{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T22:54:20Z","timestamp":1791500060664,"version":"4.3.4"},"reference-count":114,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2025,8,9]],"date-time":"2025-08-09T00:00:00Z","timestamp":1754697600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Tertiary Education Scholarships Scheme","award":["2023"],"award-info":[{"award-number":["2023"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Hidradenitis suppurativa (HS) is a chronic, relapsing inflammatory dermatosis of the pilosebaceous unit characterized by nodules, abscesses, and dermal tunnels. Recent transcriptomic studies have implicated dysregulation of innate and adaptive immune responses, epidermal barrier dysfunction, and systemic metabolic alterations. This review synthesizes findings from 16 studies investigating the HS transcriptome using bulk and single-cell RNA sequencing. Differential gene expression analyses revealed extensive upregulation of inflammatory cytokines and chemokines, particularly in lesional and perilesional skin. These changes were also mirrored in non-lesional skin, suggesting diffuse immune dysregulation beyond visibly affected areas. Downregulated pathways include those involved in lipid metabolism, muscle contraction, and neuronal signaling, potentially linking HS to obesity, metabolic syndrome, and neuropsychiatric comorbidities. Single-cell transcriptomics confirmed the enrichment of keratinocytes and immune cells (B cells, plasma cells, M1 macrophages, and T cells) with proinflammatory profiles in HS lesions. Keratinocyte dysfunction further implicated a compromised epidermal barrier in disease pathogenesis. While transcriptomic studies have advanced mechanistic understanding and highlighted therapeutic targets\u2014such as the IL-1\u03b2\u2013TH17 axis and B cell signaling pathways\u2014methodological heterogeneity limits cross-study comparisons. Integration of multi-omics data and standardized phenotyping will be essential to identify robust biomarkers, stratify HS subtypes, and guide personalized therapeutic approaches.<\/jats:p>","DOI":"10.3390\/ijms26167704","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T11:02:09Z","timestamp":1754910129000},"page":"7704","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Transcriptomic Signatures and Molecular Pathways in Hidradenitis Suppurativa\u2014A Narrative Review"],"prefix":"10.3390","volume":"26","author":[{"given":"Jasmine","family":"Spiteri","sequence":"first","affiliation":[{"name":"Centre for Molecular Medicine & Biobanking, University of Malta, MSD 2080 Msida, Malta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3705-0119","authenticated-orcid":false,"given":"Dillon","family":"Mintoff","sequence":"additional","affiliation":[{"name":"Department of Pathology, Faculty of Medicine & Surgery, University of Malta, MSD 2080 Msida, Malta"},{"name":"Department of Dermatology, Mater Dei Hospital, MSD 2090 Msida, Malta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1661-7158","authenticated-orcid":false,"given":"Laura","family":"Grech","sequence":"additional","affiliation":[{"name":"Centre for Molecular Medicine & Biobanking, University of Malta, MSD 2080 Msida, Malta"},{"name":"Department of Applied Biomedical Sciences, Faculty of Health Sciences, University of Malta, MSD 2080 Msida, Malta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7332-874X","authenticated-orcid":false,"given":"Nikolai P.","family":"Pace","sequence":"additional","affiliation":[{"name":"Centre for Molecular Medicine & Biobanking, University of Malta, MSD 2080 Msida, Malta"},{"name":"Department of Anatomy, Faculty of Medicine & Surgery, University of Malta, MSD 2080 Msida, Malta"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,9]]},"reference":[{"key":"ref_1","first-page":"868","article-title":"S2k guideline for the treatment of hidradenitis suppurativa\/acne inversa\u2014Short version","volume":"22","author":"Zouboulis","year":"2024","journal-title":"J. Dtsch. Dermatol. Ges."