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Review
. 2022 Jul 14;9(3):251-257.
doi: 10.3390/dermatopathology9030029.

Histopathology of Hidradenitis Suppurativa: A Systematic Review

Shane David Basil Smith  1 , Ginette A Okoye  2 , Olayemi Sokumbi  3   4
Affiliations
Review

Histopathology of Hidradenitis Suppurativa: A Systematic Review

Shane David Basil Smith et al. Dermatopathology (Basel). .

Abstract

Hidradenitis suppurativa (HS) is a chronic inflammatory scarring disease felt to be related to occlusion of the hair follicle unit in intertriginous areas. We perform a systematic review on HS histopathology to evaluate current knowledge and discuss future directions. PubMed and Scopus databases were searched for relevant articles published from January 1985 to January 2021 that discussed the pathology of HS. Additional articles were identified by hand-searching, which entailed manually scanning selected journals. A total of 355 citations were identified in the primary search within the main databases. Two hundred and seventy-nine articles were excluded after a review of titles, abstracts, and duplicates. Sixty-one studies did not meet the inclusion criteria or were found to be duplicates, resulting in a total of 15 articles for analysis. Three articles were hand-searched. This comprehensive systematic review of the histopathology of HS confirms a high prevalence of follicular occlusion, follicular hyperkeratosis, and hyperplasia of the follicular epithelium. These findings support the central role of follicular occlusion in the development and progression of HS while providing a potential path to directing therapeutics against follicular occlusion.

Keywords: acne inversa; dermatopathology; follicular occlusion; hidradenitis suppurativa.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram. (* Consider, if feasible to do so, reporting the number of records identified from each database or register searched (rather than the total number across all databases/registers). ** If automation tools were used, indicate how many records were excluded by a human and how many were excluded by automation tools) [26].
Figure 2
Figure 2
(a) Follicular plugging of the hair follicle-original magnification, 5× hematoxylin–eosin staining. (b) Mixed inflammatory infiltrates with a preponderance of plasma cells—original magnification, 20× hematoxylin–eosin staining.
Figure 2
Figure 2
(a) Follicular plugging of the hair follicle-original magnification, 5× hematoxylin–eosin staining. (b) Mixed inflammatory infiltrates with a preponderance of plasma cells—original magnification, 20× hematoxylin–eosin staining.
Figure 3
Figure 3
Histopathologic features of the epidermis from 796 samples (18 articles). Pseudoepitheliomatous hyperplasia—PEH.
Figure 4
Figure 4
Histopathologic features of the dermis from 796 samples (18 articles).
See this image and copyright information in PMC

References

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