Hedgehog pathway does not play a role in hidradenitis suppurativa pathogenesis

Hidradenitis suppurativa is a chronically relapsing skin disorder with onset after puberty and is characterized by inflammatory lesions in hair follicle and apocrine sweat gland-bearing skin that manifests as abscesses with formation of cysts and sinus tracts. Hedgehog family genes are required in normal embryonic skin, hair follicle, sebaceous and sweat gland development. Mutations of hedgehog pathway in adult skin have previously been found in basal cell carcinomas and in alopecia as well as in epidermal cysts and in odontogenic keratocysts. Therefore, we suggested that the hedgehog pathway might play a role in formation of sinus tracts and cysts as newly formed structures in hidradenitis suppurativa patients. None of the sinus tracts or cysts in 81 hidradenitis suppurativa histological slides from 34 patients showed positive finding for sonic hedgehog mutation. According to our findings, we have to conclude that there is no evidence that sonic hedgehog pathway is part of hidradenitis suppurativa pathogenesis.