Hidradenitis Suppurativa and Dietary Patterns: Insights from a Cross-Sectional Survey Study in the Southern U.S.

Hidradenitis Suppurativa and Dietary Patterns: Insights from a Cross-Sectional Survey Study in the Southern U.S. | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Hidradenitis Suppurativa and Dietary Patterns: Insights from a Cross-Sectional Survey Study in the Southern U.S. Ishika Patel, Mohammad Saleem, Sarah F McClees, Lauren C S Kole This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8388830/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 4 You are reading this latest preprint version Abstract Background Hidradenitis suppurativa (HS) is an inflammatory skin condition caused by follicular occlusion and is associated with painful lesions in intertriginous areas of the skin. The primary objectives of this study were to investigate the relationship between HS severity and dietary factors and to explore which specific food groups, if any, are linked to an increase in HS severity. We also aimed to identify any potential disparities that may contribute to poor dietary habits. Methods This study employed a cross-sectional, survey-based approach to determine dietary habits of patients with and without HS at a university hospital in the Southern United States. A food frequency survey was utilized to assess dietary intake. Statistical analyses involved chi-squared and ANOVA tests to identify significant association. Results A total of 386 (195 with HS, 191 controls) participants took part in this study. Statistical analysis indicated significant differences in the consumption of high glycemic index (GI) foods, processed foods, fried items, and dairy products among patients with and without HS (p < 0.05). The HS group particularly reported decreased consumption of low GI foods than their counterparts (p < 0.05). Food insecurity and affordability played a significant role in access to nutrient dense foods for patients with HS. Conclusion Our findings indicate that greater consumption of inflammatory foods is associated with exacerbation of symptoms associated with HS. Implementing dietary modifications in HS treatment plans with greater awareness of social disparities could play a valuable role in reducing disease burden and improving patients’ quality of life. Hidradenitis suppurative Acne inversa Western diet Dietary patterns Inflammation Food insecurity Introduction Hidradenitis suppurativa (HS) is an inflammatory skin condition characterized by follicular occlusion and painful lesions in intertriginous areas of skin, such as the axillae, groin, perianal, and inframammary regions[ 1 ]. The estimated global prevalence of HS falls within the range of 0.00033% to 4.10%[ 2 ]. Despite the substantial number of patients diagnosed with HS annually and the significant impact of the disease on patients’ quality of life, with individuals reporting depression, sexual distress, social stigma, vocational limitations, and diminished sleep quality, little is known about the exact etiology of HS[ 3 , 4 ]. The pathogenesis of HS involves immunological, hormonal, genetic, and environmental factors[ 5 ]. Furthermore, current treatment options remain inconsistently efficacious in many patients[ 6 ]. Given the multifactorial nature of HS, exploring modifiable factors such as diet may provide beneficial insights into the management and treatment of the disease. Existing literature highlights the profound impact that diet has on HS symptoms, with articles proposing specific dietary styles that may alleviate or exacerbate the disease process via alterations in systemic inflammation, metabolic activity, and hormonal balance[ 7 – 9 ]. Dietary patterns rich in anti-inflammatory nutrients, such as the Mediterranean diet, have been noted to mitigate HS severity and emphasize healthy fats, lean animal or plant-based proteins, and whole grains[ 10 – 12 ]. Another popular study focus is the elimination diet, which aims to mitigate HS flares by identifying and removing potential inflammatory trigger foods, such as Brewer’s yeast, dairy, and gluten, from a patient’s diet[ 13 ]. Conversely, inflammatory diets consisting of high glycemic index foods and saturated fats are linked to exacerbating follicular occlusion and inflammation associated with HS by further disturbing hormonal and metabolic activity[ 9 , 14 ]. These findings may collectively enhance existing standardized therapies for HS, and while diet-based interventions appear promising, the current evidence is limited by lack of a control group or a small sample size. Additionally, a notable gap exists in the geographic diversity of the research focused on diet and HS, with only a few studies exploring this topic in the United States (U.S.)[ 9 , 15 ]. More importantly, to our knowledge, no studies have focused on the Southern U.S., a region characterized by the highest percentage of HS hospitalizations and greatly burdened by commonly associated HS comorbidities[ 16 – 18 ]. The Southern U.S. is characterized by the population’s distinct dietary patterns, which may significantly impact HS disease course and management[ 19 ]. Furthermore, access to nutrient-dense foods is limited for some patients due to existing socioeconomic barriers across the region[ 20 ]. These contributors underscore the critical need for geographic-specific research to gain deeper insight into the intersection of diet on HS and to develop tailored nutritional interventions focused on mitigating outcomes in this disproportionately burdened population. The aim of this study is to compare dietary intake patterns and to briefly explore potential disparities contributing to poor dietary habits between individuals with and without HS using a structured survey administered at a high-volume university dermatology clinic located in the Southern U.S. We hypothesize that certain dietary patterns, specifically higher consumption of high glycemic index (GI) foods, processed foods, and dairy, are more prevalent among individuals with HS. By identifying potential dietary and disparity associations with HS, this research seeks to contribute to the evidence supporting patient-tailored interventions while addressing a fundamental regional gap in existing literature. Methods Study Design This cross-sectional survey study received exemption by the Institutional Review Board (IRB) at the University of Alabama at Birmingham (UAB) as no patient identifying information was collected. The administered questionnaire was designed based on existing nutritional surveys and literature pertaining to diet and HS. Patients were asked to report food frequency and serving size from several categories, including fruits and vegetables, whole grains, sweetened and caffeinated beverages, candies and chocolates, processed foods, dairy products, and meats, to evaluate for a potential difference in dietary patterns among patients with HS compared to a control group without HS. Further, they were asked to report whether they felt access to food and affordability of a healthier diet contributed to their dietary choices. Inclusion and Exclusion Criteria Eligible participants were adult patients at least 18 years of age presenting to the dermatology clinic at UAB between June 2024 and October 2024 and categorized into two groups: HS and control. The inclusion criteria for the group with HS was a confirmed diagnosis of HS by a board-certified dermatologist, while the control group presented to the dermatology clinic for a general skin evaluation and had no diagnosis of any inflammatory medical conditions. The exclusion criteria consisted of patients who did not meet the forementioned inclusion criteria of the two groups. Survey Design and Administration The electronic questionnaire was primarily administered by a project team member with few exceptions in which patients completed the survey independently. Prior to full administration of the survey, it was pilot tested for clarity in a subset of patients. Survey responses were anonymous and stored electronically utilizing the university’s secure Qualtrics platform in compliance with the IRB guidelines. Statistical Analysis Descriptive statistical analysis was performed