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Westerkam L, Masson R, Hsiao J, Sayed CJ. A survey-based study evaluating breastfeeding decisions and their impact on management in patients with hidradenitis suppurativa. J Am Acad Dermatol 2024; 90:1023-1025. [PMID: 38185255 DOI: 10.1016/j.jaad.2023.12.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 12/17/2023] [Accepted: 12/31/2023] [Indexed: 01/09/2024]
Affiliation(s)
- Linnea Westerkam
- University of North Carolina School of Medicine, Chapel Hill, North Carolina.
| | - Rahul Masson
- Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Jennifer Hsiao
- Department of Dermatology, University of Southern California, Los Angeles, California
| | - Christopher J Sayed
- Department of Dermatology, University of North Carolina, Chapel Hill, North Carolina
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2
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Bouwman K, Moazzen S, Kroah-Hartman M, Dijkstra G, Horváth B, Alizadeh BZ. Diet and physical activity as risk-reducing factors for hidradenitis suppurativa. J Eur Acad Dermatol Venereol 2024; 38:910-919. [PMID: 38116943 DOI: 10.1111/jdv.19726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 11/14/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is a multifactorial inflammatory skin disease that is considered to be an immune-mediated inflammatory disease (IMID). Up till now, the impact of lifestyle on (the development of) HS has not been thoroughly investigated. OBJECTIVES To investigate the effect of dietary intake and physical activity (PA) on (the development of) HS. MATERIALS AND METHODS A nested case-control study was performed within the longitudinal Lifelines Cohort Study, that took place in the Northern Netherlands, and identified 1004 adult eligible HS patients and 5000 age-matched controls. Dietary data were collected using a validated food frequency questionnaire, subsequently translated to the Lifelines Diet Score (LLDS), alternate Mediterranean Diet Score (aMED) and Dutch Dietary Guidelines score (DDG), with higher scores reflecting healthier dietary habits. PA was measured by the Short Questionnaire to Assess Health-enhancing PA score. Logistic regression analyses were performed between dietary/PA scores, and the prevalence/development and severity of HS. RESULTS Compared to controls, HS patients scored lower on the LLDS [OR = 0.98; 95% CI 0.96-0.99], aMED [0.93; 0.89-0.97] and DDG [0.93; 0.88-0.97] with multivariable regression analysis. Overall, this indicates less adherence to dietary recommendations and consumption of a low-quality diet in the HS population. Lower adherence to the LLDS and DDG was also significantly associated with a higher likelihood to HS development in univariable regression analysis [0.96; 0.94-0.99 and 0.91; 0.84-0.99, respectively], and a trend of decreased adherence to the aMED [0.93; 0.85-1.02] was noted. Besides, PA levels were found significantly lower in HS patients (p ≤ 0.001). CONCLUSIONS AND RELEVANCE Poor diet quality and lower quantities of PA were associated with HS in the general population. Identifying dietary and PA habits of HS patients can contribute to the development of prevention strategies for HS specifically, and for IMIDs in general.
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Affiliation(s)
- Klasiena Bouwman
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sara Moazzen
- Molecular Epidemiology Research Group, MDC Berlin-Buch, Max-Delbrück-Center for Molecular Medicine in der Helmholtz-Gemeinschaft, Berlin, Germany
| | - Madeline Kroah-Hartman
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Gerard Dijkstra
- Department of Gastroenterology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Barbara Horváth
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Behrooz Ziad Alizadeh
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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3
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Ring HC, Thorsen J, Kirby B, Ingram JR, Rosenø NAL, Holgersen N, Nielsen VW, Thein Aagaard DN, Maul JT, Wu JJ, Thyssen JP, Egeberg A, Thomsen SF. Long-term drug survival of adalimumab, infliximab, secukinumab and ustekinumab in hidradenitis suppurativa: a Danish nationwide cohort study. Br J Dermatol 2024; 190:769-771. [PMID: 38305415 DOI: 10.1093/bjd/ljae042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 01/14/2024] [Accepted: 02/05/2024] [Indexed: 02/03/2024]
Abstract
This nationwide cohort study included 452 patients (873 treatment series) and reported drug survival data on patients with hidradenitis suppurativa treated with biologics such as adalimumab, infliximab, ustekinumab and secukinumab. The median drug survival time for adalimumab was approximately 8 months, but bio-naïve patients had a significantly longer drug survival time compared with non-naïve patients.
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Affiliation(s)
- Hans Christian Ring
- Department of Dermato-Venereology and Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark
| | - Jonathan Thorsen
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital
| | - Brian Kirby
- The Charles Centre, Department of Dermatology, St. Vincent's University Hospital, Dublin, Ireland
| | - John R Ingram
- Department of Dermatology and Academic Wound Healing, Institute of Infection and Immunity, Cardiff University, Cardiff, UK
| | | | - Nikolaj Holgersen
- Department of Dermato-Venereology and Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark
| | - Valdemar W Nielsen
- Department of Dermato-Venereology and Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark
| | | | | | - Jashin J Wu
- Department of Dermatology, University of Miami Miller School of Medicine, Los Angeles, CA, USA
| | - Jacob P Thyssen
- Department of Dermato-Venereology and Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark
- Department of Clinical Medicine and
| | - Alexander Egeberg
- Department of Dermato-Venereology and Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark
- Department of Clinical Medicine and
| | - Simon F Thomsen
- Department of Dermato-Venereology and Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
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4
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Treadwell S, Green M, Feschuk A, Valdebran M. Understanding patient demographics and treatment strategies observed in the follicular occlusion triad and tetrad. Arch Dermatol Res 2024; 316:117. [PMID: 38573444 DOI: 10.1007/s00403-024-02852-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/26/2024] [Accepted: 03/26/2024] [Indexed: 04/05/2024]
Affiliation(s)
- Scout Treadwell
- School of Medicine, Tulane University, New Orleans, LA, United States
| | - Maxwell Green
- School of Medicine, Tulane University, New Orleans, LA, United States.
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5
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Camiña-Conforto G, Vilarrasa E, Cabo F, Fernández-Vela J, Pousa M, Romaní J. Response letter to "Tracing the origins of setons in hidradenitis suppurativa: A commentary to Vilarrasa et al's 'Drainage setons for the management of sinus tracts in hidradenitis suppurativa'". J Am Acad Dermatol 2024; 90:e141-e142. [PMID: 38056528 DOI: 10.1016/j.jaad.2023.11.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 11/26/2023] [Indexed: 12/08/2023]
Affiliation(s)
| | - Eva Vilarrasa
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Fernando Cabo
- Department of Dermatology, Complexo Hospitalario de Ourense, Orense, Spain
| | | | - María Pousa
- Department of Dermatology, Complexo Hospitalario de Ourense, Orense, Spain
| | - Jorge Romaní
- Department of Dermatology, Hospital General de Granollers, Barcelona, Spain
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Navarro-Fernandez I. Tracing the origins of setons in hidradenitis suppurativa: A commentary to Vilarrasa et al's "Drainage setons for the management of sinus tracts in hidradenitis suppurativa". J Am Acad Dermatol 2024; 90:e139. [PMID: 38049069 DOI: 10.1016/j.jaad.2023.10.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 10/07/2023] [Accepted: 10/22/2023] [Indexed: 12/06/2023]
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7
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Mohsen ST, Suntres E, Manzar D, Price EL, Croitoru D, Sibbald C. Population-based mortality in hidradenitis suppurativa: A systematic review. J Am Acad Dermatol 2024; 90:866-867. [PMID: 38151054 DOI: 10.1016/j.jaad.2023.12.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/27/2023] [Accepted: 12/20/2023] [Indexed: 12/29/2023]
Affiliation(s)
- Samiha T Mohsen
- University of Toronto, Temerty Faculty of Medicine, Toronto, Ontario
| | - Emmanuel Suntres
- University of Toronto, Temerty Faculty of Medicine, Toronto, Ontario
| | - Daud Manzar
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario
| | - Emma L Price
- University of Toronto, Temerty Faculty of Medicine, Toronto, Ontario
| | - David Croitoru
- Department of Dermatology, Women's College Hospital, Toronto, Ontario
| | - Cathryn Sibbald
- Department of Paediatrics, Dermatology, The Hospital for Sick Children, Toronto, Ontario.
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8
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Schneeweiss MC, Shay D, Ly S, Wyss R, Schneeweiss S, Glynn RJ, Mostaghimi A. Prevalence of Pretreatment Testing Recommended for Patients With Chronic Inflammatory Skin Diseases. JAMA Dermatol 2024; 160:334-340. [PMID: 38294794 PMCID: PMC10831628 DOI: 10.1001/jamadermatol.2023.5895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 12/01/2023] [Indexed: 02/01/2024]
Abstract
Importance Laboratory testing for the presence of tuberculosis, hepatitis, and other conditions before starting most systemic immunomodulatory agents is recommended in patients with chronic inflammatory skin diseases (CISD) but current testing patterns in the US are unclear. Objective To determine the prevalence of pretreatment testing that is recommended for patients with CISD (psoriasis, hidradenitis suppurativa, or atopic dermatitis). Design, Setting, and Participants This descriptive analysis of US commercial insurance claims databases from December 31, 2002, to December 31, 2020, included adult patients with CISD (psoriasis, hidradenitis suppurativa, or atopic dermatitis) who started an immunomodulatory agent, including methotrexate, tumor necrosis factor α inhibitors, interleukin (IL)-17Ai, ustekinumab, IL-23i, dupilumab, or apremilast. Main Outcomes and Measures The proportion of patients who underwent the screening tests as suggested by professional societies-including for tuberculosis, hepatitis, and liver function; complete blood cell counts; and lipid panels-were determined within 6 months before and during 2 years after treatment start. Results A total of 122 308 patients with CISDs (median [IQR] age, 49 [38-58] years; 63 663 [52.1%] male) starting systemic immunomodulatory treatment in the US were included. Treatment for patients with CISDs comprised methotrexate (28 684), tumor necrosis factor α inhibitors (40 965), ustekinumab (12 841), IL-23i (6116), IL-17Ai (9799), dupilumab (7787), or apremilast (16 116). Complete blood cell count was the most common test, performed in 41% (3161/7787) to 69% (19 659/28 684) of individuals before initiation across treatments. Between 11% (889/7787) and 59% (3613/6116) of patients had tuberculosis screening within 6 months before treatment, and 3% (149/4577) to 26% (1559/6097) had updated tests 1 year later. Between 13% (1006/7787) and 41% (16 728/40 965) had hepatitis panels before treatment. Low pretreatment testing levels before apremilast (15% [2331/16 116] to 45% [7253/16 116]) persisted a year into treatment (9% [816/8496] to 36% [2999/8496]) and were similar to dupilumab (11% [850/7787] to 41% [3161/7787] vs 3% [149/4577] to 25% [1160/4577]). Conclusions and Relevance In this descriptive analysis of patients with CISDs starting systemic immunomodulatory treatment in the US, less than 60% received the recommended pretreatment testing. Additional research is required to understand whether variations in testing affect patient outcomes.
