CMFI

Bacterial dysbiosis as a trigger factor in the pathogenesis of acne inversa

01.01.2021 bis 31.12.2021

Acne inversa, also called hidradenitis suppurativa (HS), is a chronic, recurrent inflammatory skin disease that affects the pilosebaceous unit in apocrine gland-bearing areas with a prevalence of 1-4% of the general population. HS clinical severity can be classified into three stages. The primary event in HS is follicular hyperkeratosis, eventually leading to rupture of the hair follicle, and subsequent inflammation of apocrine glands, abscess and sinus tract formation. Characteristic late lesions are deep-seated nodules that expand to form abscesses, which subsequently rupture and drain. Bacteria are thought to play a role in the development and progression of the disease, and it has been shown that there exists a bacterial dysbiosis in HS skin compared to normal skin, accordingly antibiotics are frequently used as a first-line therapy for HS. The drivers in the development and pathogenesis of HS are not well understood but seem to involve dysbiosis-driven aberrant activation of the innate immune system and marked dysregulation of antimicrobial peptides leading to excessive inflammation.