Hidradenitis suppurativa, intestinal microbiome and SIBO – a comprehensive overview of the issue

Abstract

Hidradenitis suppurativa (HS) is a chronic immune-mediated infl ammatory skin disease. It is characterized by an infl ammation that aff ects apocrine gland bearing skin in axillae, groin and under the breasts with the formation of painful nodules, abscesses and purulent discharge, sinuses and scaring. Patients with HS have an increased incidence of infl ammatory bowel disease (IBD), which also indicates their cross-sections in the pathogenesis of dysregulation congenital and adaptive immunity. Recently, there has been a signifi cant increase of interest in the intestinal microbio me and skin disease, as much as its role in the pathogenesis of HS. According to literature, intestinal dysbio sis promotes the production of proinfl ammatory cytokines and consequently the formation of HS lesions. Overgrowth of bacteria in the small intestine (SIBO) is a condition characterized by an increased concentration of bacteria in the large intestine. Eradication of SIBO was able to improve psoriasis measured by the psoriasis severity index. In this context, it is hypothesized that eredication of SIBO may have a benefi cial eff ect on the severity of manifestations in infl ammatory immune-mediated skin diseases, including HS.