Dietary Patterns in Patients With Hidradenitis Suppurativa

ABSTRACT Background Hidradenitis suppurativa (HS) is a chronic immune‐mediated inflammatory skin disease associated with obesity and metabolic syndrome. However, the role of diet is still unexplored. Objectives The aim of this study was to describe dietary habits in patients with HS and to examine the association between an unhealthy diet and disease severity. Methods In this cross‐sectional study we included patients with HS from out‐patient clinics of two different departments of dermatology. Patients were enrolled from September 2023 to November 2024. Dietary information was assessed using a food frequency questionnaire (FFQ). The participants were grouped into three: low, intermediate, and high adherence to general dietary guidelines by the Danish Health Authorities. Severity of HS was assessed using the International Hidradenitis Suppurativa Severity Score System (IHS4). The association between adherence to dietary guidelines and HS severity was examined using multivariable logistic regression model adjusted for obesity and smoking. Results Out of 131 patients enrolled in this study, 99 had mild‐to‐moderate disease (IHS4 < 11) while 25 had severe disease (IHS4 ≥ 11). The most frequently reported diets were either “healthy and varied diet” or “no specific diet”. Intermittent fasting was practiced by 11% of the participants. Patients with IHS4 < 11 reported similar frequency of intake of cake/biscuits/sweets, fast food, fish, vegetables and wholegrain as patients with IHS4 ≥ 11. Foods that exacerbated or alleviated the patients' skin condition were reported by 16.5% of the participants. Greater adherence to the national dietary guidelines was associated with a lower severity of HS, also after adjusting for obesity and smoking ( p = 0.003). Conclusions A healthy diet seems to be associated with lower disease burden in patients with HS and might indicate that diet itself has a potential beneficial effect on HS severity.