Dermatology Research Team Investigating the Most Common Disease You’ve Never Heard About

Dermatology researchers Dr. Irena Pastar, Dr. Hadar Lev-Tov and Dr. Marjana Tomic-Canic
Article Summary
  • Hidradenitis suppurativa is a dermatological condition that causes painful lumps under the skin.
  • A team of Miller School researchers were awarded a five-year, $2.2 million RO1 grant for a translational study of HS.
  • HS has no animal model upon which to base study, so the team created the first human model of the disease.

There’s potentially good news on the horizon for patients suffering with hidradenitis suppurativa (HS), a dermatological condition that causes painful lumps under the skin.

A team of researchers from the Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery at the University of Miami Miller School of Medicine was awarded a five-year, $2.2 million RO1 grant from the National Institutes of Health (NIH) for a translational study of HS.

The research study starts this month and is led by:

• Marjana Tomic-Canic, Ph.D., the William H. Eaglstein, M.D., Chair in Wound Healing, vice chair of research, director of the Wound Healing and Regenerative Medicine Research Program and professor in the Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery at the Miller School

Irena Pastar, Ph.D., research professor in the Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery at the Miller School

Hadar Lev-Tov, M.D., associate professor in the Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery at the Miller School

HS affects about 4% of the population and usually occurs in body regions such as the armpits and groin. The lumps often break open, causing wounds that can lead to severe scarring. The condition can cause pain and odor, as well as depression, social isolation, sexual disfunction and suicide because it interferes with so many daily activities.

Hope for HS Miami support group

The cause of HS is unknown, but it’s not triggered by bad hygiene and cannot be spread to others. The lumps form because of blockages of the hair follicles that trap bacteria. This leads to inflammation and rupture.

The condition is more common among women and minority populations. It disproportionately affects smokers, Black people, obese people and patients with a family history of HS.

“The genetic landscape of this disease is also being investigated, but it is too early,” said Dr. Lev-Tov, director of the newly established Miami HS Center, one of the principal investigators on the project and current president of the HS Foundation.

HS usually starts in the late teens or early adulthood. In its initial phase it looks like a little red bump that may be tender. Eventually a rupture occurs and forms a small channel, or tunnel. There is evidence that the bacteria captured inside HS tunnels are out of balance compared to the normal skin microbiome, which may cause the disease to worsen and flare.

“So now, as a response to this imbalance, you have a very strong inflammation,” said co-principal investigator Dr. Pastar, the research director of the Miami HS Center.

The grant, she said, will focus on learning how to treat the disease at this stage.

There is no cure for HS. The current treatment is radical surgery that entails removing the tissue affected with tunnels, usually a last resort. Even after surgery, the disease tends to return. Drugs can help, but only to a degree. The drugs currently in use, Dr. Tomic-Canic said, were originally developed for different dermatologic conditions and have been repurposed for treating HS.

Unfortunately, only half of all patients will respond to therapy, “and those are the ones in early stages of the disease,” said Dr. Lev-Tov.

One challenge in researching HS: it’s exclusively a human condition. With no animal models, researchers can’t recreate HS and test different therapies.

“That’s one part of why this grant is important,” said Dr. Tomic-Canic, whose team has developed the first human model of the disease. “We dissect the tunnel to grow human cells in the laboratory and then reconstruct the tunnel structure in a three-dimensional human model.”

The team will use the model to study what happens in the later stages of HS.

“The cells for HS tunnels retain a unique pathology similar to what is observed in patients,” Dr. Pastar added. “This is even more evident in the 3D model we optimized. Once we know more about the HS tunnel structures on the gene expression level, we will be able to design novel, targeted therapies.”  

The research team is part of the HS Center and wound healing and regenerative research program at the Miller School.

“HS is a cross between a wound and an inflammatory disease. The wound is deep inside your tissue, not on the surface of your skin,” said Dr. Tomic-Canic. “We are looking at what makes the HS tunnels, how they form, in terms of biology and pathology, and how can we mimic their existence so we can learn to treat and to prevent HS.”


Tags: dermatology, Dermatology and Cutaneous Surgery, Dr. Hadar Lev-Tov, Dr. Irena Pastar, Dr. Marjana Tomic-Canic, Dr. Philip Frost Department of Dermatology and Cutaneous Surgery, hidradenitis suppurativa, R01 grant