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Microbiome in Hidradenitis Suppurativa: Current Evidence and Practice

  • Wound Care (H Lev-Tov, Section Editor)
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Abstract

Purpose

The role of the host microbiome in hidradenitis suppurativa (HS) is heavily debated. Previous culture-based methods have not led to strong conclusions. Despite antibiotics being a mainstay of HS treatment, microbiome research in other cutaneous inflammatory diseases such as atopic dermatitis and psoriasis is more robust. This review evaluates the current evidence regarding the influence of skin and gut dysbiosis on HS pathogenesis. Current and potential future microbiome modulating therapeutic modalities are also discussed.

Recent Findings

Newer studies using 16S genome sequencing have furthered our understanding of the human microbiome. We find promising evidence for cutaneous dysbiosis but limited evidence for gut dysbiosis.

Summary

Both areas need future studies focusing on the temporal relationship between the microbiome and disease flare and remission and the impact of treatments on the microbiome. Detailed knowledge of microbial shifts will lead to innovations in diagnosis and treatment in the era of precision medicine.

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Authors and Affiliations

  1. University of Illinois College of Medicine, 808 S. Wood St. - 380 CME, Chicago, IL, 60612-7307, USA

    Jonwei Hwang

  2. Department of Dermatology, University of Arkansas for Medical Sciences, 4301 West Markham, Slot 576, Little Rock, AR, 72205, USA

    Jonathan Rick & Vivian Y. Shi

  3. Division of Dermatology, University of California, 200 Medical Plaza, Los AngelesLos Angeles, CA, 90035, USA

    Jennifer Hsiao

  4. Department of Dermatology, Henry Ford Health System, 3031 W Grand Blvd, Detroit, MI, 48202, USA

    Iltefat H. Hamzavi

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Conflict of Interest

VYS is on the board of directors for the Hidradenitis Suppurativa Foundation (HSF), is a stock shareholder of Learn Health, and has served as an advisory board member, investigator, speaker, and/or received research funding from Sanofi Genzyme, Regeneron, AbbVie, Eli Lilly, Novartis, SUN Pharma, LEO Pharma, Pfizer, Menlo Therapeutics, Dermira, Burt’s Bees, Galderma, Kiniksa, UCB, Altus Lab, MYOR, Polyfin, GpSkin, and Skin Actives Scientific. IHH has served as an advisory board member, investigator, and/or received research funding from Abbvie, Pfizer, Lenicura, Incyte, UCB, and Boehringer Ingelheim and serves as a non-compensated board member at the HS foundation. JLH is on the board of directors for the Hidradenitis Suppurativa Foundation (HSF) and has served as an advisory board member for Novartis and speaker for AbbVie. The other authors have no relevant COI to declare.

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Hwang, J., Rick, J., Hsiao, J. et al. Microbiome in Hidradenitis Suppurativa: Current Evidence and Practice. Curr Derm Rep 11, 21–39 (2022). https://doi.org/10.1007/s13671-021-00349-y

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