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Kirby, J., Kim, K., Zivkovic, M., Wang, S., Garg, V., Danavar, A., Li, C., Chen, N., and Garg, A. (2024). Uncovering the burden of hidradenitis suppurativa misdiagnosis and underdiagnosis: A machine learning approach. Front. Med. Technol., 6.","DOI":"10.3389\/fmedt.2024.1200400"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1111\/j.1365-2133.2009.09198.x","article-title":"Objective scoring of hidradenitis suppurativa reflecting the role of tobacco smoking and obesity","volume":"161","author":"Sartorius","year":"2009","journal-title":"Br. J. Dermatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1111\/jdv.16147","article-title":"Alterations in innate immunity and epithelial cell differentiation are the molecular pillars of hidradenitis suppurativa","volume":"34","author":"Zouboulis","year":"2020","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1159\/000536389","article-title":"The Global Hidradenitis Suppurativa Atlas Methodology: Combining Global Proportions in a Pooled Analysis","volume":"240","author":"Bouazzi","year":"2024","journal-title":"Dermatology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1001\/jamadermatol.2021.1677","article-title":"Prevalence of Hidradenitis Suppurativa: A Systematic Review and Meta-regression Analysis","volume":"157","author":"Jfri","year":"2021","journal-title":"JAMA Dermatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1111\/exd.14341","article-title":"Hidradenitis suppurativa in skin of colour","volume":"30","author":"Zouboulis","year":"2021","journal-title":"Exp. Dermatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1007\/s40257-023-00796-2","article-title":"Disease Burden and Treatment Patterns Among US Patients with Hidradenitis Suppurativa: A Retrospective Cohort Study","volume":"24","author":"Garg","year":"2023","journal-title":"Am. J. Clin. Dermatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.jaad.2017.02.005","article-title":"Incidence of hidradenitis suppurativa in the United States: A sex- and age-adjusted population analysis","volume":"77","author":"Garg","year":"2017","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1177\/1203475420972348","article-title":"Race-Specific Prevalence of Hidradenitis Suppurativa","volume":"25","author":"Sachdeva","year":"2021","journal-title":"J. Cutan. Med. Surg."},{"key":"ref_11","first-page":"92","article-title":"Hidradenitis suppurativa in Black and White patients\u2014A clinical study","volume":"27","author":"Byrd","year":"2023","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1159\/000486741","article-title":"Hidradenitis Suppurativa: Disease Burden and Etiology in Skin of Color","volume":"233","author":"Lee","year":"2018","journal-title":"Dermatology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1093\/bjd\/ljad345","article-title":"Hidradenitis suppurativa: New insights into disease mechanisms and an evolving treatment landscape","volume":"190","author":"Krueger","year":"2024","journal-title":"Br. J. Dermatol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1111\/exd.12648","article-title":"Phenotypic heterogeneity implies heterogeneous pathogenic pathways in hidradenitis suppurativa","volume":"24","author":"Frew","year":"2015","journal-title":"Exp. Dermatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1002\/der2.113","article-title":"The pathogenesis of hidradenitis suppurativa: Evolving paradigms in a complex disease","volume":"3","author":"Kozera","year":"2022","journal-title":"Dermatol. Rev."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1007\/s13555-023-01083-y","article-title":"An Atlas of the Hidradenitis Suppurativa Transcriptome","volume":"14","author":"Szukala","year":"2024","journal-title":"Dermatol. Ther."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1392","DOI":"10.1111\/bjd.14371","article-title":"Gene expression profiling of skin and blood in hidradenitis suppurativa","volume":"174","author":"Blok","year":"2016","journal-title":"Br. J. Dermatol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2459","DOI":"10.1038\/jid.2012.162","article-title":"Mutations in the \u03b3-Secretase Genes NCSTN, PSENEN, and PSEN1 Underlie Rare Forms of Hidradenitis Suppurativa (Acne Inversa)","volume":"132","author":"Pink","year":"2012","journal-title":"J. Investig. Dermatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1111\/bjd.18445","article-title":"A novel NCSTN missense mutation in the signal peptide domain causes hidradenitis suppurativa, which has features characteristic of an autoinflammatory keratinization disease","volume":"182","author":"Takeichi","year":"2020","journal-title":"Br. J. Dermatol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1935","DOI":"10.1111\/exd.14919","article-title":"A loss-of-function NCSTN mutation associated with familial Dowling Degos disease and hidradenitis suppurativa","volume":"32","author":"Tricarico","year":"2023","journal-title":"Exp. Dermatol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Freudenberg, J.M., Liu, Z., Singh, J., Thomas, E., Traini, C., Rajpal, D.K., and Sayed, C.J. (2023). A Hidradenitis Suppurativa molecular disease signature derived from patient samples by high-throughput RNA sequencing and re-analysis of previously reported transcriptomic data sets. