Elucidating the pathophysiology of hidradenitis suppurativa (HS) is revealing proinflammatory cytokines that present opportunities for therapy, such as IL-1, IL-17, IL-23, and TNF-α.

The clinical trial landscape for HS is robust, with 36 studies currently underway: 10 cytokine inhibitors, 14 non-biologic medications, 4 laser treatments, 4 procedures, and 4 wound dressings. These cover a total of 17 therapeutic targets.

Trials involving blockade of IL-17, JAK, and IL-1α are expanding upon prior clinical trials showing efficacy in HS, as measured by the Hidradenitis Suppurativa Clinical Response (HiSCR).

Pathways involving leukotriene A4 hydrolase, CD-40, IL-1β, IL-18, BTK, and others have been found to play a role in the pathogenesis of HS and are being studied as novel therapeutic targets.

Surgery and wound care play important roles in HS management. Trials investigating these modalities are underway and will provide high-quality evidence to guide therapy.