title: Hidradenitis suppurativa or acne inversa. A clinicopathological study of early lesions.
abstract: The pathogenesis of hidradenitis suppurativa (HS) has given rise to controversy about whether the central pathogenetic feature is an apocrine follicular occlusion (with subsequent bacterial infection) or it is a folliculitis with secondary involvement of both apocrine and eccrine sweat glands. Most previous concepts have focused on apocrine gland involvement. A prospective study of 27 consecutive patients (39 biopsies) was performed to investigate the immune-histological findings in early, newly formed lesions. Most of them were examined within 3 days of clinical onset. Histopathological findings showed that the initial lesion is an occluding spongiform infundibulo-folliculitis. Furthermore, it was found that T cells predominated in the lymphocytic cell population. A high percentage of HLA-DR positive lymphocytes was found in an inverse relationship with Leu-8 positive lymphocytes. Additionally, a sharp decline in the T-helper/suppressor ratio was observed after the initiation. These results reveal that the primary event in HS is an infundibulofolliculitis with secondary involvement of apocrine glands. Acne inversa would be a more appropriate name.
authors.affiliation: Department of Dermatology, Deventer Hospital, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Boer
authors.forename: E F
authors.initials: EF
authors.lastname: Weltevreden
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006684:HLA-DR Antigens / Q000032:analysis; D017497:Hidradenitis Suppurativa / Q000276:immunology / Q000473:pathology*; D006801:Humans; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012867:Skin / Q000276:immunology / Q000473:pathology*; D016176:T-Lymphocyte Subsets; D013602:T-Lymphocytes, Cytotoxic; D006377:T-Lymphocytes, Helper-Inducer; D050378:T-Lymphocytes, Regulatory
chemical_list: D006684:HLA-DR Antigens