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0284047"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Ben Abdallah, H., Bregnh\u00f8j, A., Iversen, L., and Johansen, C. (2023). Transcriptomic Analysis of Hidradenitis Suppurativa: A Unique Molecular Signature with Broad Immune Activation. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms242317014"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1016\/j.jaad.2021.07.035","article-title":"The inflammatory proteome of hidradenitis suppurativa skin is more expansive than that of psoriasis vulgaris","volume":"86","author":"Navrazhina","year":"2022","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2213","DOI":"10.1016\/j.jaci.2020.12.651","article-title":"Epithelialized Tunnels are a Source of Inflammation in Hidradenitis Suppurativa","volume":"147","author":"Navrazhina","year":"2021","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Mariottoni, P., Jiang, S.W., Prestwood, C.A., Jain, V., Suwanpradid, J., Whitley, M.J., Coates, M., Brown, D.A., Erdmann, D., and Corcoran, D.L. (2021). Single-Cell RNA Sequencing Reveals Cellular and Transcriptional Changes Associated With M1 Macrophage Polarization in Hidradenitis Suppurativa. Front. Med., 8.","DOI":"10.3389\/fmed.2021.665873"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1016\/j.jaci.2023.05.012","article-title":"Single-cell transcriptomics suggest distinct upstream drivers of IL-17A\/F in hidradenitis versus psoriasis","volume":"152","author":"Kim","year":"2023","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e2404503121","DOI":"10.1073\/pnas.2404503121","article-title":"Tissue comparability and bias in hidradenitis suppurativa transcriptomic studies","volume":"121","author":"Nebo","year":"2024","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e139930","DOI":"10.1172\/jci.insight.139930","article-title":"Contribution of plasma cells and B cells to hidradenitis suppurativa pathogenesis","volume":"5","author":"Gudjonsson","year":"2020","journal-title":"JCI Insight"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1111\/ced.13959","article-title":"Transcriptome patterns in hidradenitis suppurativa: Support for the role of antimicrobial peptides and interferon pathways in disease pathogenesis","volume":"44","author":"Shanmugam","year":"2019","journal-title":"Clin. Exp. Dermatol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1007\/s00011-020-01381-7","article-title":"Transcriptomic analysis of hidradenitis suppurativa skin suggests roles for multiple inflammatory pathways in disease pathogenesis","volume":"69","author":"Rumberger","year":"2020","journal-title":"Inflamm. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e139932","DOI":"10.1172\/jci.insight.139932","article-title":"Immunopathogenesis of hidradenitis suppurativa and response to anti\u2013TNF-\u03b1 therapy","volume":"5","author":"Lowe","year":"2020","journal-title":"JCI Insight"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1111\/bjd.19795","article-title":"Activity and components of the granulocyte colony-stimulating factor pathway in hidradenitis suppurativa","volume":"185","author":"Wolk","year":"2021","journal-title":"Br. J. Dermatol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.jaci.2021.05.027","article-title":"High inflammation in hidradenitis suppurativa extends to perilesional skin and can be subdivided by lipocalin-2 expression","volume":"149","author":"Navrazhina","year":"2022","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2544","DOI":"10.3390\/cimb46030161","article-title":"The NLRP3 Inflammasome Gene Is Overexpressed in Hidradenitis Suppurativa Lesions: A Preliminary Study on the Role of Pyroptosis in Disease