Deciphering the Microbiology of Hidradenitis Suppurativa: A Step Forward Towards Understanding an Enigmatic Inflammatory Skin Disease

The study explored the microbiology of hidradenitis suppurativa (HS), a chronic inflammatory skin disease, highlighting its complex pathophysiology. It was found that HS lesions were rarely sterile and often associated with anaerobic bacteria from the gut and oral microbiota, rather than typical skin pathogens like Staphylococcus aureus. These bacteria, termed 'pathobionts,' were thought to promote inflammation and lesion extension in HS. The study suggested that HS might be a hair follicle barrier disease, with abnormal innate immunity responses playing a role. The findings indicated that antibiotic combinations targeting specific bacteria could improve HS, but the exact role of these bacteria in the disease's pathophysiology remained unclear. Future research was recommended to focus on early HS lesions and the associated microflora to optimize treatments and reduce antibiotic use, thereby preventing antimicrobial resistance.