to summarize demographic and dietary patterns of the two groups. The differences in the dietary patterns between the HS and control groups were analyzed via chi-square tests for categorical variables. One-way analysis of variance (ANOVA) was also utilized to compare mean consumption frequencies and serving sizes across patients classified into the three Hurley stages of HS. Results A total of 386 responses were collected. Patient demographics are noted in Table 1 . The HS group consisted of 195 patients, and the control group consisted of 191 patients. Regarding race distribution, there were more Black females in the HS group and White females in the control group. While a majority of patients in the control group were of above 30 years of age, the HS group demonstrated a broader age distribution. It is worth mentioning that 22% of patients in the control group were between 60–65 years of age in contrast to only 9% in the HS group. Table 2 highlights the mean consumption of various food groups in addition to beverages, such as sweetened and caffeinated drinks and water, by patients in the HS and control groups. The average consumption of fruits and vegetables, whole grains, and water was significantly lower in patients with HS compared to their counterparts. Similarly, intake of sweetened and caffeinated beverages, candies and chocolates, processed foods, fried items, and dairy showed strong association with HS status. Of note, processed foods specifically consisted of instant noodles, pizza, and packaged snacks. No significant differences were found in the consumption of meats, protein supplements, and eggs. Table 3 depicts the mean consumption of specific food groups stratified by HS Hurley stage. A lower intake of whole grains and higher intake of sweetened and caffeinated beverages among patients with higher Hurley stages demonstrated a statistically significant association with disease severity. All other food groups did not show significant variation across the Hurley classification system. Table 4 summarizes the mean responses from patients with and without HS on experiencing food insecurity and reliance on fast food restaurants and/or packaged meals due to affordability. Discussion This cross-sectional survey revealed significantly higher intake of high GI foods, processed foods, fried items, and dairy products by patients with HS compared to individuals without HS. Additionally, decreased consumption of whole foods such as fruits, vegetables, and whole grains was associated with higher disease prevalence. Chronically elevated insulin levels from high GI foods and refined carbohydrates augment androgen production, insulin-like growth factor-1 (IGF-1) signaling, and proinflammatory pathways, all of which contribute to HS pathogenesis by aberrant upregulation of follicular keratinocytes and pilosebaceous unit activity[ 11 , 21 – 23 ]. Diminished intake of low GI foods, such as high fiber and nutrient-dense foods, further increases insulin resistance, hindering the ability to manage disease-related inflammation and optimize existing standardized treatments[ 24 , 25 ]. Like foods with high glycemic load, chronic consumption of processed foods results in insulin resistance due to their high fat content[ 26 ]. Regular consumption of saturated fats ultimately causes a lack of response to secreted insulin, resulting in elevated blood glucose levels that contribute to the development of diabetes and various other metabolic syndromes[ 27 ]. These comorbidities are strongly linked to the worsening of HS as they alter hormonal profiles and potentiate a proinflammatory state[ 17 ]. Dairy consumption may impact the pathogenesis of HS in a similar manner. Though this association does not have strong clinical evidence yet, observational studies and review articles note worsening of HS symptoms with dairy intake[ 9 , 23 ]. Existing literature has demonstrated that foods high in glucose, saturated fats, processed ingredients, and dairy are also linked to an increase in HS exacerbations and symptom severity[ 9 , 28 ]. In fact, several studies report patient testimonials of these foods triggering flares or worsening their existing symptoms[ 14 , 23 , 29 ]. Consumptions of such foods is typical of a Western diet which has been proven to cause an imbalance of the gut microbiota and increase proinflammatory cytokine activity. Several studies have even associated these foods to the development of sinus tracts and matrix remodeling in the setting of HS[ 30 – 33 ]. These foods cause increased sebum production and follicular obstruction, resulting in the development and differentiation of pilosebaceous unit which then may evolve into sinus tracts [ 32 ]. On the contrary, dietary habits involving whole foods and unprocessed foods contribute to promoting immune regulation and are even perceived by patients to reduce their symptoms [ 11 ]. On a molecular level, exacerbation of HS is linked to upregulation of various C-X-C motif chemokine receptors (CXCRs) and cytokines such as interleukin (IL). CXCR2, stimulated with high-fat diets, has been found to promote keratin production, ultimately resulting in inflammation of hair follicles via the recruitment of neutrophils[ 9 , 34 ]. Various interleukins, such as IL-1β and IL-8, have been associated with directing immune cells to sites of active inflammation, degrading the extracellular matrix, and promoting tissue destruction in HS lesions[ 35 , 36 ]. Like CXCR2, both IL-1β and IL-8 are stimulated by processed foods, refined carbohydrates, and saturated fats[ 37 ]. Of note, consumption of various meats, protein supplements, and eggs was not significantly associated with worsening of HS symptoms in this study. Although this study demonstrated no pertinent relationship in intake among the diverse meat subtypes, other reports highlight that disease severity may be dependent on the specific type of meat consumed. For instance, one survey-based study found that patients with HS reported fish (42.7%) and chicken (51.7%) as alleviating foods and red meats as exacerbating foods[ 23 ]. Another study found that consumption of a classic Western diet, one high in red meats, is associated with HS exacerbation[ 7 ]. Based on studies exploring the efficacy of Mediterranean diet in HS, it is thought that intake of processed and red meats triggers oxidative stress and systemic inflammation in HS[ 12 , 28 ]. No consensus exists in literature regarding the impact of protein supplements and eggs on HS pathogenesis to support or oppose continued consumption. When analyzing the diets of patients among the HS Hurley stages, only consumption of whole grains and sweetened and caffeinated beverages was associated with disease severity. While patients with HS consume less amounts of fruits and vegetables and more of candies and chocolates, processed items, fried foods, and dairy products, no significant relationship in these food groups was present when stratified by HS stage. The unequal distribution of patients across the three Hurley stages may have resulted in reduced reliability of the findings. Our findings are consistent with existing studies that have highlighted the impact of glycemic load, processed foods, and saturated fats in HS pathogenesis, with the notable exception of a lack of relationship between meat and protein supplement consumption and HS severity. Nonetheless, our work offers novel insight into the dietary patterns of patient with HS in the Southern U.S. While our study is the first to survey patients in this geographic region, additional large-scale investigation via randomized controlled trial is warranted to gather more information on dietary impact of HS in this population which has the highest rates of HS hospitalizations[ 16 , 18 ]. We also briefly compare the potential role of food insecurity and affordability in patients with and without HS. Patients with HS reported a significant lack of access to nutritious meals, especially due to high cost. Further exploration should also focus on food access, dietary education, and health literacy, as many individuals in this region face structural barriers preventing access to nutrient dense foods[ 38 ]. Moreover, the