Pathogenesis","volume":"46","author":"Krajewski","year":"2024","journal-title":"Curr. Issues Mol. Biol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2488","DOI":"10.1111\/jdv.18465","article-title":"Stress signalling and STAT1 activation characterize the keratinocytic gene expression pattern in Hidradenitis suppurativa","volume":"36","author":"Frings","year":"2022","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1111\/jdv.17779","article-title":"Primary alterations during the development of hidradenitis suppurativa","volume":"36","author":"Dajnoki","year":"2022","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Flora, A., Jepsen, R., Kozera, E.K., Woods, J.A., Cains, G.D., Radzieta, M., Jensen, S.O., Malone, M., and Frew, J.W. (2023). Human dermal fibroblast subpopulations and epithelial mesenchymal transition signals in hidradenitis suppurativa tunnels are normalized by spleen tyrosine kinase antagonism in vivo. PLoS ONE, 18.","DOI":"10.1101\/2023.02.23.529664"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"106896","DOI":"10.1016\/j.isci.2023.106896","article-title":"Mechanism underlying follicular hyperproliferation and oncogenesis in hidradenitis suppurativa","volume":"26","author":"Jin","year":"2023","journal-title":"iScience"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Mintoff, D., Borg, I., and Pace, N.P. (2022). Serum Immunoglobulin G Is a Marker of Hidradenitis Suppurativa Disease Severity. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms232213800"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1294","DOI":"10.1016\/j.jid.2018.11.018","article-title":"The IL-1 Pathway Is Hyperactive in Hidradenitis Suppurativa and Contributes to Skin Infiltration and Destruction","volume":"139","author":"Wolk","year":"2019","journal-title":"J. Investig. Dermatol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.1111\/bjd.14075","article-title":"Dysregulated cytokine expression in lesional and nonlesional skin in hidradenitis suppurativa","volume":"173","author":"Kelly","year":"2015","journal-title":"Br. J. Dermatol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1292","DOI":"10.1111\/j.1365-2133.2011.10254.x","article-title":"Elevated levels of tumour necrosis factor (TNF)-\u03b1, interleukin (IL)-1\u03b2 and IL-10 in hidradenitis suppurativa skin: A rationale for targeting TNF-\u03b1 and IL-1\u03b2","volume":"164","author":"Dik","year":"2011","journal-title":"Br. J. Dermatol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1228","DOI":"10.4049\/jimmunol.0903907","article-title":"Deficiency of IL-22 Contributes to a Chronic Inflammatory Disease: Pathogenetic Mechanisms in Acne Inversa","volume":"186","author":"Wolk","year":"2011","journal-title":"J. Immunol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1046\/j.1365-2133.1999.02970.x","article-title":"Forms of epithelial differentiation of draining sinus in acne inversa (hidradenitis suppurativa)","volume":"141","author":"Kurzen","year":"1999","journal-title":"Br. J. Dermatol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1554","DOI":"10.1111\/exd.14451","article-title":"Hidradenitis suppurativa: A folliculotropic disease of innate immune barrier dysfunction?","volume":"30","author":"Johnston","year":"2021","journal-title":"Exp. Dermatol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1016\/j.jaad.2024.11.050","article-title":"A genome-wide association meta-analysis links hidradenitis suppurativa to common and rare sequence variants causing disruption of the Notch and Wnt\/\u03b2-catenin signaling pathways","volume":"92","author":"Stefansdottir","year":"2025","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1016\/j.jid.2019.06.152","article-title":"A Genetic Variant in the BCL2 Gene Associates with Adalimumab Response in Hidradenitis Suppurativa Clinical Trials and Regulates Expression of BCL2","volume":"140","author":"Liu","year":"2020","journal-title":"J. Investig. Dermatol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1159\/000531978","article-title":"Discovery and Potential Functional Characterization of Long Noncoding RNAs Associated with Familial Acne Inversa with NCSTN Mutation","volume":"240","author":"He","year":"2024","journal-title":"Dermatology"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/j.jaad.2017.03.016","article-title":"Gene expression of sphingolipid metabolism pathways is altered in