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The following is a summary of “Exploring itch in hidradenitis suppurativa with lessons from atopic dermatitis and psoriasis,” published in the January 2025 issue of Dermatology by Trupiano et al. 

Itch is a prominent symptom in various skin conditions, including atopic dermatitis (AD), prurigo nodularis, psoriasis, and hidradenitis suppurativa (HS), with its underlying mechanisms in HS remaining unclear.  

Researchers conducted a retrospective study to review the literature on pruritus in HS and other itch-related conditions like AD and psoriasis to better understand the underlying causes.   

They explored pruritus in HS, psoriasis, and AD, focusing on the co-occurrence of itch and pain, the frequency, and its impact on sleep and mental health. The review also investigated mechanisms of itch, including peripheral and central sensitization, neuroinflammation, IgE production, and changes in the skin microbiome.  

The results showed itch in HS, psoriasis, and AD often co-occurred with pain, with a higher frequency at night. It significantly impacted sleep and increased the risk of psychiatric comorbidities. In AD, the itch was chronic, while in HS and psoriasis, it was more episodic. The HS-related itch was likely multifactorial, involving immune responses and changes in the skin microbiome. Few treatments for HS itch were studied, but therapies used in AD and psoriasis, such as biologics and small molecules, may offer potential. Neurological and psychiatric therapies, like anticonvulsants and cannabinoids, could also provide relief.  

Investigators concluded the precise etiology of itch in HS remains elusive, insights gleaned from other pruritic disorders offer valuable starting points for future research, which should focus on addressing the significant knowledge gaps to facilitate the development of effective itch treatments for this challenging condition. 

Source: onlinelibrary.wiley.com/doi/abs/10.1111/1346-8138.17622