concept of an anti-inflammatory diet may be unfamiliar to many patients due to limited health literacy[ 39 , 40 ]. Studies that characterize region-specific dietary preferences and health disparities are warranted to inform and aid clinicians in implementing patient-centered approaches focused on modifying a typical Southern diet. For instance, coaching on tailoring existing diets to gradually increase fruits and vegetables, reduce or replace sweetened and caffeinated beverages with low-sugar alternatives, and decrease intake of fried and processed foods may offer substantial benefits. Overall, exploring regional food preferences and availability is critical in ensuring adherence to dietary modification and optimizing clinical outcomes. Several limitations of this study highlight the need for further research. As dietary intake was self-reported, there is potential for recall and social desirability bias. Further, the administered survey was designed from literature reported food groups that worsen HS rather than utilizing an established food frequency questionnaire. This is attributed to the study being conducted at a high-volume academic institution, where time constraints and clinical demands limited the feasibility of administering a comprehensive survey. Additionally, most patients with HS reported diagnosis of HS Hurley Stages 2 and 3, likely due to delayed physician referral and patient presentation to the clinic until the disease progressed to advanced stages. The HS group also consisted predominantly of Black females whereas the control group had predominantly White females. The age of patients with HS was broadly distributed whereas individuals in the control group were mostly of age 30 or above. Though consistent with existing literature that HS disproportionately impacts Black females and patients present to clinic with advanced stages of HS, future studies should ensure inclusion of balanced group sizes in terms of age, race, and HS Hurley stages for accuracy and generalizability of the results. Despite the limitations of this study, we hope our findings provide practicing physicians, especially in the Southern U.S., with guidance and understanding of their patients’ diet and its potential impact on disease severity. Conclusion This study highlights the relationship between dietary patterns and HS, particularly the impact of high glycemic load foods, processed and fried items, sweetened and caffeinated beverages, candies and chocolates, and dairy, as well as the protective potential of whole foods such as fruits, vegetables, and whole grains. Regional factors, including food accessibility, affordability, and dietary education, are important considerations for patient-centered dietary interventions, especially in the Southern United States where HS prevalence and hospitalizations are high. These results underscore the importance of dietary counseling as a complementary strategy to optimize outcomes in HS, and they provide a foundation for future research on nutrition and health disparities in HS populations. Declarations Conflict of Interest The authors of this manuscript have no financial disclosures. Funding Declaration This research did not receive any funding. Author Contribution Conceptualization, I.P. and L.K.; methodology, I.P. and L.K.; survey creation and administration, I.P.; survey revisions I.P. and L.K.; writing – original draft and preparation, I.P.; writing – reviewing and editing, I.P., M.S., S.M., and L.K.; data analysis – I.P. and M.S.; supervision, L.K. All authors have reviewed and approved the final manuscript. Data Availability All data supporting the findings of this study are available within the paper. 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Annu Rev Nutr Aly S et al (2021) Cancer-related Beliefs and Preventive Health Practices among Residents of Rural versus Urban Counties in Alabama. Cancer Prev Res (Phila) 14(5):593–602 Tables Table 1 Demographics. Data presented in number and percentage, N (%). HS (n = 195) Control (n = 191) Gender Female 146 (75%) 124 (65%) Male 49( 25%) 67 (35%) Race Asian 1 (< 1%) 10 (5%) African American 140 (72%) 48 (25%) Hispanic 5 (3%) 3 (2%) Native American 1 (< 1%) 0 (< 1%) White 47 (24%) 130 (68%) Other 1 (< 1%) 0 (< 1%) Age 18–25 29 (15%) 17 (9%) 25–30 35 (18%) 16 (9%) 30–39 48 (24%) 37 (19%) 40–49 44 (23%) 48 (25%) 50–59 22 (11%) 31 (16%) 60–65 17 (9%) 42 (22%) Table 2 Mean Consumption of Foods by Patient in HS and Control Group. HS (n = 195) Control (n = 191) t-Test (p-value) Fruits/Vegetables a 2.06 2.70 < 0.05 Whole Grains b 1.97 2.65 < 0.05 Sweetened/Caffeinated Beverages a 2.54 2.08 < 0.05 Water a 1.93 1.46 < 0.05 Candies/Chocolates a 2.16 2.64 < 0.05 Processed Foods b 3.10 2.49 < 0.05 Fried Foods b 2.65 2.01 < 0.05 Dairy b 3.12 3.35 < 0.05 Meat b 3.76 3.34 0.70 Protein b 1.86 1.86 0.98 Eggs b 2.73 2.79 0.64 a Reported in mean servings per day. b Reported in mean servings per week. Table 3 Mean Consumption of Foods among Patient in Varying HS Hurley Stages. Hurley 1 (n = 39) Hurley 2 (n = 75) Hurley 3 (n = 81) ANOVA (p-value) Fruits/Vegetables a 1.98 2.06 2.09 0.80 Whole Grains b 2.28 1.76 2.02 < 0.05 Sweetened/Caffeinated Beverages a 2.15 2.63 2.65 < 0.05 Water a 2.15 2.08 2.23 0.63 Candies/Chocolates a 1.85 2.01 1.89 0.63 Processed Foods b 3.10 3.08 3.11 0.98 Fried Foods b 2.51 2.70 2.68 0.63 Dairy b 3.21 3.19 3.01 0.47 Meat b 3.77 3.77 3.75 0.98 Protein b 2.00 1.83 1.81 0.78 Eggs b 2.64 2.73 2.77 0.88 a Reported in mean servings per day. b Reported in mean servings per week. Table 4 Mean responses regarding food insecurity and affordability from patients with and without HS. HS non-HS t-test In the past month, how often did you worry about having enough food? 1.46 1.08 < 0.05 In the past month, how often did you eat from fast food restaurants or packaged meals because it was more affordable than cooking at home? 1.82 1.26 < 0.05 Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8388830","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":585154940,"identity":"0687a6a1-f86a-4619-9ad2-3eb34c1ed6e1","order_by":0,"name":"Ishika Patel","email":"","orcid":"","institution":"University of Alabama at Birmingham","correspondingAuthor":false,"prefix":"","firstName":"Ishika","middleName":"","lastName":"Patel","suffix":""},{"id":585154941,"identity":"152be448-2216-4fae-b377-371d9eac11e0","order_by":1,"name":"Mohammad Saleem","email":"","orcid":"","institution":"University of Alabama at Birmingham","correspondingAuthor":false,"prefix":"","firstName":"Mohammad","middleName":"","lastName":"Saleem","suffix":""},{"id":585154942,"identity":"28f5355d-4e54-4238-b677-eca95a80fca1","order_by":2,"name":"Sarah F McClees","email":"","orcid":"","institution":"University of Alabama at Birmingham","correspondingAuthor":false,"prefix":"","firstName":"Sarah","middleName":"F","lastName":"McClees","suffix":""},{"id":585154943,"identity":"4e269515-54db-45eb-bf30-03804fe19c38","order_by":3,"name":"Lauren C S Kole","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA10lEQVRIiWNgGAWjYBACPgiVAGQwH2BgbADzDPBqYYNpYWNgSyBZC48BkVrYz5h9+LgjTY6NveebxM8d2+QZ2Ju3SeDVwpNjPHPmmRxjNp6z2yR7z9w2bOA5VoZfC0OOMTNvW0Vim0TuNgnettsJDBI5Zvi18L8xZv4L0iL/5pnkX5AW+TcEtEgAbWFsywHawsMmDbGFh5CWZ8WMvW1pQL+kGVvLAv3SxpNWbIFPCz9/8maGn23Jcvzshx/efLvjtjyQsfEGPi1Y7CVN+SgYBaNgFIwCbAAAnsdAFSXAPXMAAAAASUVORK5CYII=","orcid":"","institution":"University of Alabama at Birmingham","correspondingAuthor":true,"prefix":"","firstName":"Lauren","middleName":"C S","lastName":"Kole","suffix":""}],"badges":[],"createdAt":"2025-12-17 19:53:10","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8388830/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8388830/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":101943315,"identity":"fd56df23-063d-44ef-81cf-5b57f039c256","added_by":"auto","created_at":"2026-02-05 09:41:37","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":796900,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8388830/v1/749b7c71-0148-4e85-bdc4-d4be1c3c4183.