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Dermatology322 papers

Hidradenitis suppurativa

Last edited: 4/13/2026

Overview

Hidradenitis suppurativa (HS) is a chronic, debilitating inflammatory skin disease characterized by painful, recurrent abscesses and scarring, primarily affecting apocrine gland-rich areas such as the axillae, groin, and perineum 135.

Diagnosis

  • Clinical presentation includes painful nodules, abscesses, and sinus tract formation 13.
  • Microbiome analysis may reveal dysbiosis compared to acne vulgaris 1.
  • Histopathological examination can confirm follicular occlusion and inflammation 7.
  • No specific laboratory tests; imaging (ultrasound) may help assess lesion extent 13.
  • Grading systems like Hurley staging (I-III) assess disease severity 328.

    • Management

  • First-line treatments:
    • - Topical antibiotics: Clindamycin 19. - Oral antibiotics: Long-term use of tetracyclines or clindamycin 419. - Anti-inflammatory agents: NSAIDs for pain and inflammation 4.
  • Adjunctive treatments:
    • - Androgens inhibitors: Spironolactone or dapsone 34. - Biologics: TNF-α inhibitors (e.g., adalimumab) 255. - Retinoids: Oral isotretinoin (caution in "conglobata phenotype" 16). - Surgical interventions: Excision, laser therapy, and deroofing for refractory cases 603.

    Special Populations

  • Pregnancy: Limited data; close monitoring and conservative management preferred 44.
  • Pediatrics: Rare but significant impact; early diagnosis and multidisciplinary care crucial 3738.
  • Comorbidities: Increased risk of metabolic syndrome, cardiovascular disease, and inflammatory arthritis (e.g., gout, spondyloarthropathy) 262255.

    • Key Recommendations

  • Early diagnosis and multidisciplinary management are crucial to improve outcomes and quality of life (Evidence: Strong 328).
  • Use of biologic therapies, particularly TNF-α inhibitors, should be considered for moderate to severe HS refractory to conventional treatments (Evidence: Moderate 255).
  • Regular monitoring for comorbidities such as metabolic syndrome and inflammatory arthritis is essential due to the systemic nature of HS (Evidence: Moderate 222).
  • Avoid isotretinoin in patients with HS "conglobata phenotype" due to potential flare risk (Evidence: Weak 16).
  • Implement standardized photographic documentation to assess disease progression and treatment response (Evidence: Expert opinion 43).

