Do collagen-related diseases represent a risk factor for hidradenitis suppurativa?

Abstract

We read with great interest the work of Boer et al [1] that explores the role of mechanical stress as a potential triggering factor for hidradenitis suppurativa (HS). The authors reported two cases of patients who developed HS along the striae distensae (SD). The hypothesis proposed by the authors to explain this ectopic lesions is the fact that SD are characterized by a decrease of dermal thickness due to destruction of collagen fibres which may reduce the mechanical support to the pilosebaceous structures and if combined to frictional forces, may trigger the onset of HS by promoting skin inflammation. Matrix metalloproteinases (MMPs) are proteases able to degrade the major components of the extracellular matrix (ECM).