Bacterial Colonization in Hidradenitis Suppurativa/Acne Inversa: A Cross-sectional Study of 50 Patients and Review of the Literature

Abstract

It is unclear whether bacterial colonization in hidradenitis suppurativa/acne inversa (HS) comprises a primary cause, triggering factor or secondary phenomenon of the disease pathogenesis. Furthermore, the connection between certain bacterial species, the disease severity and its localization is unknown. Bacterial species were isolated from HS lesions to reveal a potential correlation with localization and disease severity. Ninety swab tests were prospectively obtained from 90 HS lesions of 50 consecutive patients. The material was cultured under aerobic and anaerobic conditions. The identified species were statistically correlated with Hurley stage and localization of the lesions. The most prevalent isolates were reported. Hurley stage significantly correlated with disease localization. Particular bacterial species were associated with "extended" disease and Hurley III stage with the detection of both aerobic and anaerobic bacteria and with a higher number of species. The presence of bacterial species is dependent on the local milieu, which correlates with the localization of the disease, its clinical manifestations and its extension.

Alterations in innate immunity and epithelial cell differentiation are the molecular pillars of hidradenitis suppurativa

“…Susceptibility was shown to arise from carriage of more than six HBD copies, which interferes directly with the HS phenotype. Whereas the role of bacteria in HS seems to be important, HS is not considered to be primarily an infectious disease . Indeed, defensins exhibit chemotactic and pro‐inflammatory activities and on the other side no unique bacterial agent but rather a polymorphic flora seems to contribute to the severity of the disease.…”

“…Whereas the role of bacteria in HS seems to be important, HS is not considered to be primarily an infectious disease. 8,47 Indeed, defensins exhibit chemotactic and proinflammatory activities and on the other side no unique bacterial agent but rather a polymorphic flora seems to contribute to the severity of the disease. In moderate-to-severe HS, bacterial sampling reveals a mixture of aerobes and anaerobes.…”

Loss of microbial diversity and body site heterogeneity in individuals with Hidradenitis Suppurativa

“…Dysbiosis has also been reported in HS (Guet-Revillet et al 2017;Nikolakis et al 2017;Ring et al 2017b;Ring et al 2017a). Collectively, the HS microbiome has been studied by invasive and non-invasive sampling of non-lesional and lesional skin using culture and next generation sequencing analyses.…”

Standardized Photographic Documentation of Hidradenitis Suppurativa/Acne Inversa

“…Skin site-specific gene transcriptional programs [14] and different topographic distribution of skin molecules and microbiota [15] have been detected. Different bacterial colonizations in various HS skin lesions also dependent on their localization have been identified [16]. Therefore, each body region may exhibit an individual pathologic phenotype, and comparisons should be performed in identical skin regions.…”