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Affiliation(s)
- Maria C Schneeweiss
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Denys Shay
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Sophia Ly
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Richard Wyss
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Sebastian Schneeweiss
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Robert J Glynn
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Arash Mostaghimi
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
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Verde L, Cacciapuoti S, Caiazzo G, Megna M, Martora F, Cavaliere A, Mattera M, Maisto M, Tenore GC, Colao A, Savastano S, Muscogiuri G, Barrea L. Very low-calorie ketogenic diet (VLCKD) in the management of hidradenitis suppurativa (Acne Inversa): an effective and safe tool for improvement of the clinical severity of disease. Results of a pilot study. J Transl Med 2024; 22:149. [PMID: 38350939 PMCID: PMC10863195 DOI: 10.1186/s12967-024-04853-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 01/02/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Hidradenitis suppurativa (HS), an inflammatory-based dermatological condition often associated with obesity, poses significant challenges in management. The very low-calorie ketogenic diet (VLCKD) has shown efficacy in addressing obesity, related metabolic disorders, and reducing chronic inflammation. However, its effects on HS remain underexplored. In this prospective pilot study, we aimed to investigate the impact of a 28-day active phase of VLCKD on HS in a sample of treatment-naive women with HS and excess weight. METHODS Twelve women with HS and overweight or obesity (BMI 27.03 to 50.14 kg/m2), aged 21 to 54 years, meeting inclusion/exclusion criteria and agreeing to adhere to VLCKD, were included. Baseline lifestyle habits were assessed. The Sartorius score was used to evaluate the clinical severity of HS. Anthropometric parameters (waist circumference, weight, height, and body mass index), body composition via bioelectrical impedance analysis, levels of trimethylamine N-oxide (TMAO), oxidized low-density lipoprotein (oxLDL), and derivatives of reactive oxygen metabolites (dROMs) were assessed at baseline and after 28 days of the active phase of VLCKD. RESULTS VLCKD led to general improvements in anthropometric parameters and body composition. Notably, a significant reduction in the Sartorius score was observed after the intervention (Δ%: - 24.37 ± 16.64, p < 0.001). This reduction coincided with significant decreases in TMAO (p < 0.001), dROMs (p = 0.001), and oxLDL (p < 0.001) levels. Changes in the Sartorius score exhibited positive correlations with changes in TMAO (p < 0.001), dROMs (p < 0.001), and oxLDL (p = 0.002). CONCLUSION The 28-day active phase of VLCKD demonstrated notable improvements in HS severity and associated metabolic markers, highlighting the potential utility of VLCKD in managing HS and its association with metabolic derangements in women with overweight or obesity.
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Affiliation(s)
- Ludovica Verde
- Department of Public Health, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
- Centro Italiano per la cura e il Benessere del Paziente con Obesità (C.I.B.O), Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Sara Cacciapuoti
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Giuseppina Caiazzo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Matteo Megna
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Fabrizio Martora
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Annarita Cavaliere
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Maria Mattera
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Maria Maisto
- ChimNutra labs, Department of Pharmacy, University of Naples Federico II, via Domenico Montesano 49, 80131, Naples, Italy
| | - Gian Carlo Tenore
- ChimNutra labs, Department of Pharmacy, University of Naples Federico II, via Domenico Montesano 49, 80131, Naples, Italy
| | - Annamaria Colao
- Centro Italiano per la cura e il Benessere del Paziente con Obesità (C.I.B.O), Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
- Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
- Cattedra Unesco "Educazione Alla Salute E Allo Sviluppo Sostenibile", University Federico II, Naples, Italy
| | - Silvia Savastano
- Centro Italiano per la cura e il Benessere del Paziente con Obesità (C.I.B.O), Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
- Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Giovanna Muscogiuri
- Centro Italiano per la cura e il Benessere del Paziente con Obesità (C.I.B.O), Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
- Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
- Cattedra Unesco "Educazione Alla Salute E Allo Sviluppo Sostenibile", University Federico II, Naples, Italy
| | - Luigi Barrea
- Dipartimento di Scienze Umanistiche, Università Telematica Pegaso, Centro Direzionale, Via Porzio, Isola F2, 80143, Naples, Italy.
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Roster K, Xie L, Nguyen T, Lipner SR. Impact of Ketogenic and Low-Glycemic Diets on Inflammatory Skin Conditions. Cutis 2024; 113:75-80. [PMID: 38593092 DOI: 10.12788/cutis.0942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
Diet plays an emerging role in dermatologic therapy. The ketogenic and low-glycemic diets have potential anti-inflammatory and metabolic effects, making them attractive for treating inflammatory skin conditions. We provide an overview of the current evidence on the effects of ketogenic and low-glycemic diets on inflammatory skin conditions including acne, psoriasis, seborrheic dermatitis (SD), atopic dermatitis (AD), and hidradenitis suppurativa (HS). We conclude that low-glycemic diets show promise for treating acne, while the evidence for ketogenic diets in treating other inflammatory skin conditions is limited. Randomized clinical trials are needed to explore the efficacy of these diets as stand-alone or adjunctive treatments for inflammatory skin conditions.
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Affiliation(s)
- Katie Roster
- Katie Roster, Lillian Xie, and Terry Nguyen are from New York Medical College, Valhalla. Dr. Lipner is from the Department of Dermatology, Weill Cornell Medicine, New York, New York
| | - Lillian Xie
- Katie Roster, Lillian Xie, and Terry Nguyen are from New York Medical College, Valhalla. Dr. Lipner is from the Department of Dermatology, Weill Cornell Medicine, New York, New York
| | - Terry Nguyen
- Katie Roster, Lillian Xie, and Terry Nguyen are from New York Medical College, Valhalla. Dr. Lipner is from the Department of Dermatology, Weill Cornell Medicine, New York, New York
| | - Shari R Lipner
- Katie Roster, Lillian Xie, and Terry Nguyen are from New York Medical College, Valhalla. Dr. Lipner is from the Department of Dermatology, Weill Cornell Medicine, New York, New York
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Mora Hurtado AC, Endo JO. Lack of skin of color reporting in disease severity rating tools used for inflammatory skin conditions: A scoping review. J Am Acad Dermatol 2024; 90:432-434. [PMID: 37839737 DOI: 10.1016/j.jaad.2023.09.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 09/15/2023] [Accepted: 09/28/2023] [Indexed: 10/17/2023]
Affiliation(s)
| | - Justin O Endo
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; Division of Dermatology, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin.
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12
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Fonjungo FE, Barnes LA, Cai ZR, Naik HB, Eid E, Aleshin MA, Nava V, Johnson T, Chren MM, Linos E. Longitudinal remote monitoring of hidradenitis suppurativa: a pilot study. Br J Dermatol 2024; 190:274-276. [PMID: 37823362 PMCID: PMC10805523 DOI: 10.1093/bjd/ljad385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 09/07/2023] [Accepted: 10/29/2023] [Indexed: 10/13/2023]
Abstract
We sought to investigate the feasibility of longitudinal monitoring of disease activity from home in people with hidradenitis suppurativa (HS). Over 6 months, our novel digital tool collected 421 photos of HS-affected skin from 27 participants and captured trends in pain and quality of life scores. We found that participants with mild disease were more likely to share their progress than those with more severe disease, which is favourable as it may suggest a role for remote monitoring in tracking disease progression. This pilot provides proof of concept that will support future studies.
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Affiliation(s)
- Fonette E Fonjungo
- Department of Dermatology, Stanford Medicine, Palo Alto, CA
- Meharry Medical College, Nashville, TN
- Vanderbilt University School of Medicine, Nashville, TN
| | | | - Zhuo Ran Cai
- Department of Dermatology, Stanford Medicine, Palo Alto, CA
| | - Haley B Naik
- Department of Dermatology, University of California San Francisco, San Francisco, CA
, USA
| | - Edward S Eid
- Department of Dermatology, Stanford Medicine, Palo Alto, CA
| | | | - Vanessa Nava
- Department of Dermatology, Stanford Medicine, Palo Alto, CA
| | | | | | - Eleni Linos
- Department of Dermatology, Stanford Medicine, Palo Alto, CA
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13
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Nielsen VW, Ring HC, Holgersen N, Thomsen SF. Elderly male patients with hidradenitis suppurativa have more severe disease independent of disease duration. Br J Dermatol 2024; 190:292-293. [PMID: 37874834 DOI: 10.1093/bjd/ljad411] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 10/16/2023] [Indexed: 10/26/2023]
Abstract
The recent study by van der Weijden et al. proposed defining hidradenitis suppurativa (HS) in the elderly (> 60 years of age) as ‘HS tarda’. We verify and extend the findings by van der Weijden et al. by demonstrating that variation in HS severity is explained to an increasing extent by sex with increasing age, but is independent of overall disease duration, and that HS in the elderly shows significant variation in age of onset and body area involvement. This supports the idea that HS activity varies between different age groups, but the relationship remains more complex than a binary definition.
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Affiliation(s)
- Valdemar Wendelboe Nielsen
- Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Denmark, Copenhagen , Denmark
| | - Hans Christian Ring
- Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Denmark, Copenhagen , Denmark
| | - Nikolaj Holgersen
- Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Denmark, Copenhagen , Denmark
| | - Simon Francis Thomsen
- Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Denmark, Copenhagen , Denmark
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen , Denmark
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14
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Hidradenitis suppurativa: a review with new insights into disease mechanisms and potential future treatments. Br J Dermatol 2024; 190:e14. [PMID: 38262602 DOI: 10.1093/bjd/ljad512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
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15
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Li Q, Patrick MT, Sreeskandarajan S, Kang J, Kahlenberg JM, Gudjonsson JE, He Z, Tsoi LC. Large-scale epidemiological analysis of common skin diseases to identify shared and unique comorbidities and demographic factors. Front Immunol 2024; 14:1309549. [PMID: 38259463 PMCID: PMC10800546 DOI: 10.3389/fimmu.2023.1309549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 12/12/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction The utilization of large-scale claims databases has greatly improved the management, accessibility, and integration of extensive medical data. However, its potential for systematically identifying comorbidities in the context of skin diseases remains unexplored. Methods This study aims to assess the capability of a comprehensive claims database in identifying comorbidities linked to 14 specific skin and skin-related conditions and examining temporal changes in their association patterns. This study employed a retrospective case-control cohort design utilizing 13 million skin/skin-related patients and 2 million randomly sampled controls from Optum's de-identified Clinformatics® Data Mart Database spanning the period from 2001 to 2018. A broad spectrum of comorbidities encompassing cancer, diabetes, respiratory, mental, immunity, gastrointestinal, and cardiovascular conditions were examined for each of the 14 skin and skin-related disorders in the study. Results Using the established type-2 diabetes (T2D) and psoriasis comorbidity as example, we demonstrated the association is significant (P-values<1x10-15) and stable across years (OR=1.15-1.31). Analysis of the 2014-2018 data reveals that celiac disease, Crohn's disease, and ulcerative colitis exhibit the strongest associations with the 14 skin/skin-related conditions. Systemic lupus erythematosus (SLE), leprosy, and hidradenitis suppurativa show the strongest associations with 30 different comorbidities. Particularly notable associations include Crohn's disease with leprosy (odds ratio [OR]=6.60, 95% confidence interval [CI]: 3.09-14.08), primary biliary cirrhosis with SLE (OR=6.07, 95% CI: 4.93-7.46), and celiac disease with SLE (OR=6.06, 95% CI: 5.49-6.69). In addition, changes in associations were observed over time. For instance, the association between atopic dermatitis and lung cancer demonstrates a marked decrease over the past decade, with the odds ratio decreasing from 1.75 (95% CI: 1.47-2.07) to 1.02 (95% CI: 0.97-1.07). The identification of skin-associated comorbidities contributes to individualized healthcare and improved clinical management, while also enhancing our understanding of shared pathophysiology. Moreover, tracking these associations over time aids in evaluating the progression of clinical diagnosis and treatment. Discussion The findings highlight the potential of utilizing comprehensive claims databases in advancing research and improving patient care in dermatology.