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Hidradenitis Suppurativa and Dietary Patterns: Insights from a Cross-Sectional Survey Study in the Southern U.S.","fulltext":[{"header":"Introduction","content":"\u003cp\u003eHidradenitis suppurativa (HS) is an inflammatory skin condition characterized by follicular occlusion and painful lesions in intertriginous areas of skin, such as the axillae, groin, perianal, and inframammary regions[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. The estimated global prevalence of HS falls within the range of 0.00033% to 4.10%[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Despite the substantial number of patients diagnosed with HS annually and the significant impact of the disease on patients\u0026rsquo; quality of life, with individuals reporting depression, sexual distress, social stigma, vocational limitations, and diminished sleep quality, little is known about the exact etiology of HS[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. The pathogenesis of HS involves immunological, hormonal, genetic, and environmental factors[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Furthermore, current treatment options remain inconsistently efficacious in many patients[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Given the multifactorial nature of HS, exploring modifiable factors such as diet may provide beneficial insights into the management and treatment of the disease.\u003c/p\u003e \u003cp\u003eExisting literature highlights the profound impact that diet has on HS symptoms, with articles proposing specific dietary styles that may alleviate or exacerbate the disease process via alterations in systemic inflammation, metabolic activity, and hormonal balance[\u003cspan additionalcitationids=\"CR8\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Dietary patterns rich in anti-inflammatory nutrients, such as the Mediterranean diet, have been noted to mitigate HS severity and emphasize healthy fats, lean animal or plant-based proteins, and whole grains[\u003cspan additionalcitationids=\"CR11\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Another popular study focus is the elimination diet, which aims to mitigate HS flares by identifying and removing potential inflammatory trigger foods, such as Brewer\u0026rsquo;s yeast, dairy, and gluten, from a patient\u0026rsquo;s diet[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Conversely, inflammatory diets consisting of high glycemic index foods and saturated fats are linked to exacerbating follicular occlusion and inflammation associated with HS by further disturbing hormonal and metabolic activity[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. These findings may collectively enhance existing standardized therapies for HS, and while diet-based interventions appear promising, the current evidence is limited by lack of a control group or a small sample size. Additionally, a notable gap exists in the geographic diversity of the research focused on diet and HS, with only a few studies exploring this topic in the United States (U.S.)[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eMore importantly, to our knowledge, no studies have focused on the Southern U.S., a region characterized by the highest percentage of HS hospitalizations and greatly burdened by commonly associated HS comorbidities[\u003cspan additionalcitationids=\"CR17\" citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. The Southern U.S. is characterized by the population\u0026rsquo;s distinct dietary patterns, which may significantly impact HS disease course and management[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Furthermore, access to nutrient-dense foods is limited for some patients due to existing socioeconomic barriers across the region[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. These contributors underscore the critical need for geographic-specific research to gain deeper insight into the intersection of diet on HS and to develop tailored nutritional interventions focused on mitigating outcomes in this disproportionately burdened population.\u003c/p\u003e \u003cp\u003eThe aim of this study is to compare dietary intake patterns and to briefly explore potential disparities contributing to poor dietary habits between individuals with and without HS using a structured survey administered at a high-volume university dermatology clinic located in the Southern U.S. We hypothesize that certain dietary patterns, specifically higher consumption of high glycemic index (GI) foods, processed foods, and dairy, are more prevalent among individuals with HS. By identifying potential dietary and disparity associations with HS, this research seeks to contribute to the evidence supporting patient-tailored interventions while addressing a fundamental regional gap in existing literature.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design\u003c/h2\u003e \u003cp\u003eThis cross-sectional survey study received exemption by the Institutional Review Board (IRB) at the University of Alabama at Birmingham (UAB) as no patient identifying information was collected. The administered questionnaire was designed based on existing nutritional surveys and literature pertaining to diet and HS. Patients were asked to report food frequency and serving size from several categories, including fruits and vegetables, whole grains, sweetened and caffeinated beverages, candies and chocolates, processed foods, dairy products, and meats, to evaluate for a potential difference in dietary patterns among patients with HS compared to a control group without HS. Further, they were asked to report whether they felt access to food and affordability of a healthier diet contributed to their dietary choices.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eInclusion and Exclusion Criteria\u003c/h3\u003e\n\u003cp\u003eEligible participants were adult patients at least 18 years of age presenting to the dermatology clinic at UAB between June 2024 and October 2024 and categorized into two groups: HS and control. The inclusion criteria for the group with HS was a confirmed diagnosis of HS by a board-certified dermatologist, while the control group presented to the dermatology clinic for a general skin evaluation and had no diagnosis of any inflammatory medical conditions. The exclusion criteria consisted of patients who did not meet the forementioned inclusion criteria of the two groups.\u003c/p\u003e\n\u003ch3\u003eSurvey Design and Administration\u003c/h3\u003e\n\u003cp\u003eThe electronic questionnaire was primarily administered by a project team member with few exceptions in which patients completed the survey independently. Prior to full administration of the survey, it was pilot tested for clarity in a subset of patients. Survey responses were anonymous and stored electronically utilizing the university\u0026rsquo;s secure Qualtrics platform in compliance with the IRB guidelines.\u003c/p\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eDescriptive statistical analysis was performed to summarize demographic and dietary patterns of the two groups. The differences in the dietary patterns between the HS and control groups were analyzed via chi-square tests for categorical variables. One-way analysis of variance (ANOVA) was also utilized to compare mean consumption frequencies and serving sizes across patients classified into the three Hurley stages of HS.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 386 responses were collected. Patient demographics are noted in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. The HS group consisted of 195 patients, and the control group consisted of 191 patients. Regarding race distribution, there were more Black females in the HS group and White females in the control group. While a majority of patients in the control group were of above 30 years of age, the HS group demonstrated a broader age distribution. It is worth mentioning that 22% of patients in the control group were between 60\u0026ndash;65 years of age in contrast to only 9% in the HS group.