Errol P Prens

• Professor, MD, PhD
• Erasmus MC

Introduction: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterised by recurrent nodules, abscesses and draining tunnels, with patients often experiencing periodic worsening of symptoms, known as flares.1 Achieving disease control is important to reduce flare frequency.1 Bimekizumab (BKZ) is a humanised monoclonal IgG1...

Background Neutrophils are scarce in healthy skin but infiltrate lesions of hidradenitis suppurativa (HS) patients. Activated neutrophils release proinflammatory neutrophil extracellular traps (NETs), which have been implicated in the pathophysiology of HS. This study aimed to describe the distribution of NETs relative to the features of HS skin le...

This article reflects on the position of HS in dermatology in the past decades, discusses important highlights and status in the field of HS awareness, treatment and research. HS has evolved from a disease with neglible treatment options, rarely seen in dermatology four to five decades ago, to the current situation where dermatologists are in the l...

Background Hidradenitis suppurativa (HS) is a chronic, inflammatory, neutrophilic skin disease associated with a considerable clinical burden. In more severe disease, subepidermal draining tunnels may form. Objectives To characterize the clinical profile of patients with moderate–severe HS with and without draining tunnels, and the clinical and he...

Introduction This second part of the S2k guidelines is an update of the 2015 S1 European guidelines. Objective These guidelines aim to provide an accepted decision aid for the selection, implementation and assessment of appropriate and sufficient therapy for patients with hidradenitis suppurativa/acne inversa (HS). Methods The chapters have been...

Background Severe keloids are difficult to treat. Corticosteroid injections with needles are painful and associated with frequent recurrences. Therefore, more effective, safe and patient friendly alternative treatments are urgently needed. Objectives To assess the efficacy, tolerability, and patient satisfaction of intralesional bleomycin treatmen...

Hidradenitis suppurativa (HS) is a debilitating skin disease, with pain being the most impactful symptom. Treatment options are limited; bimekizumab (BKZ), a humanized monoclonal IgG1 antibody that selectively inhibits interleukin (IL)-17F and IL-17A, was studied in the phase III BE HEARD I (NCT04242446) and BE HEARD II (NCT04242498) studies. Effic...

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory disease with a considerable disease burden. Existing treatment options are limited and often suboptimal; a high unmet need exists for effective targeted therapies. Objective: To explore the effects of spesolimab treatment in patients with HS. Methods: This randomized, double-b...

Long noncoding RNAs (lncRNAs) regulate the expression of protein-coding genes and have been shown to play important roles in inflammatory skin diseases. However, we still have limited understanding of the functional impact of lncRNAs in skin, partly due to their tissue specificity and lower expression levels compared with protein-coding genes. We c...

Hidradenitis suppurativa (HS) is a chronic, recurrent and debilitating inflammatory skin disease, characterized by painful inflamed nodules, abscesses and tunnels in the skin folds. Up to 66% of HS patients can be classified as having mild disease. However, currently, most clinical trials are focusing on patients with moderate to severe disease, re...

Background Adalimumab monotherapy for hidradenitis suppurativa (HS) is often insufficient with a maximum clinical efficacy of 60% in Hidradenitis Suppurativa Clinical Response (HiSCR) and limited effect on draining tunnels. Data suggest that adalimumab therapy could be improved by concomitant antibiotics. Objective To compare the clinical effectiv...

Keloids and hypertrophic scars can cause severe pain, pruritus, and psychological distress. Conventional intralesional corticosteroid treatment with needle injections remains challenging, especially in children with needle phobia. We aimed to evaluate the effectiveness, tolerability, and patient satisfaction of intralesional treatment with triamcin...

Background: Several registries for hidradenitis suppurativa (HS) already exist in Europe and USA. There is currently no global consensus on a core dataset (CDS) for these registries.Creating a global HS registry is challenging due to logistical and regulatory constraints, which could limit opportunities for global collaboration due to differences...

Introduction: Hidradenitis suppurativa (HS) is a chronic, inflammatory disorder characterized by painful inflammatory nodules (N), abscesses (A) and draining tunnels (dT), primarily affecting intertriginous areas. Interleukin-36 (IL-36) signaling has been notably expressed within HS inflammatory lesions. To address the need for targeted therapies,...

Objectives The treatment of recalcitrant keloids is challenging. Although intralesional bleomycin using conventional needle injectors (CNI) is effective, it has important drawbacks, such as the need for repetitive and painful injections. Therefore, we aimed to evaluate the effectiveness, tolerability and patient satisfaction of intralesional bleomy...

