Mast cells in hidradenitis suppurativa: a clinicopathological study

  • Emil K. List
  • Jose C. PascualEmail author
  • Kian Zarchi
  • Birgit M. Nürnberg
  • Gregor B. E. Jemec
Concise Communication


Mast cells (MC) have been observed in hidradenitis suppurativa (HS) lesions. Their potential role in the pathogenesis of HS is unknown. The aim of this study was to assess the number and distribution MC in HS lesions, and its association with disease and itch severity. We studied biopsies from HS-lesions and perilesional skin from 34 HS patients. The samples were stained with CD117 and toluidine blue, and the number of MC determined semi-quantitatively (40 × magnification). The distribution of MC was also noted. The clinical features of the disease were extracted from patients’ case records and a questionnaire-based database. MC were present to a greater degree in HS-lesions than in perilesional skin (P = 0.004). Disease severity (Sartorius score) was correlated to with MC count and itch when adjusted for sex and age (P = 0.042). Duration of the disease could not been significantly correlated with MC count. A positive correlation between MC count and HS activity was detected, suggesting a potential link between MC and HS.


Hidradenitis suppurativa Mast cell Itch Pruritus 



Hidradenitis suppurativa


Quality of life


Mast cells




Compliance with ethical standards

Conflict of interest

JCP has been an advisory board member for Abbvie. GBJ has been an investigator, consultant, and advisory board member for Abbvie, InflaRx, InCyte, Leo Pharma, Novartis and UCB; has received unrestricted grants by Abbvie, Leo Pharma and Novartis, and has been a speaker for Galderma; an advisory board member for Janssen-Cilag, Inflarx, MSD and for Pierre-Fabre; and has been an investigator for Regeneron. KZ; EKL and BMN BE, have no conflicts of interest to declare.


