Background <p>Acne inversa (hidradenitis suppurativa, HS) is a&#xa0;chronic inflammatory follicular disease that predominantly affects intertriginous areas and is associated with a&#xa0;substantial physical, psychosocial, and socioeconomic burden. The condition is frequently first correctly diagnosed after years of symptoms, which leads to progressive tissue damage and functional impairment.</p> Objective <p>This review aims to provide a&#xa0;practice-oriented overview of the clinical features, diagnostic criteria, relevant risk factors and the clinical course and prognosis of hidradenitis suppurativa in routine clinical care.</p> Material and methods <p>Narrative analysis of current clinical guidelines, systematic reviews and clinical studies with a&#xa0;focus on diagnostic concepts, comorbidities and prognostic factors.</p> Results <p>The disease typically presents with painful nodules, abscesses and fistulous tracts in the axillary, inguinal and perianal regions. Modifiable risk factors such as smoking and obesity are strongly associated with disease severity. Standardized scoring systems enable structured follow-up and objective assessment of the disease activity.</p> Conclusion <p>An early clinical recognition, systematic assessment of comorbidities and interdisciplinary care are essential to improve the long-term prognosis and quality of life in affected patients.</p>