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Affiliation(s)
- Qinmengge Li
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States
| | - Matthew T Patrick
- Department of Dermatology, University of Michigan, Ann Arbor, MI, United States
| | - Sutharzan Sreeskandarajan
- The Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Jian Kang
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States
| | - J Michelle Kahlenberg
- Department of Dermatology, University of Michigan, Ann Arbor, MI, United States
- Rheumatology, Internal Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Johann E Gudjonsson
- Department of Dermatology, University of Michigan, Ann Arbor, MI, United States
| | - Zhi He
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States
| | - Lam C Tsoi
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States
- Department of Dermatology, University of Michigan, Ann Arbor, MI, United States
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, United States
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16
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Stancic BH, Boer J, Dolenc-Voljč M, Jemec GBE. The Role of Intra-Follicular Shear Forces in Hidradenitis Suppurativa. Skin Pharmacol Physiol 2024; 36:302-303. [PMID: 38176392 DOI: 10.1159/000536067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 12/25/2023] [Indexed: 01/06/2024]
Affiliation(s)
- Bor Hrvatin Stancic
- Dermatovenerology Department, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Jurr Boer
- Department of Dermatology, Deventer Hospital, Schalkhaar, The Netherlands
| | - Mateja Dolenc-Voljč
- Dermatovenerology Department, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Gregor B E Jemec
- Department of Dermatology, Zealand University Hospital and Health Sciences Faculty, Auckland, New Zealand
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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17
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Mintoff D, Borg I, Pace NP. NOD2 at the interface of hidradenitis suppurativa and inflammatory bowel disease-An in silico analysis. Exp Dermatol 2024; 33:e14928. [PMID: 37694954 DOI: 10.1111/exd.14928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 08/25/2023] [Accepted: 08/31/2023] [Indexed: 09/12/2023]
Affiliation(s)
- Dillon Mintoff
- Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | - Isabella Borg
- Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
- Department of Pathology, Section of Clinical Genetics, Mater Dei Hospital, Msida, Malta
- Centre for Molecular Medicine and Biobanking, University of Malta, Msida, Malta
| | - Nikolai P Pace
- Centre for Molecular Medicine and Biobanking, University of Malta, Msida, Malta
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
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18
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Kluger N. A case of hidradenitis suppurativa in a 19th-century painting at the Leopold Museum? J Eur Acad Dermatol Venereol 2024; 38:20-21. [PMID: 37715491 DOI: 10.1111/jdv.19476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 08/22/2023] [Indexed: 09/17/2023]
Affiliation(s)
- Nicolas Kluger
- Department of Dermatology, Allergology and Venereology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Société Française Des Sciences Humaines Sur la Peau (SFSHP), Société Française de Dermatologie, Paris, France
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19
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Flora A, Jepsen R, Kozera EK, Woods JA, Cains GD, Radzieta M, Jensen SO, Malone M, Frew JW. Mast cells are upregulated in hidradenitis suppurativa tissue, associated with epithelialized tunnels and normalized by spleen tyrosine kinase antagonism. Exp Dermatol 2024; 33:e14894. [PMID: 37522746 DOI: 10.1111/exd.14894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/26/2023] [Accepted: 07/16/2023] [Indexed: 08/01/2023]
Abstract
Mast cells have traditionally been associated with allergic inflammatory responses; however, they play important roles in cutaneous innate immunity and wound healing. The Hidradenitis Suppurativa tissue transcriptome is associated with alterations in innate immunity and wound healing-associated pathways; however, the role of mast cells in the disease is unexplored. We demonstrate that mast cell-associated gene expression (using whole tissue RNAseq) is upregulated, and in-silico cellular deconvolution identifies activated mast cells upregulated and resting mast cells downregulated in lesional tissue. Tryptase/Chymase positive mast cells (identified using IHC) localize adjacent to epithelialized tunnels, fibrotic regions of the dermis and at perivascular sites associated with Neutrophil Extracellular Trap formation and TNF-alpha production. Treatment with Spleen Tyrosine Kinase antagonist (Fostamatinib) reduces the expression of mast cell-associated gene transcripts, associated biochemical pathways and the number of tryptase/chymase positive mast cells in lesional hidradenitis suppurativa tissue. This data indicates that although mast cells are not the most abundant cell type in Hidradenitis Suppurativa tissue, the dysregulation of mast cells is paralleled with B cell/plasma cell inflammation, inflammatory epithelialized tunnels and epithelial budding. This provides an explanation as to the mixed inflammatory activation signature seen in HS, the correlation with dysregulated wound healing and potential pathways involved in the development of epithelialized tunnels.
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Affiliation(s)
- A Flora
- Laboratory of Translational Cutaneous Medicine, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
- University of New South Wales, Sydney, New South Wales, Australia
- Department of Dermatology, Liverpool Hospital, Sydney, New South Wales, Australia
| | - R Jepsen
- Holdsworth House Medical Practice, Sydney, New South Wales, Australia
| | - E K Kozera
- University of New South Wales, Sydney, New South Wales, Australia
- Department of Dermatology, Liverpool Hospital, Sydney, New South Wales, Australia
| | - J A Woods
- University of New South Wales, Sydney, New South Wales, Australia
- Department of Dermatology, Liverpool Hospital, Sydney, New South Wales, Australia
| | - G D Cains
- University of New South Wales, Sydney, New South Wales, Australia
- Department of Dermatology, Liverpool Hospital, Sydney, New South Wales, Australia
| | - M Radzieta
- South West Sydney Limb Preservation and Wound Research, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
- School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
| | - S O Jensen
- School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
| | - M Malone
- South West Sydney Limb Preservation and Wound Research, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
- School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
| | - J W Frew
- Laboratory of Translational Cutaneous Medicine, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
- University of New South Wales, Sydney, New South Wales, Australia
- Department of Dermatology, Liverpool Hospital, Sydney, New South Wales, Australia
- Holdsworth House Medical Practice, Sydney, New South Wales, Australia
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20
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Marquez DG, Sadeghi NB, Westerkam LL, Blum FR, Dresselhaus A, Sayed CJ. A survey-based study on experiences with and perspectives toward medical providers among patients with hidradenitis suppurativa. Br J Dermatol 2023; 190:127-129. [PMID: 37766476 DOI: 10.1093/bjd/ljad367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 08/29/2023] [Accepted: 10/03/2023] [Indexed: 09/29/2023]
Abstract
Patients with hidradenitis suppurativa frequently visit medical providers and are often misdiagnosed or inappropriately educated on their disease. This survey study investigated how often patients received misinformation about their disease. Many participants reported receiving incorrect information that caused shame and made them avoid seeing medical providers.
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Affiliation(s)
| | | | - Linnea L Westerkam
- Department of Dermatology, University of North Carolina, Chapel Hill, NC, USA
| | | | | | - Christopher J Sayed
- Department of Dermatology, University of North Carolina, Chapel Hill, NC, USA
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21
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Matucci-Cerinic C, Malattia C, Pistorio A, Rosina S, Consolaro A, Viola S, Volpi S, Caorsi R, Viglizzo G, Gattorno M. Skin manifestations help identifying different phenotypes of paediatric SAPHO syndrome. Semin Arthritis Rheum 2023; 63:152277. [PMID: 37839270 DOI: 10.1016/j.semarthrit.2023.152277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/23/2023] [Accepted: 10/03/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVES to evaluate whether the heterogeneous skin manifestations might influence the disease presentation and outcome of a cohort of SAPHO children. METHODS the clinical, serological, imaging and therapeutic data of 14 SAPHO patients, followed between 2001 and 2022 at the Unit for Autoinflammatory diseases at the Gaslini Hospital, were reviewed. According to their cutaneous manifestations, patients were divided into 2 groups: the acne-hidradenitis suppurativa (HS) and the Palmo-Plantar Pustulosis (PPP) group. Data were retrieved from the Eurofever database. RESULTS all patients presented bone involvement characterized by Chronic Recurrent multifocal Osteomyelitis (CRMO): 8 patients presented acne-HS while 6 patients had PPP. In the PPP group, all patients were female, characterized by a prepuberal disease onset with osteoarticular manifestations, followed by the appearance of PPP in the following 6 months. This group responded well to the treatments. In the acne-HS group, 7/8 patients were male: the disease onset was characterized by skin manifestations in pubertal age, followed by osteoarticular manifestations in the following year. This group presented a severe refractory skin disease that required in most cases the addition of biological therapies. A literature review confirmed our data highlighting the association males-acne-puberal age and female-PPP-prepuberal age. CONCLUSION paediatric SAPHO patients should be mainly stratified according to their skin involvement. In fact, our data suggest that two different skin phenotypes may be identified in SAPHO: the first is constituted by prepuberal females with PPP and a prevalent osteoarticular involvement, while the second by puberal males with a difficult-to-treat acne-HS.
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Affiliation(s)
- Caterina Matucci-Cerinic
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy; UOC Rheumatology and Autoinflammatory diseases, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
| | - Clara Malattia
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy; UOC Rheumatology and Autoinflammatory diseases, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Angela Pistorio
- Biostatistics Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Silvia Rosina
- UOC Rheumatology and Autoinflammatory diseases, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Alessandro Consolaro
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy; UOC Rheumatology and Autoinflammatory diseases, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Stefania Viola
- UOC Rheumatology and Autoinflammatory diseases, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Stefano Volpi
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy; UOC Rheumatology and Autoinflammatory diseases, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Roberta Caorsi
- UOC Rheumatology and Autoinflammatory diseases, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | | | - Marco Gattorno
- UOC Rheumatology and Autoinflammatory diseases, IRCCS Istituto Giannina Gaslini, Genoa, Italy
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22
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Melnik BC. Metformin attenuates mechanistic target of rapamycin complex 1/hypoxia-inducible factor-1α-driven glycolysis reducing keratinocyte and T helper 17 cell proliferation in hyperproliferative inflammatory skin diseases. Br J Dermatol 2023; 189:652-653. [PMID: 37932820 DOI: 10.1093/bjd/ljad362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 09/18/2023] [Indexed: 11/08/2023]
Affiliation(s)
- Bodo C Melnik
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany
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23
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Petrasca A, Hambly R, Kearney N, Smith CM, Pender EK, Mac Mahon J, O'Rourke AM, Ismaiel M, Boland PA, Almeida JP, Kennedy C, Zaborowski A, Murphy S, Winter D, Kirby B, Fletcher JM. Metformin has anti-inflammatory effects and induces immunometabolic reprogramming via multiple mechanisms in hidradenitis suppurativa. Br J Dermatol 2023; 189:730-740. [PMID: 37648653 DOI: 10.1093/bjd/ljad305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/11/2023] [Accepted: 08/17/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Targeting immunometabolism has shown promise in treating autoimmune and inflammatory conditions. Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease involving painful lesions in apocrine gland-bearing skin. Therapeutic options for HS are limited and often ineffective; thus, there is a pressing need for improved treatments. To date, metabolic dysregulation has not been investigated in HS. As HS is highly inflammatory, we hypothesized that energy metabolism is dysregulated in these patients. Metformin, an antidiabetic drug, which is known to impact on cellular metabolic and signalling pathways, has been shown to have anti-inflammatory effects in cancer and arthritis. While metformin is not licensed for use in HS, patients with HS taking metformin show improved clinical symptoms. OBJECTIVE To assess the effect and mechanism of action of metformin in HS. METHODS To assess the effect of metformin in vivo, we compared the immune and metabolic profiles of peripheral blood mononuclear cells (PBMCs) of patients with HS taking metformin vs. those not taking metformin. To examine the effect of metformin treatment ex vivo, we employed a skin explant model on skin biopsies from patients with HS not taking metformin, which we cultured with metformin overnight. We used enzyme-linked immunosorbent assays, multiplex cytokine assays and quantitative real-time polymerase chain reaction (RT-PCR) to measure inflammatory markers, and Seahorse flux technology and quantitative RT-PCR to assess glucose metabolism. RESULTS We showed that metabolic pathways are dysregulated in the PBMCs of patients with HS vs. healthy individuals. In metformin-treated patients, these metabolic pathways were restored and their PBMCs had reduced inflammatory markers following long-term metformin treatment. In the skin explant model, we found that overnight culture with metformin reduced inflammatory cytokines and chemokines and glycolytic genes in lesions and tracts of patients with HS. Using in vitro assays, we found that metformin may induce these changes via the NLR family pyrin domain containing 3 (NLRP3) inflammasome and the AMP-activated protein kinase (AMPK)-mammalian target of rapamycin (mTOR) pathway, which is linked to glycolysis and protein synthesis. CONCLUSIONS Our study provides insight into the mechanisms of action of metformin in HS. The anti-inflammatory effects of metformin support its use as a therapeutic agent in HS, while its effects on immunometabolism suggest that targeting metabolism is a promising therapeutic option in inflammatory diseases, including HS.
