HS is a chronic skin disease of the hair follicle with a prevalence of 14 to 20 per 100,000 in the pediatric population.23 Adalimumab, a monoclonal antibody targeting TNFα, has been approved for the management of HS in pediatric patients, although RCTs evaluating its efficacy and safety were initially performed in the adult population and have not been performed in the pediatric population.24 A systematic review evaluating the efficacy of biologics in pediatric patients with HS reported adalimumab was the most commonly used biologic in this population. Here, TNF is linked to histiocytic sarcoma.