The 14 authors of the first review article on hidradenitis suppurativa (HS) pathogenesis published 2008 in EXPERIMENTAL DERMATOLOGY cumulating from the 1^st International Hidradenitis Suppurativa Research Symposium held March 30–April 2, 2006 in Dessau, Germany with 33 participants were prophetic when they wrote “Hopefully, this heralds a welcome new tradition: to get to the molecular heart of HS pathogenesis, which can only be achieved by a renaissance of solid basic HS research, as the key to developing more effective HS therapy.” (Kurzen et al. What causes hidradenitis suppurativa?. Exp Dermatol 2008;17:455). Fifteen years later, there is no doubt that the wished renaissance of solid basic HS research is ongoing with rapid steps and that HS has developed deep roots among inflammatory diseases in Dermatology and beyond, recognized as “the only inflammatory skin disease than can be healed”. This anniversary article of 43 research‐performing authors from all around the globe in the official journal of the European Hidradenitis Suppurativa Foundation e.V. (EHSF e.V.) and the Hidradenitis Suppurativa Foundation, Inc. (HSF USA) summarizes the evidence of the intense HS clinical and experimental research during the last 15 years in all aspects of the disease and provides information of the developments to come in the near future.

Background: The association between chronic inflammatory diseases, such as rheumatoid arthritis and psoriasis, and insulin resistance (IR) has been well established. Hidradenitis suppurativa (HS) is a chronic inflammatory cutaneous disease that affects the apocrine gland‐bearing areas of the body.Objective: We aimed to determine the prevalence of IR in patients with HS.Methods: This cross‐sectional, case–control study enrolled 137 subjects, 76 patients with HS and 61 age‐ and gender‐matched controls. Demographic data, clinical examination of HS patients, anthropometric measures, cardiovascular risk factors and laboratory studies were recorded. The homeostasis model assessment of IR (HOMA‐IR) was calculated in all participants by measuring fasting plasma glucose and insulin levels.Results: The median (IQR) HOMA‐IR value in HS patients was significantly higher [2.0 (1.0–3.6)] than in controls [1.5 (0.9–2.3)] (P = 0.01). The prevalence of IR was significantly higher in cases (43.4%) compared with controls (16.4%) (P = 0.001). In the linear regression multivariable analysis after adjusting for age, sex and body mass index (BMI), HS remained as a significant factor for a higher HOMA‐IR [2.51 (0.18) vs 1.92(0.21); P = 0.04]. The HOMA‐IR value and the prevalence of IR did not differ significantly among HS patients grouped by severity of the disease.Conclusion: Our results show an increased frequency of IR in HS. Thus, we suggest HS patients to be evaluated for IR and managed accordingly.