hidradenitis suppurativa","volume":"77","author":"Dany","year":"2017","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Fincher, J.A., Jones, D.R., Korte, A.R., Dyer, J.E., Parlanti, P., Popratiloff, A., Brantner, C.A., Morris, N.J., Pirlo, R.K., and Shanmugam, V.K. (2019). Mass Spectrometry Imaging of Lipids in Human Skin Disease Model Hidradenitis Suppurativa by Laser Desorption Ionization from Silicon Nanopost Arrays. Sci. Rep., 9.","DOI":"10.1038\/s41598-019-53938-0"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"2421","DOI":"10.1016\/j.jid.2020.04.011","article-title":"Lipidomics Profiling of Hidradenitis Suppurativa Skin Lesions Reveals Lipoxygenase Pathway Dysregulation and Accumulation of Proinflammatory Leukotriene B4","volume":"140","author":"Penno","year":"2020","journal-title":"J. Investig. Dermatol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1768","DOI":"10.1016\/j.jid.2016.04.036","article-title":"Intrinsic Defect in Keratinocyte Function Leads to Inflammation in Hidradenitis Suppurativa","volume":"136","author":"Hotz","year":"2016","journal-title":"J. Investig. Dermatol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1111\/bjd.14214","article-title":"Keratinocytes and neutrophils are important sources of proinflammatory molecules in hidradenitis suppurativa","volume":"174","author":"Lima","year":"2016","journal-title":"Br. J. Dermatol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1016\/j.jid.2018.10.020","article-title":"Apocrine Gland\u2013Rich Skin Has a Non-Inflammatory IL-17\u2013Related Immune Milieu, that Turns to Inflammatory IL-17\u2013Mediated Disease in Hidradenitis Suppurativa","volume":"139","author":"Jenei","year":"2019","journal-title":"J. Investig. Dermatol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"e15087","DOI":"10.1111\/exd.15087","article-title":"Gram-negative anaerobes elicit a robust keratinocytes immune response with potential insights into HS pathogenesis","volume":"33","author":"Williams","year":"2024","journal-title":"Exp. Dermatol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1847","DOI":"10.1016\/j.jid.2020.02.046","article-title":"The Surface Microbiome of Clinically Unaffected Skinfolds in Hidradenitis Suppurativa: A Cross-Sectional Culture-Based and 16S rRNA Gene Amplicon Sequencing Study in 60 Patients","volume":"140","author":"Jais","year":"2020","journal-title":"J. Investig. Dermatol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1093\/cid\/cix285","article-title":"The Microbiological Landscape of Anaerobic Infections in Hidradenitis Suppurativa: A Prospective Metagenomic Study","volume":"65","author":"Jais","year":"2017","journal-title":"Clin. Infect. Dis."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"e140598","DOI":"10.1172\/jci.insight.140598","article-title":"Dysregulation of tryptophan catabolism at the host-skin microbiota interface in hidradenitis suppurativa","volume":"5","author":"Morel","year":"2020","journal-title":"JCI Insight"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1388","DOI":"10.1111\/exd.14141","article-title":"A systematic review and critical appraisal of metagenomic and culture studies in hidradenitis suppurativa","volume":"30","author":"Williams","year":"2021","journal-title":"Exp. Dermatol."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Lelonek, E., Bouazzi, D., Jemec, G.B.E., and Szepietowski, J.C. (2023). Skin and Gut Microbiome in Hidradenitis Suppurativa: A Systematic Review. Biomedicines, 11.","DOI":"10.3390\/biomedicines11082277"},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"\u015awierczewska, Z., Lewandowski, M., Surowiecka, A., and Bara\u0144ska-Rybak, W. (2022). Microbiome in Hidradenitis Suppurativa\u2014What We Know and Where We Are Heading. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms231911280"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"e1576","DOI":"10.1002\/hsr2.1576","article-title":"Association between metabolic syndrome and prevalent skin diseases: A systematic review and meta-analysis of case-control studies","volume":"6","author":"Sodagar","year":"2023","journal-title":"Health Sci. Rep."