\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e highlights the mean consumption of various food groups in addition to beverages, such as sweetened and caffeinated drinks and water, by patients in the HS and control groups. The average consumption of fruits and vegetables, whole grains, and water was significantly lower in patients with HS compared to their counterparts. Similarly, intake of sweetened and caffeinated beverages, candies and chocolates, processed foods, fried items, and dairy showed strong association with HS status. Of note, processed foods specifically consisted of instant noodles, pizza, and packaged snacks. No significant differences were found in the consumption of meats, protein supplements, and eggs.\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e depicts the mean consumption of specific food groups stratified by HS Hurley stage. A lower intake of whole grains and higher intake of sweetened and caffeinated beverages among patients with higher Hurley stages demonstrated a statistically significant association with disease severity. All other food groups did not show significant variation across the Hurley classification system.\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e summarizes the mean responses from patients with and without HS on experiencing food insecurity and reliance on fast food restaurants and/or packaged meals due to affordability.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis cross-sectional survey revealed significantly higher intake of high GI foods, processed foods, fried items, and dairy products by patients with HS compared to individuals without HS. Additionally, decreased consumption of whole foods such as fruits, vegetables, and whole grains was associated with higher disease prevalence.\u003c/p\u003e \u003cp\u003eChronically elevated insulin levels from high GI foods and refined carbohydrates augment androgen production, insulin-like growth factor-1 (IGF-1) signaling, and proinflammatory pathways, all of which contribute to HS pathogenesis by aberrant upregulation of follicular keratinocytes and pilosebaceous unit activity[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan additionalcitationids=\"CR22\" citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Diminished intake of low GI foods, such as high fiber and nutrient-dense foods, further increases insulin resistance, hindering the ability to manage disease-related inflammation and optimize existing standardized treatments[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Like foods with high glycemic load, chronic consumption of processed foods results in insulin resistance due to their high fat content[\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Regular consumption of saturated fats ultimately causes a lack of response to secreted insulin, resulting in elevated blood glucose levels that contribute to the development of diabetes and various other metabolic syndromes[\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. These comorbidities are strongly linked to the worsening of HS as they alter hormonal profiles and potentiate a proinflammatory state[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Dairy consumption may impact the pathogenesis of HS in a similar manner. Though this association does not have strong clinical evidence yet, observational studies and review articles note worsening of HS symptoms with dairy intake[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eExisting literature has demonstrated that foods high in glucose, saturated fats, processed ingredients, and dairy are also linked to an increase in HS exacerbations and symptom severity[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. In fact, several studies report patient testimonials of these foods triggering flares or worsening their existing symptoms[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Consumptions of such foods is typical of a Western diet which has been proven to cause an imbalance of the gut microbiota and increase proinflammatory cytokine activity. Several studies have even associated these foods to the development of sinus tracts and matrix remodeling in the setting of HS[\u003cspan additionalcitationids=\"CR31 CR32\" citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. These foods cause increased sebum production and follicular obstruction, resulting in the development and differentiation of pilosebaceous unit which then may evolve into sinus tracts [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. On the contrary, dietary habits involving whole foods and unprocessed foods contribute to promoting immune regulation and are even perceived by patients to reduce their symptoms [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eOn a molecular level, exacerbation of HS is linked to upregulation of various C-X-C motif chemokine receptors (CXCRs) and cytokines such as interleukin (IL). CXCR2, stimulated with high-fat diets, has been found to promote keratin production, ultimately resulting in inflammation of hair follicles via the recruitment of neutrophils[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. Various interleukins, such as IL-1β and IL-8, have been associated with directing immune cells to sites of active inflammation, degrading the extracellular matrix, and promoting tissue destruction in HS lesions[\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. Like CXCR2, both IL-1β and IL-8 are stimulated by processed foods, refined carbohydrates, and saturated fats[\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eOf note, consumption of various meats, protein supplements, and eggs was not significantly associated with worsening of HS symptoms in this study. Although this study demonstrated no pertinent relationship in intake among the diverse meat subtypes, other reports highlight that disease severity may be dependent on the specific type of meat consumed. For instance, one survey-based study found that patients with HS reported fish (42.7%) and chicken (51.7%) as alleviating foods and red meats as exacerbating foods[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Another study found that consumption of a classic Western diet, one high in red meats, is associated with HS exacerbation[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Based on studies exploring the efficacy of Mediterranean diet in HS, it is thought that intake of processed and red meats triggers oxidative stress and systemic inflammation in HS[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. No consensus exists in literature regarding the impact of protein supplements and eggs on HS pathogenesis to support or oppose continued consumption.\u003c/p\u003e \u003cp\u003eWhen analyzing the diets of patients among the HS Hurley stages, only consumption of whole grains and sweetened and caffeinated beverages was associated with disease severity. While patients with HS consume less amounts of fruits and vegetables and more of candies and chocolates, processed items, fried foods, and dairy products, no significant relationship in these food groups was present when stratified by HS stage. The unequal distribution of patients across the three Hurley stages may have resulted in reduced reliability of the findings.\u003c/p\u003e \u003cp\u003eOur findings are consistent with existing studies that have highlighted the impact of glycemic load, processed foods, and saturated fats in HS pathogenesis, with the notable exception of a lack of relationship between meat and protein supplement consumption and HS severity. Nonetheless, our work offers novel insight into the dietary patterns of patient with HS in the Southern U.S. While our study is the first to survey patients in this geographic region, additional large-scale investigation via randomized controlled trial is warranted to gather more information on dietary impact of HS in this population which has the highest rates of HS hospitalizations[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. We also briefly compare the potential role of food insecurity and affordability in patients with and without HS. Patients with HS reported a significant lack of access to nutritious meals, especially due to high cost. Further exploration should also focus on food access, dietary education, and health literacy, as many individuals in this region face structural barriers preventing access to nutrient dense foods[\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. Moreover, the concept of an anti-inflammatory diet may be unfamiliar to many patients due to limited health literacy[\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]. Studies that characterize region-specific dietary preferences and health disparities are warranted to inform and aid clinicians in implementing patient-centered approaches focused on modifying a typical Southern diet. For instance, coaching on tailoring existing diets to gradually increase fruits and vegetables, reduce or replace sweetened and caffeinated beverages with low-sugar alternatives, and decrease intake of fried and processed foods may offer substantial benefits. Overall, exploring regional food preferences and availability is critical in ensuring adherence to dietary modification and optimizing clinical outcomes.