Acne inversa/Hidradenitis suppurativa – Von der Pathogenese zur Therapie

 

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Zusammenfassung

Acne inversa/Hidradenitis suppurativa (AI/HS) ist eine chronisch-entzündliche Hauterkrankung, die durch das rezidivierende Auftreten von entzündlichen Knoten, Abszessen, Fistelgängen und Narben v. a. in der Axillär-, Inguinal- und Perianalregion charakterisiert ist. In den letzten Jahren rückte die Erforschung der pathophysiologischen Grundlagen der AI/HS zunehmend in den wissenschaftlichen Fokus. Parallel dazu wurde die Wirksamkeit neuer anti-inflammatorischer Therapien in klinischen Studien untersucht, die zum Teil schon Eingang in die klinische Routine gefunden haben. Schwerpunkt dieses Review ist es, den aktuellen Stand der AI/HS zugrundliegenden pathophysiologischen Mechanismen darzustellen und die sich daraus ergebenden Konsequenzen sowohl für die konservative als auch für die operative Therapie abzuleiten.

Abstract

Acne inversa/hidradenitis suppurativa is a chronic inflammatory skin disease characterized by the appearance of subcutaneous inflammatory nodules, abscesses and formation of fistulas, sinus tracts and contracting scars. In the last years scientific interest in its pathophysiology has increasingly gained interest and numerous reports have aimed to identify crucial aspects leading to the ongoing inflammation. In parallel, new systemic therapeutic approaches have been reported targeting the inflammatory component of the disease. The aim of this review is to give an overview of the clinical presentation and the current knowledge on pathophysiology with a focus on the immune system fueling chronic cutaneous inflammation. Moreover, systemic anti-inflammatory therapy and surgical interventions are described and presented in the context of pathophysiological changes.

^* A. Schuch und M. Absmaier-Kijak: Geteilte Erstautorenschaft, beide Autorinnen haben in gleichem Maße zur Publikation beigetragen

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