First-line treatment of keloids consists of intralesional needle injections with corticosteroids, but generally entails multiple painful sessions, resulting in variable clinical outcomes. Novel needle-free jet injectors may facilitate more effective and patient-friendly dermal drug delivery. Here, we evaluated the effectiveness, tolerability and pa...

Hidradenitis suppurativa (HS), also known as acne inversa, is a chronic disabling and debilitating inflammatory disease with high unmet medical need. The prevalence of HS is 1-2% in most studies, although it is likely underreported and estimates vary globally due to variance in data collection methods, ethnicity, geographical location, and underdia...

Imiquimod (IMQ) is a topical agent that induces local inflammation via the Toll-like receptor 7 pathway. Recently, an IMQ-driven skin inflammation model was developed in healthy volunteers for proof-of-pharmacology trials. The aim of this study was to profile the cellular, biochemical, and clinical effects of the marketed anti-inflammatory compound...

Antibiotic resistance is a major concern, especially in HS. However, antibiotics form a cornerstone in its treatment. Topical clindamycin is known to cause bacterial resistance, but is still advised as monotherapy for the treatment of mild to moderate HS Methods This is a randomized controlled, assessor blinded, intra-patient pilot trial to compare...

Development of pharmacological interventions for wound treatment is challenging due to both poorly understood wound healing mechanisms and heterogeneous patient populations. A standardized and well-characterized wound healing model in healthy volunteers is needed to aid in-depth pharmacodynamic and efficacy assessments of novel compounds. The curre...

Background: Anti-drug antibodies (ADA) are formed in patients treated with adalimumab (ADL). This might increase clearance of ADL, potentially causing a (secondary) non-response. Combination therapy of ADL and methotrexate (MTX) reduces ADA levels and has a clinical benefit in rheumatologic diseases. In psoriasis however, the long-term effectivene...

Background: Adalimumab, the only biologic registered for hidradenitis suppurativa (HS), shows clinical response in up to 60% of patients, leaving many patients in need for other treatment options such as surgery. Objective: To compare the clinical effectiveness of adalimumab combined with surgery versus adalimumab monotherapy in patients with mo...

Patients with hidradenitis suppurativa experience significant life impact related to their disease. Younger age, Black race, high BMI, active smoking, flares, depression, anxiety, high comorbidity burden, disability, and difficult access to a dermatologist adversely influence life impact related to having hidradenitis suppurativa. Attention to thes...

IntroductionHidradenitis suppurativa (HS) is a chronic, immune-mediated skin condition characterized by inflammatory lesions that can cause pain, impaired physical activity, and reduced quality of life. This study evaluated the efficacy and safety of risankizumab, a humanized immunoglobulin G1 monoclonal antibody that specifically inhibits interleu...

Needle-free jet injectors are used for the intralesional treatment of various dermatological indications. However, a systematic review that evaluates the efficacy and safety of these treatments has not been published. The objectives of this study are to evaluate the efficacy and safety of needle-free jet injections for dermatological indications an...

Background: Effectiveness of available biologics for the treatment of hidradenitis suppurativa (HS) is limited. Additional therapeutic options are highly needed. Objective: To investigate the efficacy and mode of action of guselkumab (an anti-IL-23p19 monoclonal antibody) 200 mg s.c., every four weeks for 16 weeks in HS patients. Methods: An o...

Background: Previously, a new dichotomous outcome was developed, calculated as 55% reduction in the International Hidradenitis Suppurativa 4 score (IHS4-55). It was validated in datasets of adalimumab and placebo treated HS patients. External validation is an important aspect of clinical outcomes. Objectives: We aimed to externally validate the...

Background: Validated, inclusive, and easy-to-use outcomes for HS are essential both in the clinical trial setting and clinical practice. The continuous IHS4 is a validated tool that dynamically assesses nodules/abscesses/draining tunnels and classifies disease severity as mild/moderate/severe. However, dichotomous outcomes are often required for...

Hidradenitis suppurativa (HS) is a chronic auto-inflammatory skin disease with a complex and multifactorial pathogenesis involving both the innate and adaptive immune system. Despite limited evidence for local complement activation, conflicting results have been published on the role of systemic complement activation in HS. It was hypothesized that...

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by recurring suppurating lesions of the intertriginous areas, resulting in substantial impact on patients' quality of life. HS pathogenesis remains poorly understood. An autoimmune component has been proposed, but disease-specific autoantibodies, autoantigens or auto...

