Journal of the European Academy of Dermatology and Venereology : JEADV
October 20, 2026 · via Europe PMC
Hidradenitis suppurativa skin microbiome: In-depth analysis and modulation by systemic therapies.
Amar Y, Baumann D, Niedermeier S, +5 more, Volz T.
AI summary — for doctors, generated from the abstract only
Hidradenitis suppurativa skin carries a distinct anaerobe-rich dysbiosis that antibiotics, but not adalimumab or secukinumab, partly corrected over 12 weeks.
What was studied
16S rRNA sequencing of 251 skin swabs from lesional and non-lesional sites of 52 HS patients and 31 controls, with a 28-patient sub-cohort followed on clindamycin/rifampicin (8), adalimumab (12) or secukinumab (8) for 12 weeks.
Key findings
- HS skin lost commensals (C. acnes, S. hominis, S. epidermidis) and gained anaerobes such as Finegoldia magna and Peptoniphilus; a 13-taxa signature had AUC 0.92.
- Antibiotics reduced pathogen load and increased microbial richness.
- Adalimumab and secukinumab did not change pathogen abundance and slightly lowered protective commensals.
Clinical relevance
The data hint that microbiome-directed adjuncts may complement biologics, which leave dysbiosis untouched.
Who should care
Limitations
Very small treatment arms, non-randomized and short follow-up, and no link shown between microbiome change and clinical response.
No change yet, but consider the microbiome as a potential target alongside immunomodulation in HS.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease with a multifactorial pathogenesis involving genetic, lifestyle and microbial factors. While cutaneous microbiome shifts have been reported for this disease, the impact of systemic immunomodulators and antibiotics on HS microbiome remains poorly defined.
Objective
To characterize species-level cutaneous dysbiosis in HS and evaluate the effects of three standard-of-care systemic therapies, clindamycin/rifampicin (ATB), adalimumab (ADA) and secukinumab (SEC) on skin microbial composition.
Methods
We performed 16S rRNA sequencing on 251 skin swabs from lesional and non-lesional sites of 52 HS patients and 31 healthy matched controls. In a sub-cohort of 28 patients, microbial shifts were evaluated following 12 weeks of therapy with ATB (n = 8), ADA (n = 12) and SEC (n = 8).
Results
HS skin exhibited profound dysbiosis defined by the depletion of homeostatic commensals (Cutibacterium acnes, Staphylococcus hominis, S. epidermidis) and a synergistic expansion of anaerobic pathogens, primarily Gram-positive anaerobic cocci (GPAC; Finegoldia magna, Peptoniphilus grossensis and Fenollaria massiliensis), Lawsonella clevelandensis and Campylobacter ureolyticus. A 13-taxa microbial signature accurately discriminated the HS phenotype (AUC = 0.92). Following 12 weeks of treatment, ATB markedly attenuated dysbiosis by reducing pathogen loads and significantly increasing microbial richness. In contrast, ADA and SEC did not alter pathogen abundance and were associated with a slight decline in protective commensals.
Conclusions
Systemic antibiotics partially restore cutaneous microbiome homeostasis in HS by targeting anaerobic pathogens while preserving beneficial commensals, an effect not observed with the tested biologics. These findings highlight the need for microbiome-directed adjuvant therapies to complement immunomodulation in HS management.
DOI
10.1111/jdv.70813
PMID
42899700
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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