\u003c/p\u003e \u003cp\u003eSeveral limitations of this study highlight the need for further research. As dietary intake was self-reported, there is potential for recall and social desirability bias. Further, the administered survey was designed from literature reported food groups that worsen HS rather than utilizing an established food frequency questionnaire. This is attributed to the study being conducted at a high-volume academic institution, where time constraints and clinical demands limited the feasibility of administering a comprehensive survey. Additionally, most patients with HS reported diagnosis of HS Hurley Stages 2 and 3, likely due to delayed physician referral and patient presentation to the clinic until the disease progressed to advanced stages. The HS group also consisted predominantly of Black females whereas the control group had predominantly White females. The age of patients with HS was broadly distributed whereas individuals in the control group were mostly of age 30 or above. Though consistent with existing literature that HS disproportionately impacts Black females and patients present to clinic with advanced stages of HS, future studies should ensure inclusion of balanced group sizes in terms of age, race, and HS Hurley stages for accuracy and generalizability of the results. Despite the limitations of this study, we hope our findings provide practicing physicians, especially in the Southern U.S., with guidance and understanding of their patients\u0026rsquo; diet and its potential impact on disease severity.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study highlights the relationship between dietary patterns and HS, particularly the impact of high glycemic load foods, processed and fried items, sweetened and caffeinated beverages, candies and chocolates, and dairy, as well as the protective potential of whole foods such as fruits, vegetables, and whole grains. Regional factors, including food accessibility, affordability, and dietary education, are important considerations for patient-centered dietary interventions, especially in the Southern United States where HS prevalence and hospitalizations are high. These results underscore the importance of dietary counseling as a complementary strategy to optimize outcomes in HS, and they provide a foundation for future research on nutrition and health disparities in HS populations.\u003c/p\u003e "},{"header":"Declarations","content":"\u003cp\u003e \u003ch2\u003eConflict of Interest\u003c/h2\u003e \u003cp\u003eThe authors of this manuscript have no financial disclosures.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eDeclaration\u003c/p\u003e \u003cp\u003eThis research did not receive any funding.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eConceptualization, I.P. and L.K.; methodology, I.P. and L.K.; survey creation and administration, I.P.; survey revisions I.P. and L.K.; writing \u0026ndash; original draft and preparation, I.P.; writing \u0026ndash; reviewing and editing, I.P., M.S., S.M., and L.K.; data analysis \u0026ndash; I.P. and M.S.; supervision, L.K. All authors have reviewed and approved the final manuscript.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eAll data supporting the findings of this study are available within the paper.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eByrd AS et al (2025) Differentiating the Role of Inflammation in Hidradenitis Suppurativa from that in Other Inflammatory Skin Diseases. J Invest Dermatol\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGoldburg SR, Strober BE, Payette MJ (2020) Hidradenitis suppurativa: Epidemiology, clinical presentation, and pathogenesis. J Am Acad Dermatol 82(5):1045\u0026ndash;1058\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCaccavale S et al (2023) Hidradenitis Suppurativa Burdens on Mental Health: A Literature Review of Associated Psychiatric Disorders and Their Pathogenesis. Life (Basel), 13(1)\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMolina-Leyva A, Cuenca-Barrales C (2020) Pruritus and Malodour in Patients with Hidradenitis Suppurativa: Impact on Quality of Life and Clinical Features Associated with Symptom Severity. Dermatology 236(1):59\u0026ndash;65\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFrew JW (2025) Unravelling the complex pathogenesis of hidradenitis suppurativa. Br J Dermatol 192(Supplement1):i3\u0026ndash;i14\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSnyder CL, Chen SX, Porter ML (2023) Obstacles to Early Diagnosis and Treatment of Hidradenitis Suppurativa: Current Perspectives on Improving Clinical Management. Clin Cosmet Investig Dermatol 16:1833\u0026ndash;1841\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMaarouf M, Platto JF, Shi VY (2019) The role of nutrition in inflammatory pilosebaceous disorders: Implication of the skin-gut axis. Australas J Dermatol 60(2):e90\u0026ndash;e98\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDattolo A et al (2025) Beyond the skin: endocrine, psychological and nutritional aspects in women with hidradenitis suppurativa. J Transl Med 23(1):167\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVural S et al (2024) Evaluating dietary considerations in hidradenitis suppurativa: a critical examination of existing knowledge. Int J Dermatol 63(8):987\u0026ndash;998\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLorite-Fuentes I et al (2022) Potential Benefits of the Mediterranean Diet and Physical Activity in Patients with Hidradenitis Suppurativa: A Cross-Sectional Study in a Spanish Population. Nutrients, 14(3)\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eShen AS, Johnson JS, Kerns ML (2023) Dietary Factors and Hidradenitis Suppurativa. Dermatol Ther (Heidelb) 13(12):3007\u0026ndash;3017\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAnnunziata G et al (2025) Plant-Based Foods for Chronic Skin Diseases: A Focus on the Mediterranean Diet. Curr Nutr Rep 14(1):42\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHaddad NR (2024) The role of diet in managing hidradenitis suppurativa: a review of current evidence and future directions. Arch Dermatol Res 316(8):508\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKesik F, Dogan-Gunaydin S, Fisunoglu M (2024) The Impact of Diet on Hidradenitis Suppurativa Severity: A Cross-Sectional Case-Control Study. Med (Kaunas), 60(12)\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSilfvast-Kaiser A, Youssef R, Paek SY (2019) Diet in hidradenitis suppurativa: a review of published and lay literature. Int J Dermatol 58(11):1225\u0026ndash;1230\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePatel A et al (2022) Hidradenitis Suppurativa in the United States: Insights From the National Inpatient Sample (2008\u0026ndash;2017) on Contemporary Trends in Demographics, Hospitalization Rates, Chronic Comorbid Conditions, and Mortality. Cureus 14(5):e24755\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGarg A et al (2022) Comorbidity screening in hidradenitis suppurativa: Evidence-based recommendations from the US and Canadian Hidradenitis Suppurativa Foundations. J Am Acad Dermatol 86(5):1092\u0026ndash;1101\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAnzaldi L et al (2020) Characterizing inpatient hospitalizations for hidradenitis suppurativa in the United States. J Am Acad Dermatol 82(2):510\u0026ndash;513\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePourmontaseri