Study: Potential Link Between Lesional IgG Autoantibodies and HS Disease Severity

A small biopsy-based study in the Journal of Investigative Dermatology Innovations adds to emerging evidence that humoral immunity may contribute to hidradenitis suppurativa (HS) pathobiology. 

Investigators analyzed skin biopsy specimens from 20 patients with HS and 5 control participants to characterize lesional IgG autoantibody profiles and assess associations with clinical features, comorbidities, and biologic therapy status.

Compared with controls, patients with HS demonstrated significantly elevated lesional IgG autoantibody levels, with greater abundance observed in chronic disease. Higher autoantibody levels were also associated with more severe disease (such as Hurley stage and HS-LASI scores), as well as lesion features such as sinus tracts and scarring.

The study authors also reported higher prevalence of increased autoantibody levels among Black patients, along with correlations with several comorbidities (including asthma, acne, and diabetes). Additional clinical associations included greater pain severity and smoking status. Specimens from patients receiving adalimumab showed lower autoantibody levels, whereas no consistent pattern was observed among those receiving infliximab, according to treatment-based analyses.

The authors said the findings were hypothesis-generating. 

“To our knowledge, this is the first study to systematically profile local IgG autoantibodies in HS and relate them with clinical parameters," the authors wrote. "These findings provide, to our knowledge, previously unreported insights into the contribution of humoral immune activation within the inflammatory milieu of HS and generate hypotheses regarding whether specific autoantibodies serve as biomarkers, participate in disease mechanisms, or represent bystander phenomena."

Source: Carmona-Rivera C, et al. JID Innovations. 2026. Doi:10.1016/j.xjidi.2026.100467