Nelson AM, et al. - This study was undertaken to determine if intracellular adhesive junctions can be aberrant in hidradenitis suppurativa (HS) [chronic, inflammatory skin disease affecting the pilosebaceous units in the axilla, groin and buttocks] patient skin. Strikingly, in ~85% of HS severe skin lesions, the authors noted a loss of E-cadherin and p120ctn protein expression, two key adherens junction proteins. In addition, the loss of protein expression was evident from HS patients in non-lesional skin and the degree of loss was positively linked with HS Hurley Stage of disease. In other inflammatory skin conditions including chronic wound epithelium, atopic dermatitis, and acne vulgaris, the expression of E-cadherin was unchanged compared to healthy skin indicating that its loss could be significant for HS pathogenesis. There was no complete loss of α-catenin, β-catenin and ZO-1. However, in HS epithelium, some cytoplasmic staining of the catenins was noted. In addition, diminished desmosome size in HS lesional skin was demonstrated. Overall, the study findings suggested that lack of adherens junction proteins and decreased desmosome size in HS skin contributes to the skin's inability to withstand mechanical stress and rationalize why mechanical stress exacerbates HS symptoms.