Patients with HS exhibit marked cutaneous immune dysregulation, featuring elevated levels of innate immune cells, adaptive immune cells, and pro-inflammatory cytokines, particularly those involved in Th1 and Th17 pathways, such as interleukin (IL)17, IL6, IL23, IL1β, IL12, interferon (IFN)-γ, IL8, and tumor necrosis factor (TNF)-alpha (Figure 1) (3–5). Here, TNF is linked to histiocytic sarcoma.