Hidradenitis suppurativa (HS) is a chronic, recurrent, inflammatory skin disease 
that affects the hair follicles of the aprocrine gland-bearing anatomical areas 
of the body. It is characterized by deep painful nodules and abscesses that 
rupture and contribute to the formation of sinus tracks and scarring. The 
management of HS is based on the assessment of disease severity and a 
combination of medical and surgical treatment according to the European 
Guidelines. Adalimumab, a recombinant, fully humanized, anti-tumor necrosis 
factor alpha (anti-TNF-α) monoclonal antibody, is the only officially approved 
treatment for the management of moderate-to-severe HS. Case reports, concerning 
42 patients who received adalimumab for severe HS (with the standard dose 
regimen for psoriasis), reported a cumulative response rate of 58% (≥50% in 23 
patients) with a relapse rate of 71% (10 out of 14 patients). The most recent 
and most well-powered phase III, randomized placebo-controlled trials for the 
evaluation of the efficacy and safety of adalimumab in treatment of 
moderate-to-severe HS (PIONEER studies I and II) showed that the Hidradenitis 
Suppurativa Clinical Response (HiSCR) rate at week 12 was significantly higher 
for patients randomized to adalimumab compared to placebo. Adverse events were 
comparable to placebo. In conclusion, adalimumab, to date, holds the most robust 
data regarding treatment efficacy in HS. Larger, registry-based studies are 
needed to further establish the efficacy and safety profile of this anti-TNF-α 
agent in HS.