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Affiliation(s)
- Andreea Petrasca
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Roisin Hambly
- Department of Dermatology, St. Vincent's University Hospital, Dublin, Ireland
- Charles Institute of Dermatology, Dublin, Ireland
| | - Niamh Kearney
- Department of Dermatology, St. Vincent's University Hospital, Dublin, Ireland
- Charles Institute of Dermatology, Dublin, Ireland
| | - Conor M Smith
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Emily K Pender
- Department of Dermatology, St. Vincent's University Hospital, Dublin, Ireland
- Charles Institute of Dermatology, Dublin, Ireland
| | - Julie Mac Mahon
- Department of Dermatology, St. Vincent's University Hospital, Dublin, Ireland
- Charles Institute of Dermatology, Dublin, Ireland
| | - Aoife M O'Rourke
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Mohamed Ismaiel
- Department of Surgery, St. Michael's Hospital, Dublin, Ireland
| | | | - Jose P Almeida
- Department of Surgery, St. Michael's Hospital, Dublin, Ireland
| | - Czara Kennedy
- Department of Surgery, St. Michael's Hospital, Dublin, Ireland
| | | | - Siun Murphy
- Department of Plastic Reconstructive and Aesthetic Surgery, Blackrock Clinic, Dublin, Ireland
| | - Desmond Winter
- Department of Surgery, St. Michael's Hospital, Dublin, Ireland
| | - Brian Kirby
- Department of Dermatology, St. Vincent's University Hospital, Dublin, Ireland
- Charles Institute of Dermatology, Dublin, Ireland
| | - Jean M Fletcher
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
- School of Medicine, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
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24
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Harb D, Abdullah L, Kurban M, Abbas O. Ketogenic Diet and the Skin. Skinmed 2023; 21:315-320. [PMID: 37945356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
In dermatology, the role of dietary modifications as a means to manage or prevent skin disorders has recently gained special attention among patients and physicians. This is especially true for the currently popular ketogenic diet (KD), which comprises low carbohydrate, high fat, and adequate amount of protein. Recent evidence from basic science research, small clinical trials, population studies, and reports has presented promising potential role of KD as a supplementary or adjuvant treatment in different cutaneous disorders mainly due to its anti-inflammatory properties. This review is directed at raising awareness among dermatologists on the potential uses of KD in managing skin disorders, such as acne, psoriasis, and hidradenitis suppurativa, among others. In addition, cutaneous adverse reactions, such as prurigo pigmentosa and nutritional deficiencies, which have been associated with KD, are also discussed in this review.
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Affiliation(s)
- Dana Harb
- Department of Dermatology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Lina Abdullah
- Department of Dermatology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Mazen Kurban
- Department of Dermatology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ossama Abbas
- Department of Dermatology, American University of Beirut Medical Center, Beirut, Lebanon;
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25
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Luo Q, Cao Q, Guo J, Chang S, Wu Y. Genetically predicted levels of circulating cytokines and the risk of six immune skin diseases: a two-sample Mendelian randomization study. Front Immunol 2023; 14:1240714. [PMID: 37954607 PMCID: PMC10637377 DOI: 10.3389/fimmu.2023.1240714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 10/12/2023] [Indexed: 11/14/2023] Open
Abstract
Background Circulating cytokines play a crucial role in the onset and progression of immune skin diseases. However, the causal relationships and the direction of causal effects require further investigation. Methods Two-sample Mendelian randomization (MR) analyses were conducted to assess the causal relationships between 41 circulating cytokines and six immune skin diseases including alopecia areata, chloasma, hidradenitis suppurativa (HS), lichen planus (LP), seborrheic dermatitis, and urticaria, using summary statistics from genome-wide association studies. Reverse MR analyses was performed to test for the reverse causation. Pleiotropy and heterogeneity tests were conducted to assess the robustness of the findings. Results Twelve unique cytokines showed a suggestive causal relationship with the risk of six immune skin diseases. Among them, the causal effects between 9 unique cytokines and immune skin diseases have strong statistical power. Additionally, the concentrations of six cytokines might be influenced by LP and urticaria. After Bonferroni correction, the following associations remained significant: the causal effect of beta-nerve growth factor on HS (odds ratio [OR] = 1.634, 95% confidence interval [CI] = 1.226-2.177, p = 7.97e-04), interleukin (IL)-6 on LP (OR = 0.615, 95% CI = 0.481-0.786, p = 1.04e-04), IL-4 on LP (OR = 1.099. 95% CI = 1.020-1.184, p = 1.26e-02), and IL-2 on urticaria (OR = 0.712, 95% CI = 0.531-0.955, p = 2.33e-02). Conclusion This study provides novel perspectives on the relationship between circulating cytokines and immune skin diseases, potentially providing valuable insights into their etiology, diagnostic approaches, and treatment.
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Affiliation(s)
- Qinghua Luo
- Department of Anorectal Surgery, Jiangmen Wuyi Hospital of Traditional Chinese Medicine, Jiangmen, China
| | - Qiurui Cao
- Department of Anorectal Surgery, Jiangmen Wuyi Hospital of Traditional Chinese Medicine, Jiangmen, China
| | - Jinyan Guo
- Department of Anorectal Surgery, Jiangmen Wuyi Hospital of Traditional Chinese Medicine, Jiangmen, China
| | - Shuangqing Chang
- Department of Anorectal Surgery, Jiangmen Wuyi Hospital of Traditional Chinese Medicine, Jiangmen, China
| | - Yunxiang Wu
- Department of Anorectal Surgery, Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang, China
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26
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Fornaro L, Marasca D, Fabbrocini G, Megna M, Martora F, Marasca C. Tattooing and hidradenitis suppurativa: stigmatization and camouflage. Ital J Dermatol Venerol 2023; 158:426-427. [PMID: 37427995 DOI: 10.23736/s2784-8671.23.07599-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Affiliation(s)
- Luigi Fornaro
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Dario Marasca
- Department of General and Specialistic Surgery, A. Cardarelli Hospital, Naples, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy -
| | - Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Fabrizio Martora
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Claudio Marasca
- Unit of Melanoma, Cancer Immunotherapy and Development Therapeutics, National Cancer Institute IRCCS "G. Pascale" Foundation, Naples, Italy
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27
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Moran B, Smith CM, Zaborowski A, Ryan M, Karman J, Dunstan RW, Smith KM, Hambly R, Musilova J, Petrasca A, Fabre A, O'Donnell M, Hokamp K, Mills KHG, Housley WJ, Winter DC, Kirby B, Fletcher JM. Targeting the NLRP3 inflammasome reduces inflammation in hidradenitis suppurativa skin. Br J Dermatol 2023; 189:447-458. [PMID: 37243544 DOI: 10.1093/bjd/ljad184] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 05/23/2023] [Accepted: 05/25/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND Treatment for the debilitating disease hidradenitis suppurativa (HS) is inadequate in many patients. Despite an incidence of approximately 1%, HS is often under-recognized and underdiagnosed, and is associated with a high morbidity and poor quality of life. OBJECTIVES To gain a better understanding of the pathogenesis of HS, in order to design new therapeutic strategies. METHODS We employed single-cell RNA sequencing to analyse gene expression in immune cells isolated from involved HS skin vs. healthy skin. Flow cytometry was used to quantify the absolute numbers of the main immune populations. The secretion of inflammatory mediators from skin explant cultures was measured using multiplex and enzyme-linked immunosorbent assays. RESULTS Single-cell RNA sequencing analysis identified a significant enrichment in the frequency of plasma cells, T helper (Th) 17 cells and dendritic cell subsets in HS skin, and the immune transcriptome was distinct and more heterogeneous than healthy skin. Flow cytometry revealed significantly increased numbers of T cells, B cells, neutrophils, dermal macrophages and dendritic cells in HS skin. Genes and pathways associated with Th17 cells, interleukin (IL)-17, IL-1β and the NLRP3 inflammasome were enhanced in HS skin, particularly in samples with a high inflammatory load. Inflammasome constituent genes principally mapped to Langerhans cells and a subpopulation of dendritic cells. The secretome of HS skin explants contained significantly increased concentrations of inflammatory mediators, including IL-1β and IL-17A, and culture with an NLRP3 inflammasome inhibitor significantly reduced the secretion of these, as well as other, key mediators of inflammation. CONCLUSIONS These data provide a rationale for targeting the NLRP3 inflammasome in HS using small-molecule inhibitors that are currently being tested for other indications.
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Affiliation(s)
- Barry Moran
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Conor M Smith
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | | | - Mark Ryan
- AbbVie, Immunology Discovery Research, AbbVie Bioresearch Center, Worcester, MA, USA
| | - Jozsef Karman
- AbbVie, Immunology Systems Computational Biology, Cambridge Research Center, Cambridge, MA, USA
| | - Robert W Dunstan
- AbbVie, Immunology Discovery Research, AbbVie Bioresearch Center, Worcester, MA, USA
| | - Kathleen M Smith
- AbbVie, Immunology Systems Computational Biology, Cambridge Research Center, Cambridge, MA, USA
| | - Roisin Hambly
- Department of Dermatology, St. Vincent's University Hospital and Charles Institute of Dermatology, University College Dublin, Dublin, Ireland
| | - Jana Musilova
- Education and Research Centre, University College Dublin, Dublin, Ireland
| | - Andreea Petrasca
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Aurelie Fabre
- Department of Histopathology, St. Vincent's University Hospital and School of Medicine, University College Dublin, Ireland
| | | | - Karsten Hokamp
- Department of Genetics, School of Genetics and Microbiology, Smurfit Institute of Genetics
| | - Kingston H G Mills
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - William J Housley
- AbbVie, Immunology Discovery Research, AbbVie Bioresearch Center, Worcester, MA, USA
| | - Desmond C Winter
- Department of Surgery, St. Vincent's University Hospital, Dublin, Ireland
| | - Brian Kirby
- Department of Dermatology, St. Vincent's University Hospital and Charles Institute of Dermatology, University College Dublin, Dublin, Ireland
| | - Jean M Fletcher
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
- School of Medicine, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
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Agamia NF, Sorror OA, Sayed NM, Ghazala RA, Echy SM, Moussa DH, Melnik BC. Overexpression of hypoxia-inducible factor-1α in hidradenitis suppurativa: the link between deviated immunity and metabolism. Arch Dermatol Res 2023; 315:2107-2118. [PMID: 36961533 PMCID: PMC10366312 DOI: 10.1007/s00403-023-02594-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 01/13/2023] [Accepted: 02/23/2023] [Indexed: 03/25/2023]
Abstract
Hypoxia-inducible factor-1α (HIF-1α) is the master transcription factor of glycolysis, Th17 cell differentiation and suppression of regulatory T cells. In the skin and serum of patients with psoriasis vulgaris, increased expression of HIF-1α has been reported, whereas HIF-1α expression in the skin and serum of patients with hidradenitis suppurativa (HS) has not yet been studied. The objective of the study is to demonstrate is there a role for HIF-1α in the pathogenesis of hidradenitis suppurativa, and its relation to HS severity. Twenty patients suffering from hidradenitis suppurativa were included in the study. Punch biopsies were taken from lesional skin for the determination of HIF-1α expression by immunohistochemical staining, and HIF-1α gene expression by quantitative reverse transcription real time PCR. Quantification of HIF-1α protein concentration was done by enzyme-linked immunosorbent assay. Twenty socio-demographically cross-matched healthy volunteers served as controls. We found increased serum levels of HIF-1α. Literature-derived evidence indicates that the major clinical triggering factors of HS, obesity, and smoking are associated with hypoxia and enhanced HIF-1α expression. Pro-inflammatory cytokines such as tumor necrosis factor-[Formula: see text] via upregulation of nuclear factor [Formula: see text]B enhance HIF-1α expression. HIF-1α plays an important role for keratinocyte proliferation, especially for keratinocytes of the anagen hair follicle, which requires abundant glycolysis providing sufficient precursors molecules for biosynthetic pathways. Metformin via inhibition of mTORC1 as well as adalimumab attenuate HIF-1α expression, the key mediator between Th17-driven deviated immunity and keratinocyte hyperproliferation. In accordance with psoriasis, our study identifies HS as an HIF-1α-driven inflammatory skin disease and offers a new rationale for the prevention and treatment of HS by targeting HIF-1[Formula: see text] overexpression.
