Expert consensus on priority research gaps in dietary and lifestyle factors in hidradenitis suppurativa: a Delphi consensus study

Yamanaka‐Takaichi, Mika; Revankar, Rishab; Shih, Terri; Gall, Margaret; Hsiao, Jennifer L.; Shi, Vivian Y.; Alavi, Afsáneh

doi:10.1007/s00403-023-02610-9

Cited by 3 publications

(3 citation statements)

References 51 publications

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“…Finally, among the exacerbating factors in HS, diet plays a key role [ 18 ]. Notably, recent studies have highlighted the potential impact of diet on HS, including the significance of the Mediterranean diet [ 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

“…Recently proposed as an obesity management nutritional strategy, the Very Low-Calorie Ketogenic Diet (VLCKD), through the production of ketone bodies, was associated with a significant reduction in body weight, inflammatory status, and gut microbiota composition [ 21 – 23 ]. While data on the efficacy of VLCKD in psoriasis is available, the efficacy of VLCKD in improving the clinical severity of HS has not been established in clinical studies, and there is no evidence in the literature [ 15 , 18 ]. Dietary strategies for reducing inflammation and body weight represent a topic of great interest to both nutritionists and dermatologists.…”

Section: Introductionmentioning

confidence: 99%

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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

Verde,

Cacciapuoti,

Caiazzo

et al. 2024

J Transl Med

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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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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Verde,

Cacciapuoti,

Caiazzo

et al. 2024

J Transl Med

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“…Although the exact pathophysiology of HS is unclear, the prevailing theory is that the condition is caused by the follicular occlusion of the folliculopilosebaceous unit, followed by rupture and inflammation [9][10][11]. Furthermore, a mutation in the γ-secretase enzyme that leads to the failure of keratin degradation has been linked to HS [12,13].…”

Section: Introductionmentioning

confidence: 99%

The Role of FDG-PET in the Evaluation of Hidradenitis Suppurativa: A Systematic Review

Talasila,

Teichner,

Subtirelu

et al. 2023

JCM

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Hidradenitis suppurativa (HS) is a chronic skin disorder characterized by nodules, comedones, and sinus tracts that often leave prominent scarring. In recent years, non-invasive imaging techniques have been used to assess the inflammatory activity, vascularization, and treatment response of lesions. Specifically, fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) scans may aid in identifying systemic inflammation in patients with HS, improving diagnosis. Inflamed hypermetabolic tissues exhibit a greater uptake of FDG due to increased glucose uptake and vascularity. A systematic review was conducted to summarize the utility of nuclear imaging techniques in the diagnosis and treatment follow-up of HS. PubMed, Scopus, and ScienceDirect databases were utilized for relevant articles discussing the utility of PET scans in managing HS. A total of 51 citations were identified in the initial search. Following the review of titles, abstracts, and duplicates, 43 articles were excluded, leaving a total of eight articles for analysis. Data were extracted from each article, encompassing the number of patients, imaging techniques employed, and final results. An analysis of the data demonstrated that FDG-PET showed evidence of identifying subclinical lesions of the disease, improving the visualization of HS, and providing an objective method of assessing severity.

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Differentiating clinical characteristics of perianal inflammatory bowel disease from perianal hidradenitis suppurativa

Yamanaka‐Takaichi,

Nadalian,

Loftus

et al. 2024

Int J Dermatology

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BackgroundPerianal draining tunnels in hidradenitis suppurativa (HS) and perianal fistulizing inflammatory bowel disease (IBD) present diagnostic and management dilemmas.MethodsWe conducted a retrospective chart review of patients with perianal disease evaluated at Mayo Clinic from January 1, 1998, through July 31, 2021. Patients' demographic and clinical data were extracted, and 28 clinical features were collected. After experimenting with several machine learning techniques, random forests were used to select the 15 most important clinical features to construct the diagnostic prediction model to distinguish perianal HS from fistulizing perianal IBD.ResultsA total of 263 patients were included (98 with HS, 100 with IBD, and 65 with both IBD and HS). Patients with HS had a higher mean body mass index, a higher smoking rate, and more commonly showed cutaneous manifestations of tunnels and comedones, while fistulas, abscesses, induration, anal tags, ulcers, and anal fissures were more common in patients with IBD. In addition to having lesions in the perianal area, patients with IBD often had lesions in the buttocks and perineum, while those with HS had additional lesions in the axillae and groin. Among the statistically significant features, the 15 most important were identified by random forest: fistula, tunnel, digestive symptom, knife‐cut ulcer, perineum, body mass index, age, axilla, abscess, tags, smoking, groin, genital cutaneous edema, erythema, and bilateral/unilateral.ConclusionsThe results of this study may help differentiate perianal lesions, especially perineal HS and fistulizing perineal IBD, and provide promise for a better therapeutic outcome.

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Expert consensus on priority research gaps in dietary and lifestyle factors in hidradenitis suppurativa: a Delphi consensus study

Cited by 3 publications

References 51 publications

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

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

The Role of FDG-PET in the Evaluation of Hidradenitis Suppurativa: A Systematic Review

Differentiating clinical characteristics of perianal inflammatory bowel disease from perianal hidradenitis suppurativa

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