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By linking metabolic dysfunction, and specifically obesity-related adipokines, to local inflammation and tissue destruction strongly sustained by metalloproteinases (MMPs) and their inhibitors (Tissue Inhibitors of MetalloproteinasesTIMPs), we aim to outline translational strategies for precision-guided therapies in HS and to highlight future directions focused at integrating the influence of the "gut-skin axis" and metabolic factors on HS pathogenesis and the optimal response to drugs

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