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Affiliation(s)
- Naglaa Fathi Agamia
- Department of Dermatology, Andrology and Venereology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt.
| | - Osama Ahmed Sorror
- Department of Dermatology, Andrology and Venereology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Naglaa Mohamed Sayed
- Department of Dermatology, Andrology and Venereology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Rasha Abdelmawla Ghazala
- Department of Medical Biochemistry, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Sammar Mohamed Echy
- Department of Clinical Pathology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Doaa Helmy Moussa
- Department of Dermatology, Andrology and Venereology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Bodo Clemens Melnik
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany
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29
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Williams JC, Alhusayen R, Guilbault S, Ingram JR, Lowes MA, Yannuzzi CA, Naik HB. Patient-reported influences on COVID-19 vaccine acceptance and hesitancy in people with hidradenitis suppurativa. Br J Dermatol 2023; 189:351-353. [PMID: 37210215 PMCID: PMC10449532 DOI: 10.1093/bjd/ljad166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 05/10/2023] [Accepted: 05/20/2023] [Indexed: 05/22/2023]
Abstract
COVID-19 continues to pose a risk to patients with hidradenitis suppurativa (HS) due to the high prevalence of comorbidities associated with severe COVID-19 disease. We aimed to characterize perspectives on COVID-19 vaccination among patients with HS. International respondents from 20 online HS support groups were recruited to complete a voluntary, anonymous, online cross-sectional survey from 25 October to 21 November 2021 to obtain perspectives from people with HS who may and may not access healthcare. We report higher rates of COVID-19 vaccine hesitancy among patients with HS who expressed dissatisfaction with their dermatological care.
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Affiliation(s)
| | - Raed Alhusayen
- Dermatology Division, Department of Medicine, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | | | - John R Ingram
- Division of Infection and Immunity, Department of Dermatology and Academic Wound Healing, Cardiff University, Cardiff, UK
| | | | | | - Haley B Naik
- Department of Dermatology, University of California, San Francisco, CA, USA
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30
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Navarro-Compán V, Puig L, Vidal S, Ramírez J, Llamas-Velasco M, Fernández-Carballido C, Almodóvar R, Pinto JA, Galíndez-Aguirregoikoa E, Zarco P, Joven B, Gratacós J, Juanola X, Blanco R, Arias-Santiago S, Sanz Sanz J, Queiro R, Cañete JD. The paradigm of IL-23-independent production of IL-17F and IL-17A and their role in chronic inflammatory diseases. Front Immunol 2023; 14:1191782. [PMID: 37600764 PMCID: PMC10437113 DOI: 10.3389/fimmu.2023.1191782] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 07/05/2023] [Indexed: 08/22/2023] Open
Abstract
Interleukin-17 family (IL-17s) comprises six structurally related members (IL-17A to IL-17F); sequence homology is highest between IL-17A and IL-17F, displaying certain overlapping functions. In general, IL-17A and IL-17F play important roles in chronic inflammation and autoimmunity, controlling bacterial and fungal infections, and signaling mainly through activation of the nuclear factor-kappa B (NF-κB) pathway. The role of IL-17A and IL-17F has been established in chronic immune-mediated inflammatory diseases (IMIDs), such as psoriasis (PsO), psoriatic arthritis (PsA), axial spondylarthritis (axSpA), hidradenitis suppurativa (HS), inflammatory bowel disease (IBD), multiple sclerosis (MS), and asthma. CD4+ helper T cells (Th17) activated by IL-23 are well-studied sources of IL-17A and IL-17F. However, other cellular subtypes can also produce IL-17A and IL-17F, including gamma delta (γδ) T cells, alpha beta (αβ) T cells, type 3 innate lymphoid cells (ILC3), natural killer T cells (NKT), or mucosal associated invariant T cells (MAIT). Interestingly, the production of IL-17A and IL-17F by innate and innate-like lymphocytes can take place in an IL-23 independent manner in addition to IL-23 classical pathway. This would explain the limitations of the inhibition of IL-23 in the treatment of patients with certain rheumatic immune-mediated conditions such as axSpA. Despite their coincident functions, IL-17A and IL-17F contribute independently to chronic tissue inflammation having somehow non-redundant roles. Although IL-17A has been more widely studied, both IL-17A and IL-17F are overexpressed in PsO, PsA, axSpA and HS. Therefore, dual inhibition of IL-17A and IL-17F could provide better outcomes than IL-23 or IL-17A blockade.
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Affiliation(s)
| | - Luis Puig
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Silvia Vidal
- Immunology-Inflammatory Diseases, Institut de Recerca de l’Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Julio Ramírez
- Arthritis Unit, Department of Rheumatology, Hospital Clínic and Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Mar Llamas-Velasco
- Department of Dermatology, Hospital Universitario La Princesa, Madrid, Spain
| | | | - Raquel Almodóvar
- Department of Rheumatology, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - José Antonio Pinto
- Department of Rheumatology, Complejo Hospitalario Universitario de A Coruña, Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain
| | | | - Pedro Zarco
- Department of Rheumatology, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - Beatriz Joven
- Department of Rheumatology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Jordi Gratacós
- Department of Rheumatology, Medicine Department Autonomus University of Barcelona (UAB), I3PT, University Hospital Parc Taulí Sabadell, Barcelona, Spain
| | - Xavier Juanola
- Department of Rheumatology, University Hospital Bellvitge, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Barcelona, Spain
| | - Ricardo Blanco
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - Salvador Arias-Santiago
- Department of Dermatology, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Department of Dermatology, Facultad de Medicina, Universidad de Granada, Spain
| | - Jesús Sanz Sanz
- Department of Rheumatology, Hospital Universitario Puerta del Hierro Majadahonda, Madrid, Spain
| | - Rubén Queiro
- Department of Rheumatology, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Juan D. Cañete
- Arthritis Unit, Department of Rheumatology, Hospital Clínic and Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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31
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Bourkas AN, Lara-Corrales I. The role of nutrition, food allergies, and gut dysbiosis in immune-mediated inflammatory skin disease: a narrative review. Curr Opin Pediatr 2023; 35:452-459. [PMID: 37335275 DOI: 10.1097/mop.0000000000001262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
PURPOSE OF REVIEW This review focuses on the emerging roles of nutrition, food allergies, and gut dysbiosis, and their influence on pediatric skin conditions such as psoriasis, hidradenitis suppurativa, and alopecia areata. As the prevalence of these conditions increases, understanding the underlying mechanisms and potential therapeutic targets is crucial for clinical practice and research. RECENT FINDINGS The review covers 32 recent articles that highlight the significance of the gut microbiome, nutrition, and gut dysbiosis in the pathogenesis and progression of inflammatory and immune-related pediatric skin conditions. The data suggest that food allergies and gut dysbiosis play a crucial role in disease pathogenesis. SUMMARY This review emphasizes the need for larger-scale studies to determine the effectiveness of dietary changes in preventing or treating inflammatory and immune-related skin conditions. Clinicians must maintain a balanced approach when implementing dietary changes in children with skin diseases like atopic dermatitis to avoid potential nutritional deficiencies and growth impairments. Further research into the complex interplay between environmental and genetic factors is warranted to develop tailored therapeutic strategies for these skin conditions in children.
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Affiliation(s)
| | - Irene Lara-Corrales
- Division of Dermatology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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32
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Dimitrion P, Hamzavi I, Yin C, Toor J, Subedi K, Khalasawi N, Miller A, Huggins R, Adrianto I, Veenstra J, Vellaichamy G, Hans A, Daveluy S, Athar M, Liao W, Lim H, Ozog D, Zhou L, Mi QS. Mass cytometry uncovers a distinct peripheral immune profile and upregulated CD38 expression in patients with hidradenitis suppurativa. Cell Mol Immunol 2023; 20:972-975. [PMID: 37248290 PMCID: PMC10387467 DOI: 10.1038/s41423-023-01037-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 05/03/2023] [Indexed: 05/31/2023] Open
Affiliation(s)
- Peter Dimitrion
- Center for Cutaneous Biology and Immunology Research, Department of Dermatology, Henry Ford Health System, Detroit, MI, 48202, USA
- Immunology Research Program, Henry Ford Cancer Institute, Henry Ford Health System, Detroit, MI, 48202, USA
- Cancer Biology Graduate Program, School of Medicine, Wayne State University, Detroit, MI, 48202, USA
| | - Iltefat Hamzavi
- Center for Cutaneous Biology and Immunology Research, Department of Dermatology, Henry Ford Health System, Detroit, MI, 48202, USA
| | - Congcong Yin
- Center for Cutaneous Biology and Immunology Research, Department of Dermatology, Henry Ford Health System, Detroit, MI, 48202, USA
- Immunology Research Program, Henry Ford Cancer Institute, Henry Ford Health System, Detroit, MI, 48202, USA
| | - Jugmohit Toor
- Center for Cutaneous Biology and Immunology Research, Department of Dermatology, Henry Ford Health System, Detroit, MI, 48202, USA
- Immunology Research Program, Henry Ford Cancer Institute, Henry Ford Health System, Detroit, MI, 48202, USA
- Cancer Biology Graduate Program, School of Medicine, Wayne State University, Detroit, MI, 48202, USA
| | - Kalpana Subedi
- Center for Cutaneous Biology and Immunology Research, Department of Dermatology, Henry Ford Health System, Detroit, MI, 48202, USA
- Immunology Research Program, Henry Ford Cancer Institute, Henry Ford Health System, Detroit, MI, 48202, USA
| | - Namir Khalasawi
- Center for Cutaneous Biology and Immunology Research, Department of Dermatology, Henry Ford Health System, Detroit, MI, 48202, USA
- Immunology Research Program, Henry Ford Cancer Institute, Henry Ford Health System, Detroit, MI, 48202, USA
| | - Angela Miller
- Center for Cutaneous Biology and Immunology Research, Department of Dermatology, Henry Ford Health System, Detroit, MI, 48202, USA
| | - Richard Huggins
- Center for Cutaneous Biology and Immunology Research, Department of Dermatology, Henry Ford Health System, Detroit, MI, 48202, USA
| | - Indra Adrianto
- Center for Cutaneous Biology and Immunology Research, Department of Dermatology, Henry Ford Health System, Detroit, MI, 48202, USA
- Immunology Research Program, Henry Ford Cancer Institute, Henry Ford Health System, Detroit, MI, 48202, USA
- Center for Bioinformatics, Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, 48202, USA
| | - Jesse Veenstra
- Center for Cutaneous Biology and Immunology Research, Department of Dermatology, Henry Ford Health System, Detroit, MI, 48202, USA
- Immunology Research Program, Henry Ford Cancer Institute, Henry Ford Health System, Detroit, MI, 48202, USA
| | - Gautham Vellaichamy
- Center for Cutaneous Biology and Immunology Research, Department of Dermatology, Henry Ford Health System, Detroit, MI, 48202, USA
| | - Aakash Hans
- Center for Cutaneous Biology and Immunology Research, Department of Dermatology, Henry Ford Health System, Detroit, MI, 48202, USA
- Immunology Research Program, Henry Ford Cancer Institute, Henry Ford Health System, Detroit, MI, 48202, USA
| | - Steven Daveluy
- Department of Dermatology, Wayne State University School of Medicine, Detroit, MI, 48202, USA
| | - Mohammad Athar
- University of Alabama at Birmingham (UAB) Research Center of Excellence in Arsenicals, Department of Dermatology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Wilson Liao
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - Henry Lim
- Center for Cutaneous Biology and Immunology Research, Department of Dermatology, Henry Ford Health System, Detroit, MI, 48202, USA
| | - David Ozog
- Center for Cutaneous Biology and Immunology Research, Department of Dermatology, Henry Ford Health System, Detroit, MI, 48202, USA
| | - Li Zhou
- Center for Cutaneous Biology and Immunology Research, Department of Dermatology, Henry Ford Health System, Detroit, MI, 48202, USA.