Background: After excision surgery in patients with hidradenitis suppurativa (HS), wounds are usually left open for secondary intention healing. To evaluate wound healing, reliable wound measurement is important. However, digital wound measurement tools for measuring the surface area are validated for small wounds located on flat or mildly convex...

Background: Nearly half of patients with hidradenitis suppurativa (HS) report dissatisfaction with their treatment. However, factors related to treatment satisfaction have not been explored. Objectives: To measure associations between treatment satisfaction and clinical and treatment-related characteristics among patients with HS. Methods: Tre...

The European Hidradenitis Suppurativa Foundation (EHSF) e.V. has taken several initiatives to collaborative studies. They result from the data of the European Registry of Hidradenitis Suppurativa (ERHS) based on the knowledge obtained from the regional Northern countries (HISREG) and Italian (IRHIS) registries and the real‐world data generated from...

Background: Hidradenitis Suppurativa (HS) is a chronic, recurrent, inflammatory, follicular skin disease whose pathology is complex and not fully understood. The objective of this study was to elucidate the role of IL-17A in moderate to severe HS. Methods: Transcriptomic and histological analyses were conducted on ex vivo HS (n=19; lesional and...

Introduction Adalimumab is normally prescribed with methotrexate (MTX) in rheumatoid arthritis given the enhanced treatment effect and reduced antidrug antibody (ADA) formation compared to adalimumab monotherapy. In psoriasis, the long-term treatment effects and pharmacokinetic profile have not been investigated extensively. Methods We conducted a...

Hidradenitis Suppurativa (HS) is a chronic, debilitating, inflammatory skin disorder with a prevalence of around 1%, and profound impact on patient’s quality of life. Characteristic lesions such as inflammatory nodules, abscesses, and sinus tracts develop in the axillae, inguinal, and gluteal areas, typically during or after puberty. A complex inte...

Objectives Needle-free jet injectors are frequently used in dermatological practice. Injection-generated small-droplet aerosols could be harmful upon inhalation when chemotherapeutics, like bleomycin, are used. Here, we aim to explore jet injector-induced small-droplet aerosol formation of bleomycin in relation to air ventilation and to provide saf...

Introduction Hidradenitis suppurativa (HS) is a chronic, auto-inflammatory skin condition and is associated with several comorbidities. Previous studies report variable prevalence rates of HS, depending on the methodology, however the exact prevalence remains unknown. Objectives To estimate the prevalence of HS in a large population-based cohort i...

Background Hidradenitis suppurativa (HS) is a chronic, inflammatory disease of the apocrine gland-rich (AGR) skin region. The initial steps of disease development are not fully understood, despite intense investigations into immune alterations in lesional HS skin. Objectives We aimed to systematically investigate the inflammatory molecules involve...

Background during photodynamic therapy (PDT) oxygen is transformed into reactive oxygen species (ROS) to induce cellular apoptosis in (pre)malignant cells. Real time oxygen availability measurement is clinically available with the Cellular Oxygen Metabolism (COMET) monitor. Methods Primary objective is to show that mitochondrial oxygen availabilit...

IL-17A has been shown to be up-regulated in psoriasis lesions and is central to psoriasis pathogenesis. IL-19, along with other IL-20 subfamily cytokines such as IL-20 and IL-24, is induced by IL-17A and contributes especially to epidermal hyperplasia in psoriasis. However, the regulation, cellular sources of IL-19 and whether targeting of IL-17A b...

Hidradenitis suppurativa (HS) is a prevalent and debilitating skin disease that arises from pathological inflammation in the hair follicle, particularly those located within the axillae, groin, and buttocks. Disease management is difficult and there are many unmet medical needs. There is a high degree of clinical heterogeneity. HS can be limited to...

Importance Surgery is a mainstay in the management of hidradenitis suppurativa (HS). Adalimumab is the first drug approved for HS. Objective To investigate the efficacy and safety of adalimumab in combination with wide-excision surgery followed by secondary intention healing. Design, Setting, and Participants The Safety and Efficacy of Adalimumab...

Hidradenitis suppurativa (HS) is a chronic, recurrent, auto-inflammatory skin disease originating from the hair follicles. The typical inflammatory nodules, abscesses, and draining sinus tracts (tunnels) are characterized by a massive influx of neutrophils, macrophages, B-cells, plasma cells, T helper (Th)1, Th17 cells and upregulation of pro-infla...

