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Hidradenitis suppurativa is a chronic inflammatory skin disease, with a poor therapeutic response and a significant impact on the patient's quality of life. The aim of this review-type article is to assess the role of bacterial infections in both the pathogenesis and evolution of the hidradenitis suppurativa, but also to evaluate the convenience of antibiotherapy in the management of the disease. Antibiotherapy plays an important role in its longterm management, mainly due to the anti-inflammatory action of the frequently recommended agents from the schemes of treatment. The therapy's initiation ought to be consistent with the antibiotic sensitivity profile of microorganisms isolated in the laboratory, personalized depending on the disease’s severity, history of antibiotic use, the risk of drug interactions and the patient's comorbidities. Moreover, the association of antibiotics with anti-TNF-α (tumour necrosis factor) biologic therapy represents a valid therapeutic alternative that can significantly enhance the quality of life, of great utility especially in severe disease stages. In order to elucidate the pathogenesis, we propose two main research directions. Firstly, the profile analysis of virulence of microorganisms and its correlation with the host response to bacterial insult. Secondly, the description of the bacterial biofilm communities, both architecturally and physiologically in-depth analyzes of inter-cellular communication mechanisms. These steps are necessary for the discovery of new therapeutic agents. [ABSTRACT FROM AUTHOR]

Hidradenitis suppurativa represents a chronic, recurrent inflammatory disease, characterized by the formation of painful abscesses, sinuous tracts, foul smelling secretions, vicious scaring, with a severe reduction of the patients' quality of life. The pathophysiology of hidradenitis suppurativa is complex, follicular hyperkeratosis being regarded as the main pathogenetic mechanism. Bacterial colonization and follicular dysbiosis are of secondary importance in the pathogenesis of the disease, by triggering immunemediated inflammation. The formation of bacterial biofilms in sinuous tracts inhibits the efficacy of antibiotics, thus inducing chronic lesions. This article aims to highlight the role of bacterial colonization in the pathophysiology of hidradenitis suppurativa, as well as therapeutic options that act by regulating follicular dysbiosis. [ABSTRACT FROM AUTHOR]