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Biomarkers of severity in hidradenitis suppurativa

Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition of the follicular epithelium occurring predominantly in the axillae, inframammary folds, groins and buttocks (Gansevoort et al. 2011). Dependent on the disease severity, various pharmacologic and surgical interventions to prevent and treat new lesions, as well as remove existing inflammatory nodules, abscesses, and sinus tracts, can be initiated. Biomarkers reflecting disease severity and activity of HS could potentially aid the need for better tools to diagnose HS as well as determine treatment effects (Blok et al. 2016). Here both imaging and blood-based techniques have been proposed. For imaging, ultrasound (US) is the most well-characterized method, while other methods such as medical infrared thermography (MIT) and optical coherence tomography (OCT) are emerging methods which demonstrate higher degree of accuracy compared to US (Grand et al. 2019).

The extracellular matrix (ECM) of the skin results in generation of protein fragments released into the blood, which can be quantified as blood-based biomarkers. Such biomarkers reflect scarring and fibrosis of the skin and could be potential emerging targets for HS (Dengjel et al. 2020Sand et al. 2018).

We hypothesized that serological biomarkers of ECM remodelling linked to chronic inflammation are upregulated in patients diagnosed with HS compared to healthy subjects and associated with disease severity and activity, and systemic inflammation.

The findings indicate an association between biomarkers of tissue turnover and disease severity and activity. Such biomarkers may be utilized to assess patients’ eligibility to targeted treatments and fill the medical need for biomarkers in clinical management and trials.

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