The registration of the tumour necrosis factor‐α inhibitor adalimumab in 2015 was a major step forward in the treatment of hidradenitis suppurativa/acne inversa (HS). However, it soon became evident that the effectiveness of adalimumab in daily practice was highly variable. A significant unmet medical need of HS patients remained, and the search fo...

The reported incidence of COVID-19 among cohorts of patients with inflammatory bowel and skin diseases under treatment with biologicals is low. Treatment may further modify disease severity as some biological modifiers, such as anakinra, are also proposed for the management of COVID-19 patients potentially providing HS patients with an advantage. T...

Background Biologics are often required for treatment of hidradenitis suppurativa (HS). However, data on the drug survival of biologics in daily practice are currently lacking. Objectives To assess the drug survival of anti‐TNF biologics in a daily practice cohort of HS patients and to identify predictors for drug survival. Methods A retrospectiv...

Background COVID-19 is commonly associated with skin manifestations, and may also exacerbate existing skin diseases, yet the relationship between COVID-19 and skin diseases remains unclear. Objective By investigating this relationship through a multi-omics approach, we sought to ascertain whether patients with skin conditions are more susceptible...

Hidradenitis suppurativa (HS; also designated as acne inversa) is a chronic inflammatory disorder, which affects the intertriginous skin and is associated with numerous systemic comorbidities. The estimated prevalence of HS is ~1% in most studied countries. Typically starting in early adulthood, cutaneous inflamed nodules, abscesses and pus-dischar...

Hidradenitis suppurativa (HS) rarely affects pediatric patients. The literature on pediatric HS patients is scarce. This is a cross-sectional study based on case note review or interviews and clinical examination of 140 pediatric patients undergoing secondary or tertiary level care. Patients were predominantly female (75.5%, n = 105) with a median...

IntroductionPatients with atopic dermatitis (AD) have a greater risk of conjunctivitis and other ocular surface disorders than the general population. We evaluated the burden of ocular surface disorders and related symptoms prior to treatment initiation in adults with moderate-to-severe AD.Methods Patients were enrolled in a randomized, placebo-con...

Importance Hidradenitis suppurativa is a chronic, inflammatory skin disease in which genetic factors are considered to play a role, with up to 38% of patients reporting a family history. Variations in the γ-secretase genes are found mainly in familial cases with an autosomal dominant pattern of inheritance. These variations are rare in the general...

The 14 authors of the first review article on hidradenitis suppurativa (HS) pathogenesis published 2008 in EXPERIMENTAL DERMATOLOGY cumulating from the 1st International Hidradenitis Suppurativa Research Symposium held March 30–April 2, 2006 in Dessau, Germany with 33 participants were prophetic when they wrote “Hopefully, this heralds a welcome ne...

Hidradenitis Suppurativa (HS) is a debilitating chronic inflammatory skin disease characterized by chronic abscess formation and development of multiple draining sinus tracts in the groin, axillae, and perineum. Utilizing proteomic and transcriptomic approaches, we characterized the inflammatory responses in HS in depth, revealing immune responses...

Most of the currently available cytokine and antimicrobial peptide (AMP) expression data from Hidradenitis suppurativa (HS) lesions have been obtained through painful, invasive sampling techniques such as biopsies.1 In contrast, a Transdermal Analysis Patch (TAP, FibroTx, Tallinn, Estonia) captures and measures biomarkers at the skin surface and as...

Objective Interleukin‐17A (IL‐17A) and tumor necrosis factor (TNF) contribute to the pathogenesis of psoriatic arthritis (PsA). However, their functional relationship in PsA synovitis has not been fully elucidated. Additionally, although CD8+ T cells in PsA have been recognized via flow cytometry as a source of IL‐17A production, it is not clear wh...

For the second year in a row the European Academy of Dermatology and Venereology (EADV) School on Hidradenitis suppurativa/acne inversa (HS), which took place on February 3‐4, 2020 in Athens with the participation of 4 specialists and 20 residents (17 female, 7 male; Table 1) systematically assessed its effect on the participants knowledge. The glo...

Omiganan is an indolicidin analogue with antimicrobial properties that could be beneficial for patients with atopic dermatitis. This randomized, double‐blind, placebo‐controlled phase II trial explored efficacy, pharmacodynamics and safety of topical omiganan once daily in 36 patients with mild to moderate AD. Patients were randomized to apply topi...

The prevalence of spondyloarthritis (SpA) reported among patients with hidradenitis suppurativa (HS) ranges from 2.3 to 28.2 %, depending on the diagnostic method used.1 A key feature of SpA and one of the European Spondyloarthropathy Study Group (ESSG) diagnostic criteria for this group of diseases is enthesitis; inflammation at insertion of tendo...

