help in managing this condition.