Hidradenitis suppurativa (HS), an inflammatory, potentially scarring disease of the hair follicle, affects the apocrine gland-bearing skin areas. Obesity and smoking are considered to be the major comorbid disorders associated with the occurrence or the aggravation of this disease. But the association of these factors and the HS disease remains controversial.

A study aimed to assess the importance of metabolic disorders/obesity, smoking/environmental toxins, and inflammation in HS by utilizing the differential expression of major relevant protein markers in lesional skin of obese/smoking versus non-obese/non-smoking HS patients.

The investigators derived the Lesional skin specimens from two groups of HS patients (BMI >30 and smokers vs. BMI <30 and non-smokers), which were stained with antibodies raised against irisin, PPARγ, and IGF-1R, which correlate with metabolic disorders/obesity, EGFR and AhR, associated with smoking, and IL-17, IL-17R, and S100A8, as markers of inflammation.

They found -

Marked differential expression of metabolic disorders/obesity-related markers between the two groups, while a limited differential expression of smoking-associated markers. 

Obese/smokers showed stronger IL-17R expression, 

S100A8 staining showed intense strong immunoreactivity in both groups without significant difference.

Thus the researchers concluded by saying that the concept of obesity playing a role in HS development appeared to be supported by the prominent regulation of the associated lesional biomarkers. While Tobacco smoking might contribute less to HS than previously suspected.

Source: Dermatology. 2021 Jul 22:1-9. doi: 10.1159/000517017. Epub ahead of print. PMID: 34293747.