H, Khanmohammadi S (2024) Demographic risk factors of pro-inflammatory diet: a narrative review. Front Nutr 11:1448806\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVadiveloo M et al (2019) Geographic Differences in the Dietary Quality of Food Purchases among Participants in the Nationally Representative Food Acquisition and Purchase Survey (FoodAPS). Nutrients, 11(6)\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAbu Rached N et al (2022) The Role of Hormones in Hidradenitis Suppurativa: A Systematic Review. Int J Mol Sci, 23(23)\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBelamarić M, Miše J, Bukvić Z, Mokos (2023) The Association Between Hidradenitis Suppurativa and Diet: An Update. Acta Dermatovenerol Croat 31(4):213\u0026ndash;219\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFernandez JM et al (2020) Alleviating and exacerbating foods in hidradenitis suppurativa. Dermatol Ther 33(6):e14246\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFrew JW, Hawkes JE, Krueger JG (2019) Topical, systemic and biologic therapies in hidradenitis suppurativa: pathogenic insights by examining therapeutic mechanisms. Ther Adv Chronic Dis 10:2040622319830646\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMandour MO et al (2023) Metabolic endoscopy and a simplified low-carbohydrate-high-dietary fiber template as novel treatments for hidradenitis suppurativa - A case series. JAAD Case Rep 34:23\u0026ndash;26\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlqallaf J et al (2024) The Effect of High-Fat Diet on Intramyocellular Lipid Content in Healthy Adults: A Systematic Review, Meta-Analysis, and Meta-Regression. J Nutr 154(4):1087\u0026ndash;1100\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMaharjan BR et al (2021) The Effect of a Sustained High-Fat Diet on the Metabolism of White and Brown Adipose Tissue and Its Impact on Insulin Resistance: A Selected Time Point Cross-Sectional Study. Int J Mol Sci, 22(24)\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWeber I, Giefer J, Martin KL (2023) Effects of Exercise and Dietary Modifications on Hidradenitis Suppurativa: A Systematic Review. Am J Clin Dermatol 24(3):343\u0026ndash;357\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlikhan A et al (2019) North American clinical management guidelines for hidradenitis suppurativa: A publication from the United States and Canadian Hidradenitis Suppurativa Foundations: Part I: Diagnosis, evaluation, and the use of complementary and procedural management. J Am Acad Dermatol 81(1):76\u0026ndash;90\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKhan A, Chang MW (2022) The role of nutrition in acne vulgaris and hidradenitis suppurativa. Clin Dermatol 40(2):114\u0026ndash;121\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKaragiannidis I et al (2016) Hidradenitis suppurativa/Acne inversa: an endocrine skin disorder? Rev Endocr Metab Disord 17(3):335\u0026ndash;341\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHaddad NR et al (2024) Positive correlation of hidradenitis suppurativa and ultra-processed foods consumption. Arch Dermatol Res 316(5):172\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMolnar J et al (2020) Hidradenitis Suppurativa and 1-Carbon Metabolism: Role of Gut Microbiome, Matrix Metalloproteinases, and Hyperhomocysteinemia. Front Immunol 11:1730\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNakamizo S et al (2021) High-fat diet induces a predisposition to follicular hyperkeratosis and neutrophilic folliculitis in mice. J Allergy Clin Immunol 148(2):473\u0026ndash;485e10\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWolk K, Join-Lambert O, Sabat R (2020) Aetiology and pathogenesis of hidradenitis suppurativa. Br J Dermatol 183(6):999\u0026ndash;1010\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWitte K et al (2022) Phytotherapeuthics Affecting the IL-1/IL-17/G-CSF Axis: A Complementary Treatment Option for Hidradenitis Suppurativa? Int J Mol Sci, 23(16)\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePelczyńska M et al (2023) The Preventive Mechanisms of Bioactive Food Compounds against Obesity-Induced Inflammation. Antioxid (Basel), 12(6)\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMcCullough ML et al (2022) Association of Socioeconomic and Geographic Factors With Diet Quality in US Adults. JAMA Netw Open 5(6):e2216406\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTucker KL, Noel SE (2025) Cultural Considerations in Assessing Dietary Intake in Racially, Ethnically, or Socioeconomically Diverse Populations. Annu Rev Nutr\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAly S et al (2021) Cancer-related Beliefs and Preventive Health Practices among Residents of Rural versus Urban Counties in Alabama. Cancer Prev Res (Phila) 14(5):593\u0026ndash;602\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographics. Data presented in number and percentage, \u003cem\u003eN (%).\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eHS (n\u0026thinsp;=\u0026thinsp;195)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eControl (n\u0026thinsp;=\u0026thinsp;191)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e146 (75%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e124 (65%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e49( 25%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e67 (35%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRace\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAsian\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e1 (\u0026lt;\u0026thinsp;1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e10 (5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAfrican American\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e140 (72%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e48 (25%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHispanic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e5 (3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e3 (2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNative American\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e1 (\u0026lt;\u0026thinsp;1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0 (\u0026lt;\u0026thinsp;1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhite\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e47 (24%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e130 (68%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e1 (\u0026lt;\u0026thinsp;1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0 (\u0026lt;\u0026thinsp;1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e18\u0026ndash;25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e29 (15%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e17 (9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e25\u0026ndash;30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e35 (18%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e16 (9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e30\u0026ndash;39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e48 (24%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e37 (19%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e40\u0026ndash;49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e44 (23%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e48 (25%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e50\u0026ndash;59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e22 (11%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e31 (16%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e60\u0026ndash;65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e17 (9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e42 (22%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMean Consumption of Foods by Patient in HS and Control Group.