Passive smoking and hidradenitis suppurativa: a retrospective analysis

Abstract

Dear Editor, Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the hair follicle presenting with recurrent painful nodules, abscesses, fistulas and scarring on the apocrine gland-rich areas. 1 Smoking is recognized as one of the main risk factors in HS development and its prevalence is high, varying between 40% and 90%. 1 Despite some conflicting results, smoking has been linked to severity, 1,2 extension 3 and weaker treatment response. 4,5 Passive smoking refers to the involuntary inhalation of tobacco smoke and appears to be equally responsible for the development of numerous pathologies. However, the prevalence of passive smoking in HS patients and its role in the disease has not been described.A retrospective analysis of HS patients observed in a tertiary hospital, between January 2014 and May 2022, was conducted. Patients declared as nonsmokers were identified, and a telephone survey was carried out to assess passive smoking. Exposure to passive smoking was assessed by selfreport and was defined as living with someone who smokes or working or spending time regularly with people who are smoking. Descriptive statistics were calculated to determine passive smoking prevalence and characterize the active and passive smokers group. In addition, the association between smoking and age at onset and severity of disease (iHS4) was analysed, using the Kruskal-Wallis test. Post hoc pairwise comparisons were conducted using the Dunn test for multiple comparisons with Bonferroni correction. p < 0.05 was considered statistically significant.A total of 266 patients were included, 71.1% (n = 189) smokers and 28.9% (n = 77) declared as nonsmokers. Passive smoking was identified in 53.2% (n = 41) of patients who had declared themselves as nonsmokers at the baseline visit. Unintentional tobacco smoke exposure was mostly recorded at home (87.8%). Characteristics of smokers (active and passive) are summarized in Table 1. The age at disease onset was different in smoking (active and passive) and nonsmoking groups (p < 0.001). No significant statistical difference was found between disease severity (iHS4), p = 0.382 (Table 2).Despite the high prevalence of smokers in HS patients and the common belief that smoking is related to disease development, available studies linking tobacco with HS development are sparse. The prevalence of active smoking in our population (71.3%) is aligned with the previously described. However, global (active and passive) tobacco exposure (86.7%) and particularly the prevalence of passive smoking (53.2% of patients declared as nonsmokers and 15.4% of total) have not been reported so far. In our sample, smoking seems

“It’s Like Having an Uncontrolled Situation”: Using Body Maps to Understand the Embodied Experiences of People with Hidradenitis Suppurativa, a Chronic Dermatological Condition

“…The couple of participants who represented the passage of time related to their HS diagnosis demonstrated the continued importance of Bury's (1982) notion of biographical disruption. However, this is often more complicated for HS patients, as many see the onset of the illness as the disruption of their life trajectory rather than the diagnosis itself, given that HS can sometimes take years to diagnose (Aparício Martins et al 2023). This study also builds on previous applications of biographical disruption in dermatological conditions (Jobling 1988; Al-Muhandis 2024) that importantly highlight how disfigurement is somewhat unique to these conditions.…”

S2k-Leitlinie zur Therapie der Hidradenitis suppurativa/Acne inversa (ICD-10-Code: L73.2)

“…Klinisch korrelierte die Erkrankungsschwere der HS/AI und das Ansprechen auf eine Therapie in 2 Studien mit den Rauchgewohnheiten [152,153]. Eine neuere Studie unterstreicht den Zusammenhang zwischen Rauchen und HS/AI, indem sie zeigt, dass mehr als 50 % der vermeintlichen Nichtraucher dem Zigarettenrauch passiv ausgesetzt waren [154]. Ein solcher starker Zusammenhang weist auf das Rauchen als Risikofaktor für HS/AI hin [11].…”

Hidradenitis suppurativa associated telomere‐methylome dysregulations in blood

“…The immunopathology of HS includes genetic factors and environmental factors including obesity and smoking (both active and passive) and various epigenetic alterations have been reported. [6][7][8][9][10][11][12] Studies of various large-scale exomes and candidate γ-secretase gene mutations have been reported to have identified ~80 different gene variants involved in HS disease aetiology across the globe, 13,14 as well as genetic heterogeneity. 15 Most variants were detected in patients with a family history of HS, but a small number were also found in sporadic cases.…”