Hidradenitis suppurativa (HS) is a chronic inflammatory dermatological disease characterized by recurrent abscesses and skin tunnels. Tobacco use is a common finding among patients with HS; as such it is theorized to act as a risk factor in the development of the disease or disease severity. Neither the casual relationship nor the pathophysiological role of smoking in patients with HS has been identified.1 However, data on the association between smoking-­activated interleukin-17 pathways provide insight into the possible pathogenesis of psoriasis and could also lay the groundwork for an explanation for the observed association between HS and smoking.2