    • References

    1 Chen W, Lai X, Tang X, Ye Q, Zhang C, Yang Y et al.. Dysbiosis in Acne Vulgaris and Hidradenitis Suppurativa: A Comparative Microbiome Analysis. Experimental dermatology 2026. link 2 Gupta AK, Liddy A, Economopoulos V, Magalhaes R. Global Patterns of Comorbidities Among Patients With Hidradenitis Suppurativa: A Systematic Review and Meta-Analysis. International journal of dermatology 2026. link 3 Frew J, Smith A, Penas PF, Ellis E, Foley P, Rubel D et al.. Australasian hidradenitis suppurativa management guidelines. The Australasian journal of dermatology 2025. link 4 Alhusayen R, Dienes S, Lam M, Alavi A, Alikhan A, Aleshin M et al.. North American clinical practice guidelines for the medical management of hidradenitis suppurativa in special patient populations. Journal of the American Academy of Dermatology 2025. link 5 Zouboulis CC, Bechara FG, Benhadou F, Bettoli V, Bukvić Mokos Z, Del Marmol V et al.. European S2k guidelines for hidradenitis suppurativa/acne inversa part 2: Treatment. Journal of the European Academy of Dermatology and Venereology : JEADV 2025. link 6 Chang HC, Chiu TM, Tsai RY, Li CP, Wu YL, Chen SJ et al.. Association between Hidradenitis Suppurativa and Gout: A Propensity Score-Matched Cohort Study. Dermatology (Basel, Switzerland) 2025. link 7 Sampath AJ, Westerkam LL, Blum FR, Alhusayen R, Bechara FG, Caffrey J et al.. Standardized Protocols for Clinical and Histopathological Characterization of Hidradenitis Suppurativa Tissue Specimens. The Journal of investigative dermatology 2025. link 8 Carnero González L, Garcias-Ladaria JG, Rivera-Díaz R, Bassas Vila J, Salgado-Boquete L, Masferrer E et al.. Spanish Hidradenitis Suppurativa Registry (REHS) of the Spanish Academy of Dermatology and Venereology: description and data from its first year of operation. Actas dermo-sifiliograficas 2025. link 9 Zouboulis CC, Bechara FG, Fritz K, Goebeler M, Hetzer FH, Just E et al.. S2k guideline for the treatment of hidradenitis suppurativa / acne inversa - Short version. Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG 2024. link 10 Kirschner U, Kahn M, Papukchieva S, Stosio K, Keis A, Biermann MHC et al.. Diagnostic delay in Hidradenitis suppurativa investigated using data from social media and from statutory health insurances. Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG 2024. link 11 Liao YH, Chu CB, Hui CR, Li CY, Lin SY, Tseng HC et al.. Taiwanese Dermatological Association (TDA) consensus recommendations for the definition, classification, diagnosis, and management of hidradenitis suppurativa. Journal of the Formosan Medical Association = Taiwan yi zhi 2024. link 12 Johnston LA, Poelman SM. Hidradenitis Suppurativa Patient Referrals to a Canadian Community Dermatology Practice: A Retrospective Chart Review. Journal of cutaneous medicine and surgery 2024. link 13 Wortsman X, Ortiz-Orellana G, Valderrama Y, Ferreira-Wortsman C, Reyes F, Herane MI. Ultrasonography of Facial and Submandibular Hidradenitis Suppurativa and Concomitance With Acne Vulgaris. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine 2024. link 14 Zouboulis CC, Prignano F. 12th European Hidradenitis Suppurativa (EHSF) e.V. Conference-Facing HS according to the Renessaince style. Experimental dermatology 2023. link 15 Schultheis M, Staubach-Renz P, Grabbe S, Hennig K, Khoury F, Nikolakis G et al.. Can hidradenitis suppurativa patients classify their lesions by means of a digital lesion identification scheme?. Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG 2023. link 16 Daoud M, Suppa M, Heudens S, Daxhelet M, Njimi H, Nobile L et al.. Treatment of Acne with Isotretinoin Should Be Avoided in Patients with Hidradenitis Suppurativa "Conglobata Phenotype". Dermatology (Basel, Switzerland) 2023. link 17 Sun Q, Broadaway KA, Edmiston SN, Fajgenbaum K, Miller-Fleming T, Westerkam LL et al.. Genetic Variants Associated With Hidradenitis Suppurativa. JAMA dermatology 2023. link 18 Morales-Heil DJ, Cao L, Sweeney C, Malara A, Brown F, Milam P et al.. Rare missense variants in the SH3 domain of . HGG advances 2023. link 19 Aarts P, Reeves JL, Ardon CB, van der Zee HH, Prens EP. Clindamycin-Benzoyl Peroxide Gel Compared with Clindamycin Lotion for Hidradenitis Suppurativa: A Randomized Controlled Assessor-Blinded Intra-Patient Pilot Study. Dermatology (Basel, Switzerland) 2023. link 20 Orenstein LAV, Salame N, Siira MR, Urbanski M, Flowers NI, Echuri H et al.. Pain experiences among those living with hidradenitis suppurativa: a qualitative study. The British journal of dermatology 2023. link 21 Phan K, Ng WHS, Lai B, Garg A, Smith SD. Hidradenitis suppurativa and association with stroke: systematic review and meta-analysis. The Journal of dermatological treatment 2022. link 22 Sokumbi O, Hodge DO, Ederaine SA, Alavi A, Alikhan A. Comorbid diseases of hidradenitis suppurativa: a 15-year population-based study in Olmsted County, Minnesota, USA. International journal of dermatology 2022. link 23 Bouwman K, Aarts P, Dudink K, Hao J, Alizadeh BZ, Prens LM et al.. Drug Survival of Oral Retinoids in Hidradenitis Suppurativa: A Real-Life Cohort Study. American journal of clinical dermatology 2022. link 24 Seetan K, Eldos B, Saraireh M, Omari R, Rubbai Y, Jayyusi A et al.. Prevalence of low vitamin D levels in patients with Hidradenitis suppurativa in Jordan: A comparative cross-sectional study. PloS one 2022. link 25 Lovrić I, Brkić J, Ćorluka M, Čović M, Pejić J, Zeljko Penavić J. Two Cases of Hidradenitis Suppurativa Treated with Adalimumab at the Department of Dermatology and Venereology, Clinical Hospital Mostar. Acta dermatovenerologica Croatica : ADC 2021. link 26 Dunstan RW, Salte KM, Todorović V, Lowe M, Wetter JB, Harms PW et al.. Histologic progression of acne inversa/hidradenitis suppurativa: Implications for future investigations and therapeutic intervention. Experimental dermatology 2021. link 27 Kirsten N, Zander N, Augustin M. Prevalence and cutaneous comorbidities of hidradenitis suppurativa in the German working population. Archives of dermatological research 2021. link 28 Özkur E, Karadağ AS, Üstüner P, Aksoy B, Eşme P, Çalışkan E et al.. Clinical and demographic features of hidradenitis suppurativa: a multicentre study of 1221 patients with an analysis of risk factors associated with disease severity. Clinical and experimental dermatology 2021. link 29 Sayed CJ, Hsiao JL, Okun MM. Clinical Epidemiology and Management of Hidradenitis Suppurativa. Obstetrics and gynecology 2021. link 30 Briede K, Valiukeviciene S, Kucinskiene V, Gollnick HPM. Biologic Therapy for Hidradenitis Suppurativa Plus Conglobate Acne Associated with SAPHO Syndrome: A Case Report. Acta dermato-venereologica 2020. link 31 Jalenques I, Ciortianu L, Pereira B, D'Incan M, Lauron S, Rondepierre F. The prevalence and odds of anxiety and depression in children and adults with hidradenitis suppurativa: Systematic review and meta-analysis. Journal of the American Academy of Dermatology 2020. link 32 Włodarek K, Stefaniak A, Matusiak Ł, Szepietowski JC. Could Residents Adequately Assess the Severity of Hidradenitis Suppurativa? Interrater and Intrarater Reliability Assessment of Major Scoring Systems. Dermatology (Basel, Switzerland) 2020. link 33 Orenstein LAV, Nguyen TV, Damiani G, Sayed C, Jemec GBE, Hamzavi I. Medical and Surgical Management of Hidradenitis Suppurativa: A Review of International Treatment Guidelines and Implementation in General Dermatology Practice. Dermatology (Basel, Switzerland) 2020. link 34 Lyons AB, Peacock A, McKenzie SA, Jacobsen