Skin tape stripping: Can it pave the way for early diagnosis in HS?

Skin tape stripping is an effective, non-invasive way to detect biomarkers associated with early disease in hidradenitis suppurativa.

Biopsies are the gold standard, but a minimally invasive approach is needed

“Diagnosis of early HS remains a major clinical challenge,” said Dr Kristina Navrazhina (Icahn School of Medicine at Mount Sinai, NY, USA)1. In practice, a significant diagnostic and treatment delay exists, amongst others due to a lack of biomarkers that can identify early-stage disease.

Until today, biopsies are considered the gold standard for studying molecular alterations in HS skin; however, a reproducible, minimally invasive approach is needed for the diagnosis of early HS, and for longitudinal disease monitoring in trials. Therefore, Dr Navrazhina and her team explored whether skin tape strips can non-invasively detect early and late molecular alterations in HS and identify biomarkers of disease activity.

Tape strips were collected from lesional and healthy-appearing skin of HS patients (n=22) and healthy controls (n=21) and underwent RNA sequencing.

The strips identified novel therapeutic targets

Upregulation of known HS biomarkers (e.g. IL-17, TNFα) was detected both in non-lesional and lesional skin of HS patients compared with controls. Moreover, the tape strips identified several novel therapeutic targets in lesional and non-lesional skin, including OX40, JAK3, and C-C Chemokine Receptor 4 (P<0.05 vs controls). 

A significant correlation was detected between the expression of genes within the Th17 and TNFα pathways between tape strips and biopsy. Generally, there is a high variability of expression of known HS targets across HS patients, but HS clinical severity was associated with a higher expression of biomarkers in HS lesional and/or non-lesional skin. “Already Hurley stage 1 skin is different from normal skin even when it looks normal,” Dr Navrazhina commented.

The study shows that tape strips can reliably identify cutaneous biomarkers of early and late-stage HS. Thus, it could be a valid and minimally invasive way to identify patients who can benefit from early therapeutic intervention, which might be able to prevent scarring.

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  1. Navrazhina K. Skin Tape stripping is a minimally-invasive approach that accurately detects biomarkers of early and chronic disease in hidradenitis suppurativa. D2T01.3H, EADV Congress 2023, 11–14 October, Berlin, Germany.