- Immunology Research Program, Henry Ford Cancer Institute, Henry Ford Health System, Detroit, MI, 48202, USA.
- Department of Biochemistry, Microbiology, and Immunology, School of Medicine, Wayne State University, Detroit, MI, 48202, USA.
| | - Qing-Sheng Mi
- Center for Cutaneous Biology and Immunology Research, Department of Dermatology, Henry Ford Health System, Detroit, MI, 48202, USA.
- Immunology Research Program, Henry Ford Cancer Institute, Henry Ford Health System, Detroit, MI, 48202, USA.
- Cancer Biology Graduate Program, School of Medicine, Wayne State University, Detroit, MI, 48202, USA.
- Department of Biochemistry, Microbiology, and Immunology, School of Medicine, Wayne State University, Detroit, MI, 48202, USA.
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Grotenhermen F, Oláh A. Case in Context: Acne Inversa ( Hidradenitis Suppurativa). Cannabis Cannabinoid Res 2023; 8:608-611. [PMID: 37074343 DOI: 10.1089/can.2023.0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Affiliation(s)
| | - Attila Oláh
- Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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34
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Wolinska A, Murray G, Andrawis M, Beatty P, Costa Blasco M, Doyle C, Mc Feely O, Murphy L, Tobin AM. Comparison of Social Media Content on Hidradenitis Suppurativa: A Cross-Sectional Study. Dermatology 2023; 239:840-842. [PMID: 37231820 DOI: 10.1159/000531041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 04/10/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Research has shown that patients may turn to social media seeking information regarding diagnosis and treatment. This study aimed to analyze and compare content related to hidradenitis suppurativa (HS) using the "hashtag" tool across three of the most popular social media platforms to determine the information that patients are exposed to online. METHODS We identified hashtags across Instagram, TikTok, and Facebook for "#hidradenitissuppurativa." The top 50 videos returned by the algorithm across each site were selected for analysis. Data extracted for comparison included content creator demographics, number of followers, type of content (educational vs. noneducational), and associated hashtags. RESULTS Sixty-seven percent of posts were created by females (n = 101/150), 10% by males (n = 16/150), and 22% other (n = 33/150). Distribution was similar across all platforms. User accounts on TikTok have a significantly higher number of followers (median = 38,700, range = 902-17,600,000 followers) compared to Facebook (median = 1,375, range = 58-777,000 followers) and Instagram (median = 2,818, range = 57-9,800 followers). CONCLUSION This study suggests that there is a disproportionate number of patients creating content to raise awareness on HS on social media compared to patient support groups or medical professionals. We propose that social media is a useful platform that dermatologists and official institutional bodies can utilize as an alternative method of health promotion and patient education. Further research to explore social media trends across a range of dermatological conditions can help guide targeted education campaigns in the future.
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Affiliation(s)
- Anna Wolinska
- Department of Dermatology, Tallaght University Hospital, Dublin, Ireland
| | - Gregg Murray
- Department of Dermatology, Beaumont Hospital, Dublin, Ireland
| | - Madonna Andrawis
- Department of Dermatology, Tallaght University Hospital, Dublin, Ireland
| | - Paula Beatty
- Department of Dermatology, Tallaght University Hospital, Dublin, Ireland
| | - Marta Costa Blasco
- Department of Dermatology, Tallaght University Hospital, Dublin, Ireland
| | - Claire Doyle
- Department of Dermatology, Tallaght University Hospital, Dublin, Ireland
| | - Orla Mc Feely
- Department of Dermatology, Tallaght University Hospital, Dublin, Ireland
| | - Lisa Murphy
- Department of Dermatology, Tallaght University Hospital, Dublin, Ireland
| | - Anne-Marie Tobin
- Department of Dermatology, Tallaght University Hospital, Dublin, Ireland
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35
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Schultheis M, Grabbe S, Staubach P, Hennig K, Mauch M, Burckhardt M, Langer G, Heise M, Zamsheva M, Strobel A. Clinical Features of Persons Suffering from Acne Inversa. Dtsch Arztebl Int 2023; 120:345-346. [PMID: 37482806 PMCID: PMC10408280 DOI: 10.3238/arztebl.m2023.0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 10/07/2022] [Accepted: 01/12/2023] [Indexed: 07/25/2023]
Affiliation(s)
- Michael Schultheis
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University Mainz
| | - Stephan Grabbe
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University Mainz
| | - Petra Staubach
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University Mainz
| | - Katharina Hennig
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University Mainz
| | | | - Marion Burckhardt
- German Wound Healing Society, Gießen
- School of Business and Health, Baden-Wuerttemberg Cooperative State University (DHBW) Stuttgart
| | - Gero Langer
- Institute of Health and Nursing Sciences, German Center for Evidence-based Nursing, Martin Luther University Halle-Wittenberg
- Profilzentrum Gesundheitswissenschaften, Medical Faculty of Martin Luther University Halle-Wittenberg
| | - Marcus Heise
- Institute of Health and Nursing Sciences, German Center for Evidence-based Nursing, Martin Luther University Halle-Wittenberg
- Institute of General Practice, Medical Faculty of Martin Luther University Halle-Wittenberg
- Profilzentrum Gesundheitswissenschaften, Medical Faculty of Martin Luther University Halle-Wittenberg
| | - Marina Zamsheva
- Institute of Health and Nursing Sciences, German Center for Evidence-based Nursing, Martin Luther University Halle-Wittenberg
- Institute of Medical Epidemiology, Biometry, and Informatics,Medical Faculty of Martin Luther University Halle-Wittenberg
- Profilzentrum Gesundheitswissenschaften, Medical Faculty of Martin Luther University Halle-Wittenberg
| | - Alexandra Strobel
- Institute of Medical Epidemiology, Biometry, and Informatics,Medical Faculty of Martin Luther University Halle-Wittenberg
- Profilzentrum Gesundheitswissenschaften, Medical Faculty of Martin Luther University Halle-Wittenberg
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36
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Neutrophil migration in hidradenitis suppurativa. Br J Dermatol 2023; 188:e36. [PMID: 37078763 DOI: 10.1093/bjd/ljad093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
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37
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Egeberg A, Thyssen JP. The optimal biologic treatment target for hidradenitis suppurativa remains undiscovered. Lancet 2023; 401:708-710. [PMID: 36746172 DOI: 10.1016/s0140-6736(23)00059-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 01/06/2023] [Indexed: 02/05/2023]
Affiliation(s)
- Alexander Egeberg
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen 2400, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen 2400, Denmark.
| | - Jacob P Thyssen
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen 2400, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen 2400, Denmark
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Kluger N. Rigorous insistence on smoking cessation as a condition for surgery is detrimental for hidradenitis suppurativa patients. Ann Dermatol Venereol 2023; 150:1-2. [PMID: 36813639 DOI: 10.1016/j.annder.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 11/01/2022] [Accepted: 01/13/2023] [Indexed: 02/22/2023]
Affiliation(s)
- N Kluger
- Department of Dermatology, Allergology and Venereology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
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Macchiarella G, Cornacchione V, Cojean C, Riker J, Wang Y, Te H, Ceci M, Gudjonsson JE, Gaulis S, Goetschy JF, Wollschlegel A, Gass SK, Oetliker-Contin S, Wettstein-Ling B, Schaefer DJ, Meschberger P, de Roche R, Osinga R, Wieczorek G, Naumann U, Lehmann JCU, Schubart A, Hofmann A, Roth L, Florencia EF, Loesche C, Traggiai E, Avrameas A, Prens EP, Röhn TA, Roediger B. Disease Association of Anti‒Carboxyethyl Lysine Autoantibodies in Hidradenitis Suppurativa. J Invest Dermatol 2023; 143:273-283.e12. [PMID: 36116506 DOI: 10.1016/j.jid.2022.08.051] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 08/01/2022] [Accepted: 08/05/2022] [Indexed: 01/25/2023]
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by recurring suppurating lesions of the intertriginous areas, resulting in a substantial impact on patients' QOL. HS pathogenesis remains poorly understood. An autoimmune component has been proposed, but disease-specific autoantibodies, autoantigens, or autoreactive T cells have yet to be described. In this study, we identify a high prevalence of IgM, IgG, and IgA antibodies directed against Nε-carboxyethyl lysine (CEL), a methylglyoxal-induced advanced glycation end-product, in the sera of patients with HS. Titers of anti-CEL IgG and IgA antibodies were highly elevated in HS compared with those in healthy controls and individuals with other inflammatory skin diseases. Strikingly, the majority of anti-CEL IgG was of the IgG2 subclass and correlated independently with both disease severity and duration. Both CEL and anti-CEL‒producing plasmablasts could be isolated directly from HS skin lesions, further confirming the disease relevance of this autoimmune response. Our data point to an aberration of the methylglyoxal pathway in HS and support an autoimmune axis in the pathogenesis of this debilitating disease.