G, Naik HB, Shi VY et al.. Evaluation of Hidradenitis Suppurativa Disease Course During Pregnancy and Postpartum. JAMA dermatology 2020. link 35 Gadelha RL, Paiva RDSR, Palitot EB, Costa JEFD. PsAPASH: a rare and recent autoinflammatory syndrome associated with hidradenitis suppurativa. Anais brasileiros de dermatologia 2020. link 36 Au J, Gibson FT, Aronson IK. Follicular occlusion triad: an isotopic response or adverse effect of rituximab?. Dermatology online journal 2020. link 37 Vaiopoulos AG, Nikolakis G, Zouboulis CC. Hidradenitis suppurativa in paediatric patients: a retrospective monocentric study in Germany and review of the literature. Journal of the European Academy of Dermatology and Venereology : JEADV 2020. link 38 Riis PT, Saunte DM, Sigsgaard V, Villani AP, Guillem P, Pascual JC et al.. Clinical characteristics of pediatric hidradenitis suppurativa: a cross-sectional multicenter study of 140 patients. Archives of dermatological research 2020. link 39 Brandao L, Moura R, Tricarico PM, Gratton R, Genovese G, Moltrasio C et al.. Altered keratinization and vitamin D metabolism may be key pathogenetic pathways in syndromic hidradenitis suppurativa: a novel whole exome sequencing approach. Journal of dermatological science 2020. link 40 Charrow A, Savage KT, Flood K, Kimball AB. Hidradenitis suppurativa for the dermatologic hospitalist. Cutis 2019. link 41 Magalhães RF, Rivitti-Machado MC, Duarte GV, Souto R, Nunes DH, Chaves M et al.. Consensus on the treatment of hidradenitis suppurativa - Brazilian Society of Dermatology. Anais brasileiros de dermatologia 2019. link 42 Posso-De Los Rios CJ, Sarfo A, Ghias M, Alhusayen R, Hamzavi I, Lowes MA et al.. Proceeding report of the third symposium on Hidradenitis Suppurativa advances (SHSA) 2018. Experimental dermatology 2019. link 43 Zouboulis CC, Nogueira da Costa A. Standardized Photographic Documentation of Hidradenitis Suppurativa/Acne Inversa. Dermatology (Basel, Switzerland) 2019. link 44 Gallagher CG, Kirthi SK, Cotter CC, Revuz JR, Tobin AMT. Could isotretinoin flare hidradenitis suppurativa? A case series. Clinical and experimental dermatology 2019. link 45 Kurihara Y, Furue M. Gluteal hidradenitis suppurativa presenting pemphigus-like findings: case report. BMC dermatology 2019. link 46 Wertenteil S, Strunk A, Garg A. Overall and subgroup prevalence of acne vulgaris among patients with hidradenitis suppurativa. Journal of the American Academy of Dermatology 2019. link 47 Chernyshov PV, Zouboulis CC, Tomas-Aragones L, Jemec GB, Svensson A, Manolache L et al.. Quality of life measurement in hidradenitis suppurativa: position statement of the European Academy of Dermatology and Venereology task forces on Quality of Life and Patient-Oriented Outcomes and Acne, Rosacea and Hidradenitis Suppurativa. Journal of the European Academy of Dermatology and Venereology : JEADV 2019. link 48 Coskun BN, Yagiz B, Pehlivan Y, Dalkilic E. Isotretinoin-induced sacroiliitis in patients with hidradenitis suppurativa: a case-based review. Rheumatology international 2019. link 49 Veraldi S, Guanziroli E, Benzecry V, Nazzaro G. Multidisciplinary approach for hidradenitis suppurativa patients. Giornale italiano di dermatologia e venereologia : organo ufficiale, Societa italiana di dermatologia e sifilografia 2018. link 50 Lee JH, Kwon HS, Jung HM, Kim GM, Bae JM. Prevalence and comorbidities associated with hidradenitis suppurativa in Korea: a nationwide population-based study. Journal of the European Academy of Dermatology and Venereology : JEADV 2018. link 51 Yang JH, Moon J, Kye YC, Kim KJ, Kim MN, Ro YS et al.. Demographic and clinical features of hidradenitis suppurativa in Korea. The Journal of dermatology 2018. link 52 Garg A, Lavian J, Strunk A. Low Utilization of the Dermatology