Hidradenitis suppurativa (HS) is known to have a profound impact on the quality of life (QoL) of patients.1 Only a few small studies have assessed the Short Form‐36 (SF‐36) questionnaire in HS patients.2‐5 The relation between patient characteristics, patient reported outcome measures (PROMs) and SF‐36 scores has never been evaluated, even though y...

9TH CONFERENCE OF THE EUROPEAN HIDRADENITIS SUPPURATIVA FOUNDATION - ATHENS

Background: Mutations in the γ-secretase enzyme subunits have been described in multiple kindreds with familial hidradenitis supurativa (HS). Objective: In this study we report a novel nicastrin (NCSTN) mutation causing HS in a Dutch family. We sought to explore the immunobiological function of NCSTN mutations using data of the Immunological Gen...

Background Hidradenitis suppurativa (HS), also known as acne inversa, is a recurring, painful, chronic, and sometimes disfiguring inflammatory skin disease.Objectives Our objective was to report the baseline clinical characteristics, natural history, and associated outcomes of patients with HS from the ongoing, prospective, non-interventional UNITE...

Omiganan (omiganan, a synthetic cationic peptide) and imiquimod (imiquimod, a TLR7 agonist) have synergistic effects on interferon responses in vitro. The objective of this study was to translate this to a human model for proof‐of‐concept, and to explore the potential of omiganan add‐on treatment for viral skin diseases. Sixteen (16) healthy volunt...

Bleomycin is widely used as off-label treatment for various dermatological indications. However, a much-needed critical appraisal of the currently available evidence is lacking. We, therefore, evaluated the quality of clinical evidence for the efficacy and safety of intralesional bleomycin treatment for dermatological indications with the aim to pr...

Introduction Le dupilumab (DPL) est approuvé dans plusieurs pays pour le traitement des patients (pts) adultes souffrant de dermatite atopique (DA) modérée à sévère insuffisamment contrôlée. Matériel et méthodes Il s’agit d’une analyse post-hoc des données groupées de deux essais de phase 3 (SOLO1 : NCT02277743 ; SOLO2 : NCT02277769) visant à déte...

Conjunctivitis is a common condition that causes the eye to become red, itchy and oozing. It is common in patients with atopic dermatitis (also called eczema), and in other allergic diseases, including asthma. Apart from allergies, conjunctivitis can also be caused by infections, chemicals, irritants, and other diseases. Dupilumab is a prescription...

结膜炎是一种导致眼睛变红、瘙痒和渗出的常见疾病。它在特应性皮炎(也称为湿疹)和其他过敏性疾病(包括哮喘)的患者中常见。除了过敏,感染、化学品、刺激物和其他疾病也可引起结膜炎。Dupilumab 是一种处方药,在美国批准用于不能通过局部外用(外用到皮肤)处方药控制或不能局部外用药物的≥ 12 岁中重度 AD 患者,在其他国家批准用于通过现有治疗无法控制的 AD 成人,和用于通过当前用药无法控制的≥12 岁中重度哮喘患者的维持治疗。Dupilumab 可阻滞导致这些过敏性疾病的特定物质的活性。在大部分 AD 研究中,接受dupilumab治疗患者中的结膜炎发生率多于安慰剂(模拟药物)组。为了研究这一作用,作者们评估了在 AD、哮喘、慢性鼻窦炎伴鼻息肉(CRSwNP) 和嗜酸性粒细胞性食管炎(Eo...

Hidradenitis suppurativa (HS) is a chronic, recurring inflammatory skin condition for which the pathogenesis is not completely elucidated1. With the increase in HS‐related research comes the need to enhance reproducibility, quality and accuracy of scientific methods. Unlike other inflammatory dermatoses such as psoriasis or atopic dermatitis, HS le...

Background A needs assessment for patients with hidradenitis suppurativa (HS) will support advancements in multidisciplinary care, treatment, research, advocacy, and philanthropy. Objective To evaluate unmet needs from the perspective of HS patients. Methods Prospective multinational survey of patients between October 2017 and July 2018. Results...

Background The concurrent occurrence of gut and skin diseases has led to the postulation of the existence of a gut-skin axis in which gut microbiota is thought to contribute to extra-intestinal skin manifestations. A dysbiotic skin microbiome has been demonstrated in the chronic inflammatory skin disease hidradenitis suppurativa (HS), but it remain...