Serological biomarkers of extracellular matrix proteins are associated with hidradenitis suppurativa disease severity and treatment response.

Chronic inflammation in hidradenitis suppurativa (HS) disrupts tissue architecture and basement membrane integrity. Biomarkers of extracellular matrix (ECM) and basement membrane degradation (BGM, C7M, C4M) increase with disease severity, while NIC (linker protein degradation) decreases. Elevated baseline C7M is significantly associated with greater improvement in IHS4 following TNF-α inhibitor therapy. ECM remodelling biomarkers reflect tissue destruction and may aid in identifying patients at risk of disease progression and in monitoring treatment response.