Ambulatory Encounter among Patients with Hidradenitis Suppurativa: A Population-Based Retrospective Cohort Analysis in the USA. Dermatology (Basel, Switzerland) 2017. link 53 Sisic M, Tan J, Lafreniere KD. Hidradenitis Suppurativa, Intimate Partner Violence, and Sexual Assault. Journal of cutaneous medicine and surgery 2017. link 54 Vural S, Gundogdu M, Kundakci N, Ruzicka T. Familial Mediterranean fever patients with hidradenitis suppurativa. International journal of dermatology 2017. link 55 Chen W, Plewig G. Should hidradenitis suppurativa/acne inversa best be renamed as "dissecting terminal hair folliculitis"?. Experimental dermatology 2017. link 56 Huang CM, Kirchhof MG. A New Perspective on Isotretinoin Treatment of Hidradenitis Suppurativa: A Retrospective Chart Review of Patient Outcomes. Dermatology (Basel, Switzerland) 2017. link 57 Guillet A, Brocard A, Bach Ngohou K, Graveline N, Leloup AG, Ali D et al.. Verneuil's disease, innate immunity and vitamin D: a pilot study. Journal of the European Academy of Dermatology and Venereology : JEADV 2015. link 58 Vazquez BG, Alikhan A, Weaver AL, Wetter DA, Davis MD. Incidence of hidradenitis suppurativa and associated factors: a population-based study of Olmsted County, Minnesota. The Journal of investigative dermatology 2013. link 59 Scheinfeld N. Diseases associated with hidranitis suppurativa: part 2 of a series on hidradenitis. Dermatology online journal 2013. link 60 van der Zee HH, Prens EP, Boer J. Deroofing: a tissue-saving surgical technique for the treatment of mild to moderate hidradenitis suppurativa lesions. Journal of the American Academy of Dermatology 2010. link 61 Poli F, Wolkenstein P, Revuz J. Back and face involvement in hidradenitis suppurativa. Dermatology (Basel, Switzerland) 2010. link 62 Canoui-Poitrine F, Revuz JE, Wolkenstein P, Viallette C, Gabison G, Pouget F et al.. Clinical characteristics of a series of 302 French patients with hidradenitis suppurativa, with an analysis of factors associated with disease severity. Journal of the American Academy of Dermatology 2009. link 63 Shuster S. The nature and consequence of Karl Marx's skin disease. The British journal of dermatology 2008. link 64 Jemec GB. Medical treatment of hidradenitis suppurativa. Expert opinion on pharmacotherapy 2004. link 65 Leybishkis B, Fasseas P, Ryan KF, Roy R. Hidradenitis suppurativa and acne conglobata associated with spondyloarthropathy. The American journal of the medical sciences 2001. link 66 Jansen I, Altmeyer P, Piewig G. Acne inversa (alias hidradenitis suppurativa). Journal of the European Academy of Dermatology and Venereology : JEADV 2001. link 67 Jemec GB, Gniadecka M. Sebum excretion in hidradenitis suppurativa. Dermatology (Basel, Switzerland) 1997. link 68 Bhalla R, Sequeira W. Arthritis associated with hidradenitis suppurativa. Annals of the rheumatic diseases 1994. link 69 Rosner IA, Burg CG, Wisnieski JJ, Schacter BZ, Richter DE. The clinical spectrum of the arthropathy associated with hidradenitis suppurativa and acne conglobata. The Journal of rheumatology 1993. link 70 Boyd AS, Zemtsov A. A case of pyoderma vegetans and the follicular occlusion triad. The Journal of dermatology 1992. link 71 Fitzsimmons JS, Guilbert PR. A family study of hidradenitis suppurativa. Journal of medical genetics 1985. link 72 Vasey FB, Fenske NA, Clement GB, Bridgeford PH, Germain BF, Espinoza LR. Immunological studies of the arthritis of acne conglobata and hidradenitis suppurativa. Clinical and experimental rheumatology 1984. link 73 Ray B. Hidradenitis suppurativa of the scrotum. The Journal of urology 1977. link58158-6) 74 McDonald RM, Reed WB. Natal teeth and steatocystoma multiplex complicated by hidradenitis suppurativa. A new syndrome. Archives of dermatology 1976. link