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Affiliation(s)
- Giulio Macchiarella
- Biomarker Development (BMD), Novartis Institutes for BioMedical Research, Novartis Pharma AG, Basel, Switzerland; Biozentrum, Faculty of Sciences, University of Basel, Basel, Switzerland
| | - Vanessa Cornacchione
- NIBR Biologics Center (NBC), Novartis Institutes for BioMedical Research, Novartis Pharma AG, Basel, Switzerland
| | - Celine Cojean
- Autoimmunity, Transplantation and Inflammation (ATI) Disease Area, Novartis Institutes for BioMedical Research, Novartis Pharma AG, Basel, Switzerland
| | - Julia Riker
- Autoimmunity, Transplantation and Inflammation (ATI) Disease Area, Novartis Institutes for BioMedical Research, Novartis Pharma AG, Basel, Switzerland
| | - Yichen Wang
- Autoimmunity, Transplantation and Inflammation (ATI) Disease Area, Novartis Institutes for BioMedical Research, Novartis Pharma AG, Basel, Switzerland
| | - Helene Te
- Autoimmunity, Transplantation and Inflammation (ATI) Disease Area, Novartis Institutes for BioMedical Research, Novartis Pharma AG, Basel, Switzerland
| | - Melanie Ceci
- Autoimmunity, Transplantation and Inflammation (ATI) Disease Area, Novartis Institutes for BioMedical Research, Novartis Pharma AG, Basel, Switzerland
| | | | - Swann Gaulis
- Autoimmunity, Transplantation and Inflammation (ATI) Disease Area, Novartis Institutes for BioMedical Research, Novartis Pharma AG, Basel, Switzerland
| | - Jean François Goetschy
- Autoimmunity, Transplantation and Inflammation (ATI) Disease Area, Novartis Institutes for BioMedical Research, Novartis Pharma AG, Basel, Switzerland
| | - Audrey Wollschlegel
- Autoimmunity, Transplantation and Inflammation (ATI) Disease Area, Novartis Institutes for BioMedical Research, Novartis Pharma AG, Basel, Switzerland
| | - Stephanie K Gass
- Department of Plastic, Reconstructive & Aesthetic Surgery and Hand Surgery, University Hospital, University of Basel, Switzerland
| | - Sofia Oetliker-Contin
- Department of Plastic, Reconstructive & Aesthetic Surgery and Hand Surgery, University Hospital, University of Basel, Switzerland
| | - Barbara Wettstein-Ling
- Department of Plastic, Reconstructive & Aesthetic Surgery and Hand Surgery, University Hospital, University of Basel, Switzerland
| | - Dirk J Schaefer
- Department of Plastic, Reconstructive & Aesthetic Surgery and Hand Surgery, University Hospital, University of Basel, Switzerland
| | | | | | - Rik Osinga
- Department of Plastic, Reconstructive & Aesthetic Surgery and Hand Surgery, University Hospital, University of Basel, Switzerland; Praxis beim Merian Iselin, Basel, Switzerland
| | - Grazyna Wieczorek
- Autoimmunity, Transplantation and Inflammation (ATI) Disease Area, Novartis Institutes for BioMedical Research, Novartis Pharma AG, Basel, Switzerland
| | - Ulrike Naumann
- Chemical Biology and Therapeutics (CBT), Novartis Institutes for BioMedical Research, Novartis Pharma AG, Basel, Switzerland
| | - Joachim C U Lehmann
- Autoimmunity, Transplantation and Inflammation (ATI) Disease Area, Novartis Institutes for BioMedical Research, Novartis Pharma AG, Basel, Switzerland
| | - Anna Schubart
- Autoimmunity, Transplantation and Inflammation (ATI) Disease Area, Novartis Institutes for BioMedical Research, Novartis Pharma AG, Basel, Switzerland
| | - Andreas Hofmann
- Biotherapeutic and Analytical Technologies, Novartis Institutes for BioMedical Research, Novartis Pharma AG, Basel, Switzerland
| | - Lukas Roth
- Autoimmunity, Transplantation and Inflammation (ATI) Disease Area, Novartis Institutes for BioMedical Research, Novartis Pharma AG, Basel, Switzerland
| | - Edwin F Florencia
- Department of Dermatology, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Christian Loesche
- Translational Medicine, Novartis Institutes for BioMedical Research, Novartis Pharma AG, Basel, Switzerland
| | - Elisabetta Traggiai
- NIBR Biologics Center (NBC), Novartis Institutes for BioMedical Research, Novartis Pharma AG, Basel, Switzerland
| | - Alexandre Avrameas
- Biomarker Development (BMD), Novartis Institutes for BioMedical Research, Novartis Pharma AG, Basel, Switzerland
| | - Errol P Prens
- Department of Dermatology, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Till A Röhn
- Autoimmunity, Transplantation and Inflammation (ATI) Disease Area, Novartis Institutes for BioMedical Research, Novartis Pharma AG, Basel, Switzerland
| | - Ben Roediger
- Autoimmunity, Transplantation and Inflammation (ATI) Disease Area, Novartis Institutes for BioMedical Research, Novartis Pharma AG, Basel, Switzerland.
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40
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Okun MM. The promise of personalized medicine for hidradenitis suppurativa. Br J Dermatol 2023; 188:3. [PMID: 36689524 DOI: 10.1093/bjd/ljac033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 10/05/2022] [Indexed: 01/22/2023]
Affiliation(s)
- Martin M Okun
- Dermatology Department, Fort HealthCare, Fort Atkinson, WI, USA
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Schneider-Burrus S, Kalus S, Fritz B, Wolk K, Gomis-Kleindienst S, Sabat R. The impact of hidradenitis suppurativa on professional life. Br J Dermatol 2023; 188:122-130. [PMID: 36689513 DOI: 10.1093/bjd/ljac027] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/19/2022] [Accepted: 09/24/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is a chronic inflammatory disease that affects intertriginous skin. OBJECTIVES To determine the extent of work ability and productivity impairment as a result of HS in Germany. METHODS A prospective, multicentre, epidemiological, noninterventional study of patients with HS was conducted. Medical history, medical examination performed by dermatologists and patient-reported outcomes [Work Ability Index (WAI) and Work Productivity and Activity Impairment (WPAI)] were collected. RESULTS Of the 481 patients with HS included in the study, 99% were below the current statutory retirement age. In total, 53·3% of patients were working full time, 16·8% part time and 7·3% had retired. The unemployment rate was 12·6%, two times higher than in the general German population. Medical leave because of HS, within the last 6 months, was reported in 41·4% [95% confidence interval (CI) 36·9-46·0], with a duration of 39·3 days on average (95% CI 32·4-46·1). The mean HS-related WPAI absenteeism was 13.3% (95% CI 9·7-16·8), and the loss in productivity because of HS during working hours (WPAI presenteeism) was 25.2% (95% CI 21·8-28·6). Presenteeism was associated with HS disease severity. Overall work impairment because of HS was 33·4% (95% CI 29·3-37·6). The WAI score for patients was 32·2, ∼20% lower than for the average German employee. Only 62·8% of patients were relatively certain that they would be able to perform their work in the coming 2 years. Being more depressed and having more severe pain were associated with lower work ability and overall work impairment. The estimated annual loss of gross value added because of HS for Germany was ∼€12.6 billion (€3.3 billion related to a lower employment rate, €3.5 billion related to absenteeism and €5.8 billion related to presenteeism). CONCLUSIONS HS leads to a substantial decrease in work ability and productivity and considerable loss of gross value added. Impairment during working hours correlates with disease severity, underlining the socioeconomic importance of early and adequate treatment. Furthermore, decreased work ability and productivity is linked to depressed mood and severe pain, aspects that need more attention in patient care.
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Affiliation(s)
- Sylke Schneider-Burrus
- Interdisciplinary Group of Molecular Immunopathology, Dermatology/Medical Immunology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Centre for Dermatosurgery, Havelklinik, Gatower Str. 191, 13595 Berlin, Germany
| | - Stefanie Kalus
- GKM Gesellschaft für Therapieforschung mbH, Lessingstraße 14, 80336 Munich, Germany
| | - Björn Fritz
- AbbVie Deutschland GmbH & Co. KG, Mainzer Straße 81, 65189 Wiesbaden, Germany
| | - Kerstin Wolk
- Interdisciplinary Group of Molecular Immunopathology, Dermatology/Medical Immunology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Psoriasis Research and Treatment Centre, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | | | - Robert Sabat
- Interdisciplinary Group of Molecular Immunopathology, Dermatology/Medical Immunology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Psoriasis Research and Treatment Centre, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
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Lived experiences of patients with hidradenitis suppurativa-related pain. Br J Dermatol 2023; 188:e6. [PMID: 36689534 DOI: 10.1093/bjd/ljac162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Kearney N, Kirby B. The devastating impact of hidradenitis suppurativa on employment. Br J Dermatol 2023; 188:9-10. [PMID: 36689516 DOI: 10.1093/bjd/ljac079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 10/05/2022] [Indexed: 01/11/2023]
Affiliation(s)
- Niamh Kearney
- Department of Dermatology, St Vincent's University Hospital, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Brian Kirby
- Department of Dermatology, St Vincent's University Hospital, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
- Charles Institute of Dermatology, University College Dublin, Dublin, Ireland
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Brown-Korsah JB, McKenzie S, Omar D, Syder NC, Elbuluk N, Taylor SC. Variations in genetics, biology, and phenotype of cutaneous disorders in skin of color - Part I: Genetic, biologic, and structural differences in skin of color. J Am Acad Dermatol 2022; 87:1239-1258. [PMID: 35809800 DOI: 10.1016/j.jaad.2022.06.1193] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 05/27/2022] [Accepted: 06/13/2022] [Indexed: 11/18/2022]
Abstract
Skin of color (SOC) populations include those who identify as Black/African, Hispanic/Latinx, Asian/Pacific Islander, American Indian/Native Alaskan, Indigenous Australian, Middle Eastern, biracial/multiracial, or non-White; this list is far from exhaustive and may vary between and within cultures. Recent genetic and immunological studies have suggested that cutaneous inflammatory disorders (atopic dermatitis, psoriasis, and hidradenitis suppurativa) and malignancies (melanoma, basal cell carcinoma, and cutaneous T-cell lymphoma) may have variations in their immunophenotype among SOC. Additionally, there is growing recognition of the substantial role social determinants of health play in driving health inequalities in SOC communities. It is critically important to understand that social determinants of health often play a larger role than biologic or genetic factors attributed to "race" in health care outcomes. Herein, we describe the structural, genetic, and immunological variations and the potential implications of these variations in populations with SOC. This article underscores the importance of increasing the number of large, robust genetic studies of cutaneous disorders in SOC to create more targeted, effective therapies for this often underserved and understudied population. Part II of this CME will highlight the clinical differences in the phenotypic presentation of and the health disparities associated with the aforementioned cutaneous disorders in SOC.
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Affiliation(s)
- Jessica B Brown-Korsah
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; Case Western Reserve University, School of Medicine, Cleveland, Ohio
| | - Shanice McKenzie
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Deega Omar
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; George Washington University, School of Medicine and Health Sciences, Washington, District of Columbia
| | - Nicole C Syder
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Nada Elbuluk
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Susan C Taylor
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
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Cordero-Ramos J, Merino-Bohórquez V, Delgado-Valverde M, Barros-Tornay R, Cameán-Fenández M, Calleja-Hernández MÁ. Formulation, long-term physicochemical and microbiological stability of 15% topical resorcinol for hidradenitis suppurativa. Eur J Hosp Pharm 2022; 29:313-318. [PMID: 33328205 PMCID: PMC9614138 DOI: 10.1136/ejhpharm-2020-002534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 11/19/2020] [Accepted: 12/01/2020] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Topical resorcinol 15% is a self-treatment for painful hidradenitis suppurativa nodules and abscesses with good results in reducing pain and lesion duration. The aim of this study is to establish a 15% topical resorcinol formula, to develop a physicochemical and microbiological stability study and to further determine the compounding shelf-life in different package conditions following the European Pharmacopoeia (Ph. Eur.) specifications. METHODS Physicochemical and microbiological stability studies of the formulation were conducted for 12 months at room temperature (25°C±2°C) in different package conditions: aluminium tubes (aluminium A7-99.7% varnish DF-6172), plastic tubes (low density polyethylene) and amber plastic containers (polyethylene terephthalate). High performance liquid chromatography (HPLC) was developed as a method of indicating the stability of the resorcinol formulation. A microbiological growth assay was also validated according to the Ph. Eur. Physical properties were inspected to determine parameters such as odour, colour, pH, emulsion phase and extensibility index and its evolution. RESULTS The HPLC method was validated according to the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines. At day 365, visual inspection remained unchanged only for preparations packaged in aluminium tubes. The pH did not vary by more than 0.3 units in all conditions. The extensibility index decreased in the preparations packaged in plastic and amber plastic containers. HPLC analysis conducted over 1 year did not show a degradation greater than 7% of resorcinol in the preparation in plastic and aluminium packages. The ability of ATCC strains to grow in resorcinol formulation was confirmed under the suitability test. Resorcinol packed in aluminium tubes achieved microbiological stability at day 365. CONCLUSIONS Only the formulation package in aluminium tubes showed physicochemical and microbiological stability of resorcinol for 12 months at room temperature (25°C±2°C).
