The cause of<unk>  remains unknown, and experts disagree over proposed causes. The condition probably results from a combination of genetic and environmental factors. Lesions occur in any body areas with hair follicles, although areas such as the axilla, groin, and perianal region are more commonly involved. This theory includes most of these potential indicators: * Post-pubescent individuals * Blocked hair follicles or blocked apocrine sweat glands * Excessive sweating * Androgen dysfunction * Genetic disorders that alter cell structure * Patients with more advanced cases may find exercise intolerably painful, which may increase the rate of obesity among sufferers. The historical understanding of the disease suggests dysfunctional apocrine glands or dysfunctional hair follicles, possibly triggered by a blocked gland, which creates inflammation, pain, and a swollen lesion.<unk>  Stage III Triggering factors Several triggering factors should be taken into consideration: * Obesity is an exacerbating rather than a triggering factor, through mechanical irritation, occlusion, and skin maceration. * Tight clothing, and clothing made of heavy, nonbreathable materials * Deodorants, depilation products, shaving of the affected area – their association with<unk>  is still an ongoing debate amongst researchers. * Drugs, in particular oral contraceptive pills and lithium. * Hot and especially humid climates. Predisposing factors * Genetic factors: an autosomal dominant inheritance pattern has been proposed. * Endocrine factors: sex hormones, especially an excess of androgens, are thought to be involved, although the apocrine glands are not sensitive to these hormones. Women often have outbreaks before their menstrual period and after pregnancy;<unk>  severity usually decreases during pregnancy and after menopause. Some cases have been found to result from mutations in the NCSTN, PSEN1, or PSENEN genes. The genes produce proteins that are all components of a complex called gamma- (γ-) secretase. This complex cuts apart (cleaves) many different proteins, which is an important step in several chemical signaling pathways. One of these pathways, known as notch signaling, is essential for the normal maturation and division of hair follicle cells and other types of skin cells. Notch signaling is also involved in normal immune system function. Studies suggest that mutations in the NCSTN, PSEN1, or PSENEN gene impair notch signaling in hair follicles. Although little is known about the mechanism, abnormal notch signaling appears to promote the development of nodules and to lead to inflammation in the skin. In addition, the composition of the intestinal microflora and as a consequence dietary patterns appear to play a role. Although dysbiosis of the cutaneous microbiome apparent in<unk>  is not observed, the concurrent existence of inflammatory gut and skin diseases has led to the postulation of a gut-skin axis in which gut microbiota is implicated. Indeed, analysis of bacterial taxa in fecal samples from<unk>  patients support the possibility of a role for intestinal microbial alterations in this chronic inflammatory skin disease.
Hidradenitis suppurativa
Acne
Folliculitis decalvans
Pilonidal disease
Streptococcal intertrigo
Acne conglobata
Helicobacter cellulitis
Keratolysis exfoliativa