  1. 1.
    Harvima IT (2008) Induction of matrix metalloproteinase-9 in keratinocytes by histamine. J Invest Dermatol 128:2748–2750CrossRefGoogle Scholar
  2. 2.
    Jemec GBE, Hansen U (1996) Histology of hidradenitis suppurativa. J Am Acad Dermatol 34:994–999CrossRefGoogle Scholar
  3. 3.
    Kwak IS, Choi YH, Jang YC, Lee YK (2014) Immunohistochemical analysis of neuropeptides (protein gene product 9.5, substance P and calcitonin gene-related peptide) in hypertrophic burn scar with pain and itching. Burns 40:1661–1667CrossRefGoogle Scholar
  4. 4.
    Laffert M, Helmbold P, Wohlrab J, Fiedler E, Stadie V, Marsch WC (2010) Hidradenitis suppurativa (acne inversa): early inflammatory events at terminal follicles and at interfollicular epidermis. Exp Dermatol 19:533–537CrossRefGoogle Scholar
  5. 5.
    Lima AL, Karl I, Giner T, Poppe H, Schmidt M, Presser D, Goebeler M, Bauer B (2016) Keratinocytes and neutrophils are important sources of proinflammatory molecules in hidradenitis suppurativa. Br J Dermatol 174:514–521CrossRefGoogle Scholar
  6. 6.
    Lin AM, Rubin CJ, Khandpur R, Wang JY, Riblett M, Yalavarthi S, Villanueva EC, Shah P, Kaplan MJ, Bruce AT (2011) Mast cells and neutrophils release IL-17 through extracellular trap formation in psoriasis. J Immunol 187:490–500CrossRefGoogle Scholar
  7. 7.
    Matusiak Ł, Szczęch J, Bieniek A, Nowicka-Suszko D, Szepietowski JC (2017) Increased interleukin (IL)-17 serum levels in patients with hidradenitis suppurativa: implications for treatment with anti-IL-17 agents. J Am Acad Dermatol 76:670–675CrossRefGoogle Scholar
  8. 8.
    Michaloudi H, Batzios C, Chiotelli M, Grivas I, Papadopoulos GC (2008) Mast cells populations fluctuate along the spinal dura mater of the developing rat. Brain Res 1226:8–17CrossRefGoogle Scholar
  9. 9.
    Mion F, D’Incà F, Danelli L, Toffoletto B, Guarnotta C, Frossi B, Burocchi A, Rigoni A, Gerdes N, Lutgens E, Tripodo C, Colombo MP, Rivera J, Vitale G, Pucillo CE (2014) Mast cells control the expansion and differentiation of IL-10—competent B cells. J Immunol 193:4568–4579CrossRefGoogle Scholar
  10. 10.
    Nograles KE, Zaba LC, Guttman-Yassky E, Fuentes-Duculan J, Suárez-Fariñas M, Cardinale I, Khatcherian A, Gonzalez J, Pierson KC, White TR, Pensabene C, Coats I, Novitskaya I, Lowes MA, Krueger JG (2008) Th17 cytokines interleukin (IL)-17 and IL-22 modulate distinct inflammatory and keratinocyte-response pathways. Br J Dermatol 159:1092–1102Google Scholar
  11. 11.
    Pascual JC, Alvarez P, Encabo B, Gonzalez I, Hispan P, Poveda I, Romero D (2017) Comment on Assessing pruritus in hidradenitis suppurativa: a cross-sectional study. Am J Clin Dermatol 18:705–706CrossRefGoogle Scholar
  12. 12.
    Pascual JC, Garcia-Martinez FJ, Martorell A, Gonzalez I, Hispan P (2016) Increased total serum IgE in moderate-to severe hidradenitis suppurativa. Br J Dermatol 175:1101–1102CrossRefGoogle Scholar
  13. 13.
    Riis PT, Vinding GR, Ring HC, Jemec GBE (2016) Disutility in patients with hidradenitis suppurativa: a cross-sectional study using EuroQoL-5D. Acta Derm 96:222–226CrossRefGoogle Scholar
  14. 14.
    Schlapbach C, Hänni T, Yawalkar N, Hunger RE (2011) Expression of the IL-23/Th17 pathway in lesions of hidradenitis suppurativa. J Am Acad Dermatol 65:790–798CrossRefGoogle Scholar
  15. 15.
    Sartorius K, Lapins J, Emtestam L, Jemec GBE (2003) Suggestions for uniform outcome variables when reporting treatment effects in hidradenitis suppurativa. Br J Dermatol 149:211–213CrossRefGoogle Scholar
  16. 16.
    Van Der Zee HH, De Ruiter L, Boer J, Van Den Broecke DG, Den Hollander JC, Laman JD, Prens EP (2012) Alterations in leucocyte subsets and histomorphology in normal-apperaring perilesional skin and early and chronic hidradenitis suppurativa lesions. Br J Dermatol 166:98–106CrossRefGoogle Scholar
  17. 17.
    van der Zee HH, de Ruiter L, van den Broecke DG, Dik WA, Laman JD, Prens EP (2017) Elevated levels of tumour necrosis factor (TNF)-α, interleukin (IL)-1β and IL-10 in hidradenitis suppurativa skin: a rationale for targeting TNF-α and IL-1β. Br J Dermatol 164:1292–1298Google Scholar
  18. 18.
    Van Der Zee HH, Jemec GBE (2015) New insights into the diagnosis of hidradenitis suppurativa: Clinical presentations and phenotypes. J Am Acad Dermatol 73:S23–S26CrossRefGoogle Scholar
  19. 19.
    Von Laffert M, Stadie V, Wohlrab J, Marsch WC (2011) Hidradenitis suppurativa/acne inversa: bilocated epithelial hyperplasia with very different sequelae. Br J Dermatol 164:367–371CrossRefGoogle Scholar
  20. 20.
    Vossen ARJV, Schoenmakers A, van Straalen KR, Prens EP, van der Zee HH (2017) Assessing pruritus in hidradenitis suppurativa: a cross-sectional study. Am J Clin Dermatol 18:687–695CrossRefGoogle Scholar
  21. 21.
    Wölfle U, Haarhaus B, Schempp CM (2015) Amarogentin displays immunomodulatory effects in human mast cells and keratinocytes. Mediators Inflamm 630128:1–8CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of DermatologyZealand University HospitalRoskildeDenmark
  2. 2.Health Sciences FacultyUniversity of CopenhagenCopenhagenDenmark
  3. 3.Department of Dermatology, Alicante University General HospitalAlicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation)AlicanteSpain
  4. 4.Department of PathologyZealand University HospitalRoskildeDenmark

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