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHS (n\u0026thinsp;=\u0026thinsp;195)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eControl (n\u0026thinsp;=\u0026thinsp;191)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003et-Test (p-value)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFruits/Vegetables\u003c/b\u003e\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWhole Grains\u003c/b\u003e\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSweetened/Caffeinated Beverages\u003c/b\u003e\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWater\u003c/b\u003e\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCandies/Chocolates\u003c/b\u003e\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eProcessed Foods\u003c/b\u003e\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFried Foods\u003c/b\u003e\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDairy\u003c/b\u003e\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMeat\u003c/b\u003e\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.70\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eProtein\u003c/b\u003e \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.98\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEggs\u003c/b\u003e\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.64\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003csup\u003e \u003cem\u003ea\u003c/em\u003e \u003c/sup\u003e \u003cem\u003eReported in mean servings per day.\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003csup\u003e \u003cem\u003eb\u003c/em\u003e \u003c/sup\u003e \u003cem\u003eReported in mean servings per week.\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMean Consumption of Foods among Patient in Varying HS Hurley Stages.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHurley 1 (n\u0026thinsp;=\u0026thinsp;39)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHurley 2 (n\u0026thinsp;=\u0026thinsp;75)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHurley 3 (n\u0026thinsp;=\u0026thinsp;81)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eANOVA (p-value)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFruits/Vegetables\u003c/b\u003e\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.80\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWhole Grains\u003c/b\u003e\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSweetened/Caffeinated Beverages\u003c/b\u003e\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWater\u003c/b\u003e\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.63\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCandies/Chocolates\u003c/b\u003e\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.63\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eProcessed Foods\u003c/b\u003e\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.98\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFried Foods\u003c/b\u003e\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.63\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDairy\u003c/b\u003e\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.47\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMeat\u003c/b\u003e\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.98\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eProtein\u003c/b\u003e \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.78\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEggs\u003c/b\u003e\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.88\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003csup\u003e \u003cem\u003ea\u003c/em\u003e \u003c/sup\u003e \u003cem\u003eReported in mean servings per day.\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003csup\u003e \u003cem\u003eb\u003c/em\u003e \u003c/sup\u003e \u003cem\u003eReported in mean servings per week.\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMean responses regarding food insecurity and affordability from patients with and without HS.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHS\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003enon-HS\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003et-test\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIn the past month, how often did you worry about having enough food?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIn the past month, how often did you eat from fast food restaurants or packaged meals because it was more affordable than cooking at\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ehome?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e "}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"archives-of-dermatological-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Archives of Dermatological Research](https://www.springer.com/journal/403)","snPcode":"403","submissionUrl":"https://submission.nature.com/new-submission/403/3","title":"Archives of Dermatological Research","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Hidradenitis suppurative, Acne inversa, Western diet, Dietary patterns, Inflammation, Food insecurity","lastPublishedDoi":"10.21203/rs.3.rs-8388830/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8388830/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eHidradenitis suppurativa (HS) is an inflammatory skin condition caused by follicular occlusion and is associated with painful lesions in intertriginous areas of the skin. The primary objectives of this study were to investigate the relationship between HS severity and dietary factors and to explore which specific food groups, if any, are linked to an increase in HS severity. We also aimed to identify any potential disparities that may contribute to poor dietary habits.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThis study employed a cross-sectional, survey-based approach to determine dietary habits of patients with and without HS at a university hospital in the Southern United States. A food frequency survey was utilized to assess dietary intake. Statistical analyses involved chi-squared and ANOVA tests to identify significant association.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eA total of 386 (195 with HS, 191 controls) participants took part in this study. Statistical analysis indicated significant differences in the consumption of high glycemic index (GI) foods, processed foods, fried items, and dairy products among patients with and without HS (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). The HS group particularly reported decreased consumption of low GI foods than their counterparts (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Food insecurity and affordability played a significant role in access to nutrient dense foods for patients with HS.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eOur findings indicate that greater consumption of inflammatory foods is associated with exacerbation of symptoms associated with HS. Implementing dietary modifications in HS treatment plans with greater awareness of social disparities could play a valuable role in reducing disease burden and improving patients\u0026rsquo; quality of life.\u003c/p\u003e","manuscriptTitle":"Hidradenitis Suppurativa and Dietary Patterns: Insights from a Cross-Sectional Survey Study in the Southern U.S.","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-05 05:33:56","doi":"10.21203/rs.3.rs-8388830/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewersInvited","content":"","date":"2026-02-03T06:06:10+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-12-19T15:48:45+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-12-19T15:47:37+00:00","index":"","fulltext":""},{"type":"submitted","content":"Archives of Dermatological Research","date":"2025-12-17T19:37:01+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"archives-of-dermatological-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Archives of Dermatological Research](https://www.springer.com/journal/403)","snPcode":"403","submissionUrl":"https://submission.nature.com/new-submission/403/3","title":"Archives of Dermatological Research","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"b5f3d6e4-470c-4ea8-9d41-2bf58e429def","owner":[],"postedDate":"February 5th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-02-05T05:33:56+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-05 05:33:56","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8388830","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8388830","identity":"rs-8388830","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}