Histological Characterization of Hidradenitis Suppurativa in Comparison to Healthy Skin

INTRODUCTION: Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that presents as recurrent, painful, draining abscesses, which undergo cycles of inflammation and healing with fibrosis. This condition may significantly impact patients undergoing flareups and result in loss of normal daily routine and functions. These are characterized as stage I, involving isolated nodules; stage II, associated with recurrent inflammation with tract formation; and stage III, involving coalesced tracts. 

OBJECTIVE: This study aims to compare HS cytoarchitecture from a series of 11 patients with healthy skin in order to further understand the disease and identify potential therapeutic targets.

MATERIALS AND METHODS: Samples included in the present analysis were formalin-fixed, paraffin-embedded skin biopsies from 11 patients suffering from HS, who underwent surgical excision from May 2014 to June 2018. Six patients had stage III disease; 1 had stage I, and the remaining 4 were not staged. Histopathological analysis included hematoxylin and eosin (H&E) staining and imaging at 10-times magnification. These were compared with healthy human skin cytoarchitecture, analyzed as above side by side. 

RESULTS: Histopathological analysis showed HS samples contained a wider and thicker epidermal layer compared with normal skin, with increased frequency and irregularity of rete ridges. The epidermis extended into and engulfed the dermis resulting in dermal islands within the epidermis. Collagen fibers were disorganized compared with healthy skin. Furthermore, there was extensive lymphocyte infiltration and aggregation in the dermis of 10 of 11 patients. There were no differences found in apocrine, eccrine, and sebaceous gland histology. One sample showed the formation of an epithelialized tract within the dermis. A different sample showed epithelialization around a hair follicle. 

CONCLUSIONS: Epidermal and dermal cytoarchitecture of HS lesions differ in comparison with healthy skin. Ongoing work is aimed at further characterization for potential proteins involved in the pathogenesis as well as molecular characterization.

CITATION
Nisar S, Carney BC, Alkhalil A, Moffatt LT, Shupp JW. Histological characterization of Hidradenitis suppurativa in comparison to healthy skin. Poster presented at: Symposium on Advanced Wound Care Fall; November 2-4, 2018; Las Vegas, NV.

Product: Not available 

This abstract was not subject to the WOUNDS peer-review process.