The Role of Mechanical Stress in Hidradenitis Suppurativa.

Mechanical stress can act as a possible trigger in the development of hidradenitis suppurativa (HS). The mechanical stress has been supported by (1) the special biomechanical conditions in the typically topographic areas of HS; (2) the indirect proof of similar findings in associated follicular occlusion diseases such as acne mechanica and pilonidal sinus disease, and in limb amputees after expression of mechanical forces; (3) pathohistologic, ultrasonography, and immunologic findings; and (4) overweight patients seem to be most susceptible to the effects of mechanical stress.