Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Apr 2;14(7):2424.
doi: 10.3390/jcm14072424.

Unraveling the Skin Microbiome in Hidradenitis Suppurativa: Implications for Treatment and Disease Progression

Corina Ioana Cucu  1 , Călin Giurcăneanu  1 , Mara Madalina Mihai  1 , Teodora Andronic  2 , Ioan Ancuta  3 , Mircea Ioan Popa  4 , Ioana Sabina Macovei  4 , Liliana Gabriela Popa  1
Affiliations

Unraveling the Skin Microbiome in Hidradenitis Suppurativa: Implications for Treatment and Disease Progression

Corina Ioana Cucu et al. J Clin Med. .

Abstract

Background: Hidradenitis suppurativa (HS) is a chronic, disabling, and disfiguring inflammatory disease with a complex, incompletely elucidated pathogenesis. The role of skin dysbiosis in the development and progression of HS has not yet been clarified. Methods: We performed an observational, prospective culture-based study that included 40 HS patients and analyzed the bacterial load and diversity in HS skin lesions, their correlation with disease severity, and several host and environmental factors. Additionally, we investigated the prevalence of antibiotic resistance and determined the resistance profile of bacterial strains isolated from chronic HS lesions. Results: An impressive number and diversity of bacterial strains were isolated from both superficial and deep HS lesions. 201 aerobic and anaerobic bacterial strains were isolated, polymicrobial growth being detected in the majority of samples. The most frequently isolated bacteria were Staphylococcus epidermidis, Staphylococcus aureus, Staphylococcus lugdunensis, Peptoniphilus spp., and Enterococcus faecalis in superficial lesions and Staphylococcus epidermidis, Staphylococcus aureus, and Corynebacterium tuberculostearicum in deep lesions. A significantly higher bacterial density and diversity was found in male patients, regardless of the affected area and in patients with severe HS. The proportion of bacterial strains resistant to antibiotics was lower in our study (8.95%) compared to the previously reported data. Conclusions: Our findings indicate dysbiosis as a key player in the initiation and maintenance of the inflammatory process in HS. Further large-scale, prospective studies are required to comprehensively characterize the microbiological landscape of HS and shed light on its contribution in the pathogenesis of the disease.

Keywords: antibiotic resistance; hidradenitis suppurativa; inflammation; skin microbiome.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Bacterial strains isolated from superficial HS lesions in the axillary region.
Figure 2
Figure 2
Bacterial strains isolated from superficial HS lesions in the axillary region depending on Hurley stage.
Figure 3
Figure 3
Bacterial strains isolated from superficial HS lesions in the axillary region depending on the patients’ body mass index (BMI).
Figure 4
Figure 4
Bacterial strains isolated from superficial HS lesions in the inguinal and gluteal regions.
Figure 5
Figure 5
Bacterial strains isolated from superficial HS lesions in the inguinal and gluteal regions depending on Hurley severity stage.
Figure 6
Figure 6
Bacterial strains isolated from superficial HS lesions in the inguinal and gluteal regions depending on the patients’ BMI.
Figure 7
Figure 7
Bacterial strains isolated from superficial HS lesions in the face and neck region.
Figure 8
Figure 8
Bacterial strains isolated from superficial HS lesions in the face and neck region depending on the Hurley severity stage.
Figure 9
Figure 9
Bacterial strains isolated from superficial HS lesions in the face and neck region depending on the patients’ BMI.
Figure 10
Figure 10
Bacterial strains isolated from deep HS lesions located in the axillary region.
Figure 11
Figure 11
Bacterial strains isolated from deep HS lesions located in the axillary region depending on the Hurley stage.
Figure 12
Figure 12
Bacterial strains isolated from deep HS lesions located in the axillary region depending on the patients’ BMI.
Figure 13
Figure 13
Bacterial strains isolated from deep HS lesions located in the inguinal and gluteal regions.
Figure 14
Figure 14
Bacterial strains isolated from deep lesions located in the inguinal and gluteal regions depending on Hurley stage.
Figure 15
Figure 15
Bacterial strains isolated from deep HS lesions located in the inguinal and gluteal regions depending on the patients’ BMI.
See this image and copyright information in PMC

References

    1. Jemec G.B. Hidradenitis suppurativa. N. Engl. J. Med. 2012;366:158–164. doi: 10.1056/NEJMcp1014163. - DOI - PubMed
    1. Jahns A.C., Killasli H., Nosek D., Lundskog B., Lenngren A., Muratova Z., Emtestam L., Alexeyev O.A. Microbiology of hidradenitis suppurativa (acne inversa): A histological study of 27 patients. APMIS. 2014;122:804–809. doi: 10.1111/apm.12220. - DOI - PubMed
    1. Velpeau A. Dictionnaire de Medicine, un Repertoire des Sciences Medicales sons le Rapport, Theorique et Pratique. 2nd ed. Nabu Press; Paris, France: 1839. p. 91.
    1. Verneuil A. Etudes sur les tumeurs de la peau et quelques maladies des glandes sudoripores. Arch. Gen. Med. 1854;4:693–705.
    1. Schiefferdecker B. Die Hautdrusen des Menschen und der Saugetierre ihre Histologishe und Rassenanatomische Bedeutung, Sowie Die Muscularis Sexualis. 1st ed. E. Schweizerbert; Stuttgart, Germany: 1922.

LinkOut - more resources