Complement, Hidradenitis Suppurativa and Pathogen‐Driven Positive Selection

Abstract

The precise pathogenesis of Hidradenitis Suppurativa (HS) remains unclear. Kanni et al¹ provides novel data implicating C5a and the membrane attack complex in HS pathogenesis. This opens the possibility of therapeutic blockade of C5a for the treatment of HS, although the results do require replication in larger patient cohorts. The current HS pathogenic paradigm involves dysregulation of the Th17:T‐reg axis with contribution from genetic polymorphisms, metabolic syndrome, the microbiome and smoking, so data implicating complement is somewhat unexpected, stimulating the need for reconsideration of the current pathogenic paradigm.

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