    Original source

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      Dysbiosis in Acne Vulgaris and Hidradenitis Suppurativa: A Comparative Microbiome Analysis. — Chen W, Lai X, Tang X, Ye Q, Zhang C, Yang Y et al. Experimental dermatology (2026)
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      Global Patterns of Comorbidities Among Patients With Hidradenitis Suppurativa: A Systematic Review and Meta-Analysis. — Gupta AK, Liddy A, Economopoulos V, Magalhaes R International journal of dermatology (2026)
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      Australasian hidradenitis suppurativa management guidelines. — Frew J, Smith A, Penas PF, Ellis E, Foley P, Rubel D et al. The Australasian journal of dermatology (2025)
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      North American clinical practice guidelines for the medical management of hidradenitis suppurativa in special patient populations. — Alhusayen R, Dienes S, Lam M, Alavi A, Alikhan A, Aleshin M et al. Journal of the American Academy of Dermatology (2025)
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      European S2k guidelines for hidradenitis suppurativa/acne inversa part 2: Treatment. — Zouboulis CC, Bechara FG, Benhadou F, Bettoli V, Bukvić Mokos Z, Del Marmol V et al. Journal of the European Academy of Dermatology and Venereology : JEADV (2025)
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      Association between Hidradenitis Suppurativa and Gout: A Propensity Score-Matched Cohort Study. — Chang HC, Chiu TM, Tsai RY, Li CP, Wu YL, Chen SJ et al. Dermatology (Basel, Switzerland) (2025)
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      Standardized Protocols for Clinical and Histopathological Characterization of Hidradenitis Suppurativa Tissue Specimens. — Sampath AJ, Westerkam LL, Blum FR, Alhusayen R, Bechara FG, Caffrey J et al. The Journal of investigative dermatology (2025)
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      Spanish Hidradenitis Suppurativa Registry (REHS) of the Spanish Academy of Dermatology and Venereology: description and data from its first year of operation. — Carnero González L, Garcias-Ladaria JG, Rivera-Díaz R, Bassas Vila J, Salgado-Boquete L, Masferrer E et al. Actas dermo-sifiliograficas (2025)
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      Taiwanese Dermatological Association (TDA) consensus recommendations for the definition, classification, diagnosis, and management of hidradenitis suppurativa. — Liao YH, Chu CB, Hui CR, Li CY, Lin SY, Tseng HC et al. Journal of the Formosan Medical Association = Taiwan yi zhi (2024)
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      Hidradenitis Suppurativa Patient Referrals to a Canadian Community Dermatology Practice: A Retrospective Chart Review. — Johnston LA, Poelman SM Journal of cutaneous medicine and surgery (2024)
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      Ultrasonography of Facial and Submandibular Hidradenitis Suppurativa and Concomitance With Acne Vulgaris. — Wortsman X, Ortiz-Orellana G, Valderrama Y, Ferreira-Wortsman C, Reyes F, Herane MI Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine (2024)
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      12th European Hidradenitis Suppurativa (EHSF) e.V. Conference-Facing HS according to the Renessaince style. — Zouboulis CC, Prignano F Experimental dermatology (2023)
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      Can hidradenitis suppurativa patients classify their lesions by means of a digital lesion identification scheme? — Schultheis M, Staubach-Renz P, Grabbe S, Hennig K, Khoury F, Nikolakis G et al. Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG (2023)
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      Genetic Variants Associated With Hidradenitis Suppurativa. — Sun Q, Broadaway KA, Edmiston SN, Fajgenbaum K, Miller-Fleming T, Westerkam LL et al. JAMA dermatology (2023)
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      Clindamycin-Benzoyl Peroxide Gel Compared with Clindamycin Lotion for Hidradenitis Suppurativa: A Randomized Controlled Assessor-Blinded Intra-Patient Pilot Study. — Aarts P, Reeves JL, Ardon CB, van der Zee HH, Prens EP Dermatology (Basel, Switzerland) (2023)
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      Pain experiences among those living with hidradenitis suppurativa: a qualitative study. — Orenstein LAV, Salame N, Siira MR, Urbanski M, Flowers NI, Echuri H et al. The British journal of dermatology (2023)
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      Comorbid diseases of hidradenitis suppurativa: a 15-year population-based study in Olmsted County, Minnesota, USA. — Sokumbi O, Hodge DO, Ederaine SA, Alavi A, Alikhan A International journal of dermatology (2022)
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      Drug Survival of Oral Retinoids in Hidradenitis Suppurativa: A Real-Life Cohort Study. — Bouwman K, Aarts P, Dudink K, Hao J, Alizadeh BZ, Prens LM et al. American journal of clinical dermatology (2022)
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      Prevalence of low vitamin D levels in patients with Hidradenitis suppurativa in Jordan: A comparative cross-sectional study. — Seetan K, Eldos B, Saraireh M, Omari R, Rubbai Y, Jayyusi A et al. PloS one (2022)
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      Two Cases of Hidradenitis Suppurativa Treated with Adalimumab at the Department of Dermatology and Venereology, Clinical Hospital Mostar. — Lovrić I, Brkić J, Ćorluka M, Čović M, Pejić J, Zeljko Penavić J Acta dermatovenerologica Croatica : ADC (2021)
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      Histologic progression of acne inversa/hidradenitis suppurativa: Implications for future investigations and therapeutic intervention. — Dunstan RW, Salte KM, Todorović V, Lowe M, Wetter JB, Harms PW et al. Experimental dermatology (2021)
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      Clinical and demographic features of hidradenitis suppurativa: a multicentre study of 1221 patients with an analysis of risk factors associated with disease severity. — Özkur E, Karadağ AS, Üstüner P, Aksoy B, Eşme P, Çalışkan E et al. Clinical and experimental dermatology (2021)
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