Current concepts of hidradenitis suppurativa. Experience with interleukin-17 inhibitor in a patient with severe hidradenitis suppurativa

Hidradenitis suppurativa (HS) is a chronic inflammatory dermatosis characterized by a recurrent, debilitating course and significantly reducing the quality of life of patients. The disease can lead to irreversible changes in the skin in the form of scars and fistulas. The incidence worldwide is up to 1% of the population, most often affects young people aged 18 to 50 years, although cases have also been registered in adolescence. Women are more often affected, the ratio to men is 3:1. The disease is of an immune-mediated inflammatory nature and is often associated with multiple comorbid pathologies: metabolic syndrome, obesity, diabetes mellitus, arterial hypertension, dyslipidemia, inflammatory bowel disease and joint damage. The genetic factor is currently assigned a leading role in the development of pathology; it has been identified that mutations in 4 genes (PSENEN, NCSTN, TMED10 and WNT10A) can lead to disruption of keratinization processes and be the cause of disruption of cytokine regulation and imbalance in the T-helper cell axis of the 17th type, similar to that in patients with psoriasis. The use of topical and systemic antibacterial drugs, antiseptics, retinoids and steroids often does not lead to stable improvement and remission in patients with severe hidradenitis suppurativa. Genetically engineered biological therapy is a promising direction for the treatment of moderate to severe hidradenitis. Inhibition of the cytokine IL-17 shows good results in this group of patients. This article presents the experience and results of 12-week treatment of a patient with severe hidradenitis suppurativa (stage 3 according to Hurley) with the IL-17A inhibitor secukinumab.