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Affiliation(s)
- Jaime Cordero-Ramos
- Pharmacy Unit, Hospital Universitario Virgen Macarena, Sevilla, Spain
- Department of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, Universidad de Sevilla, Sevilla, Spain
| | - Vicente Merino-Bohórquez
- Pharmacy Unit, Hospital Universitario Virgen Macarena, Sevilla, Spain
- Department of Pharmacology, Faculty of Pharmacy, Universidad de Sevilla, Sevilla, Spain
| | - Mercedes Delgado-Valverde
- Infectious Diseases, Clinical Microbiology and Preventative Medicine Unit, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen Macarena/CSIC/Universidad de Sevilla, Sevilla, Spain
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Moon S, Jang YK, Shin JU, Kim DH, Lee HJ. Innate Immunity Protein Markers Are Significantly Elevated in Hidradenitis Suppurativa Skin Than in Psoriasis Vulgaris. Yonsei Med J 2022; 63:971-973. [PMID: 36168251 PMCID: PMC9520045 DOI: 10.3349/ymj.2022.0160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/14/2022] [Accepted: 08/09/2022] [Indexed: 11/27/2022] Open
Affiliation(s)
- Sujin Moon
- CHA University College of Medicine, Seongnam, Korea
| | - Yun Kyung Jang
- Department of Dermatology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Jung U Shin
- Department of Dermatology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Dong Hyun Kim
- Department of Dermatology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Hee Jung Lee
- Department of Dermatology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.
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van Straalen KR, Dudink K, Aarts P, van der Zee HH, van den Bosch TPP, Giang J, Prens EP, Damman J. Complement activation in Hidradenitis suppurativa: Covert low-grade inflammation or innocent bystander? Front Immunol 2022; 13:953674. [PMID: 36211440 PMCID: PMC9535337 DOI: 10.3389/fimmu.2022.953674] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/04/2022] [Indexed: 11/13/2022] Open
Abstract
Hidradenitis suppurativa (HS) is a chronic auto-inflammatory skin disease with a complex and multifactorial pathogenesis involving both the innate and adaptive immune system. Despite limited evidence for local complement activation, conflicting results have been published on the role of systemic complement activation in HS. It was hypothesized that complement was consumed in highly inflamed HS skin, trapping complement from the circulation. Therefore, the aim of this study was to evaluate this local complement deposition in HS skin lesions using routine and commonly used complement antibodies.Direct immunofluorescence for C1q, C3c, C4d, C5b-9, and properdin was performed on frozen tissue sections of 19 HS patients and 6 controls. C5a receptor 1 (C5aR1) was visualized using immunohistochemistry.Overall, we found no significant local complement deposition in HS patients versus controls regarding C1q, C3c, C4d, C5b-9, or properdin on either vessels or immune cells. C5aR1 expression was exclusively found on immune cells, predominantly neutrophilic granulocytes, but not significantly different relatively to the total infiltrate in HS lesions compared with controls. In conclusion, despite not being able to confirm local complement depositions of C1q, C3c, C4d, or properdin using highly sensitive and widely accepted techniques, the increased presence of C5aR1 positive immune cells in HS suggests the importance of complement in the pathogenesis of HS and supports emerging therapies targeting this pathway.
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Affiliation(s)
- K. R. van Straalen
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, United States
| | - K. Dudink
- Department of Dermatology, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands
| | - P. Aarts
- Department of Dermatology, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands
| | - H. H. van der Zee
- Department of Dermatology, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands
| | - T. P. P. van den Bosch
- Department of Pathology, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands
| | - J. Giang
- Department of Pathology, Maasstad Hospital, Rotterdam, Netherlands
| | - E. P. Prens
- Department of Dermatology, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands
- Laboratory for Experimental Immunodermatology, Department of Dermatology, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands
| | - J. Damman
- Department of Pathology, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands
- *Correspondence: J. Damman,
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Aroonsakul N, Phinyo P, Lumkul L, Jarupanich N, Szepietowski J, Chuamanochan M, Nochaiwong S. Pharmacological interventions for hidradenitis suppurativa: a protocol for systematic review and network meta-analysis of randomised trials and non-randomised studies. BMJ Open 2022; 12:e062351. [PMID: 36691211 PMCID: PMC9462131 DOI: 10.1136/bmjopen-2022-062351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 08/14/2022] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION Therapeutic recommendations for hidradenitis suppurativa (HS) have recently shifted towards non-invasive pharmacological options. Recent evidence has shown promising efficacy for specific treatments. However, data regarding the comparative efficacy of these treatments in patients with HS are still limited. Therefore, we plan to conduct a systematic review and network meta-analysis (NMA) to summarise the benefits and harms of different pharmacological interventions for treating people living with HS. METHODS AND ANALYSIS We will search electronic databases, including Medline, Embase, PubMed, Web of Science, Scopus, CINAHL and Cochrane Library beginning from their inception dates with no language restrictions. A grey literature search will be performed to supplement the electronic databases. Both randomised trials and non-randomised studies using validated measurement tools that investigated the benefits and harms of pharmacological interventions among people living with HS will be included. The predefined primary outcomes will include treatment responses that reflect the patient's perspective and all-cause discontinuation. Screening, selection, extraction, assessment of the risk of bias and analysis of the strength of the evidence will be performed independently by a pair of reviewers. A two-step approach of traditional pairwise and NMA will be performed. Based on a random-effects model, standardised weighted mean differences and ORs with corresponding 95% CIs will be pooled as effect estimates for the continuous and categorical endpoints, respectively. Statistical and methodological heterogeneities will be assessed. Preplanned subgroup analyses and univariate meta-regression will be conducted to quantify the potential sources of heterogeneity. Evidence-based synthesis will be based on the magnitudes of effect size, evidence certainty and the surface under the cumulative ranking curve values. ETHICS AND DISSEMINATION Ethical approval is not required because this study is based on existing published data. These findings will be disseminated through scientific meetings and publications in peer-reviewed journals. PROSPERO REGISTRATION NUMBER CRD42022302795.
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Affiliation(s)
| | - Phichayut Phinyo
- Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Suthep, Thailand
| | - Lalita Lumkul
- Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | - Jacek Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Mati Chuamanochan
- Department of Internal Medicine, Chiang Mai University, Muang, Thailand
- Pharmacoepidemiology and Statistics Research Center (PESRC), Chiang Mai University, Chiang Mai, Thailand
| | - Surapon Nochaiwong
- Pharmacoepidemiology and Statistics Research Center (PESRC), Chiang Mai University, Chiang Mai, Thailand
- Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand
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Seetan K, Eldos B, Saraireh M, Omari R, Rubbai Y, Jayyusi A, Abu Jubran M. Prevalence of low vitamin D levels in patients with Hidradenitis suppurativa in Jordan: A comparative cross-sectional study. PLoS One 2022; 17:e0265672. [PMID: 35303020 PMCID: PMC8932615 DOI: 10.1371/journal.pone.0265672] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 03/06/2022] [Indexed: 12/26/2022] Open
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the apocrine gland bearing skin, presenting various stages of flexural skin pain, erythema, painful nodules, abscesses, sinuses, and fistulas. We aimed to assess serum vitamin D levels in patients with (HS) in Jordan. a cross-sectional comparative study conducted among 110 patients with HS and 110 matched controls, who didn’t previously receive vitamin D therapy. Serum vitamin D was measured and classified into normal (>30 ng/ml), insufficient (20–30 ng/ml), and low (<20 ng/ml). The mean age of the cases was 43.1 ± 12.9 years and the mean disease duration was 19.4 months. The mean body mass index among patients with HS was 30 and about 34% of them were smokers. The mean Vitamin D level was 8.4 ng/ml and all HS patients were vitamin D deficient. Patients of HS were more likely to have vitamin D deficiency compared to healthy controls. Most of the study subjects and particularly all of the patients with HS have low vitamin D levels. Smoking and high BMI, were associated with HS. We suggest the implementation standard public dietary recommendations of Vitamin D supplementation, smoking cessation, and weight reduction behaviors with further assessment of disease course among HS patients.
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Affiliation(s)
- Khaled Seetan
- Department of Clinical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
- * E-mail:
| | - Batool Eldos
- Department of Clinical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Muthanna Saraireh
- Department of Clinical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Rami Omari
- Department of Clinical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Yousef Rubbai
- Princess Aisha Bint Al-Hussein College of Nursing and Health Sciences, Al-Hussein Bin Talal University, Maan, Jordan
| | - Anas Jayyusi
- Department of Clinical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Maha Abu Jubran
- Department of Clinical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
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Lorite-Fuentes I, Montero-Vilchez T, Arias-Santiago S, Molina-Leyva A. Potential Benefits of the Mediterranean Diet and Physical Activity in Patients with Hidradenitis Suppurativa: A Cross-Sectional Study in a Spanish Population. Nutrients 2022; 14:nu14030551. [PMID: 35276909 PMCID: PMC8840522 DOI: 10.3390/nu14030551] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 02/01/2023] Open
Abstract
There is scarce scientific information regarding the potential benefits of healthy lifestyles in patients with hidradenitis suppurativa (HS). The objective of this study is to explore the potential association between the adherence to a Mediterranean diet (MD), physical activity and HS severity. A cross-sectional study that included patients with HS was conducted. Disease severity was evaluated by the International Hidradenitis Suppurativa Severity Score System (IHS4) and self-reported disease activity using a Numeric Rating Scale (NRS, 0−10). The adherence to a MD was assessed by the PREvención con DIeta MEDiterránea (PREDIMED) questionnaire and the level of physical activity by the International Physical Activity questionnaire. A total of 221 patients with HS were included in our study. The adherence to a MD was average for a Spanish population. A higher adherence to a MD was associated with lower disease activity, lower self-reported Hurley and lower IHS4. The use of extra virgin olive oil as the main culinary lipid was the dietary habit that implied a lower degree of disease activity (p < 0.05). Regarding physical activity, both the self-reported severity and IHS4 presented an inverse association with the intensity of physical activity. The adherence to a MD and the intensity of physical activity were positively associated. The Mediterranean dietary pattern may have an impact on HS. Greater adherence to a MD is related to lower HS severity and more physical activity also correlates to lower disease severity. The MD could be an appropriate dietary pattern for patients with HS due to its anti-inflammatory properties, and combining this with increased levels of physical activity could have additional benefits.
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Affiliation(s)
- Irene Lorite-Fuentes
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Avenida de Madrid 15, 18014 Granada, Spain;
| | - Trinidad Montero-Vilchez
- Hidradenitis Suppurativa Clinic, Dermatology, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain; (T.M.-V.); (A.M.-L.)
- Instituto de Investigación Biosanitaria Granada, 18014 Granada, Spain
| | - Salvador Arias-Santiago
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Avenida de Madrid 15, 18014 Granada, Spain;
- Hidradenitis Suppurativa Clinic, Dermatology, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain; (T.M.-V.); (A.M.-L.)
- Instituto de Investigación Biosanitaria Granada, 18014 Granada, Spain
- Correspondence: ; Tel.: +34-958023422
| | - Alejandro Molina-Leyva
- Hidradenitis Suppurativa Clinic, Dermatology, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain; (T.M.-V.); (A.M.-L.)
- Instituto de Investigación Biosanitaria Granada, 18014 Granada, Spain
- European Hidradenitis Suppurativa Foundation (EHSF), 06844 Dessau-Roßlau, Germany
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