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1001\/jamadermatol.2014.1165","article-title":"Association of metabolic syndrome and hidradenitis suppurativa","volume":"150","author":"Miller","year":"2014","journal-title":"JAMA Dermatol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1111\/bjd.13777","article-title":"Hidradenitis suppurativa and metabolic syndrome: A comparative cross-sectional study of 3207 patients","volume":"173","author":"Shalom","year":"2015","journal-title":"Br. J. Dermatol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"e67","DOI":"10.1111\/jdv.20110","article-title":"Assessment of metabolic dysfunction-associated steatotic liver disease in patients with hidradenitis suppurativa: A cross-sectional study","volume":"39","author":"Omari","year":"2025","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"2131","DOI":"10.1111\/jdv.15764","article-title":"High prevalence of non-alcoholic fatty liver disease among hidradenitis suppurativa patients independent of classic metabolic risk factors","volume":"33","author":"Iruzubieta","year":"2019","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1159\/000517017","article-title":"Metabolic Disorders\/Obesity Is a Primary Risk Factor in Hidradenitis Suppurativa: An Immunohistochemical Real-World Approach","volume":"238","author":"Kaleta","year":"2022","journal-title":"Dermatology"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1111\/1346-8138.17328","article-title":"Causal relationship between metabolic syndrome and hidradenitis suppurativa: A two-sample bidirectional Mendelian randomization study","volume":"51","author":"Luo","year":"2024","journal-title":"J. Dermatol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1159\/000447716","article-title":"South Italy: A Privileged Perspective to Understand the Relationship between Hidradenitis Suppurativa and Overweight\/Obesity","volume":"2","author":"Fabbrocini","year":"2016","journal-title":"Ski. Appendage Disord."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1111\/ijd.14639","article-title":"Hidradenitis suppurativa in a cohort of overweight and obese children and adolescents","volume":"59","author":"Kromann","year":"2020","journal-title":"Int. J. Dermatol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1016\/j.jaad.2019.08.034","article-title":"Association between obesity and hidradenitis suppurativa among children and adolescents: A population-based analysis in the United States","volume":"82","author":"Balgobind","year":"2020","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1111\/jdv.13522","article-title":"Body composition and basal metabolic rate in Hidradenitis Suppurativa: A Danish population-based and hospital-based cross-sectional study","volume":"30","author":"Miller","year":"2016","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1111\/1346-8138.13572","article-title":"Hidradenitis suppurativa is not associated with the metabolic syndrome based on body type: A cross-sectional study","volume":"44","author":"Vossen","year":"2017","journal-title":"J. Dermatol."},{"key":"ref_74","first-page":"437","article-title":"Body mass index at the onset of hidradenitis suppurativa","volume":"19","author":"Vanlaerhoven","year":"2021","journal-title":"J. Dtsch. Dermatol. Ges."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"e713","DOI":"10.1111\/jdv.20525","article-title":"Causal association between body fat percentage and hidradenitis suppurativa: A two-sample Mendelian randomization study","volume":"39","author":"Mintoff","year":"2025","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.jdermsci.2022.08.005","article-title":"Understanding the systemic burden of disease in hidradenitis suppurativa from plasma lipidomic analysis","volume":"107","author":"Choi","year":"2022","journal-title":"J. Dermatol. Sci."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1111\/exd.12926","article-title":"Mechanical stress and the development of pseudo-comedones and tunnels in Hidradenitis suppurativa\/Acne inversa","volume":"25","author":"Boer","year":"2016","journal-title":"Exp. Dermatol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1111\/exd.14234","article-title":"Mechanical forces and Hidradenitis Suppurativa","volume":"30","author":"Boer","year":"2021","journal-title":"Exp. Dermatol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1111\/ijd.17186","article-title":"Risk of cardiovascular disorders in hidradenitis suppurativa patients: A large-scale, propensity-matched global retrospective cohort study","volume":"63","author":"Krajewski","year":"2024","journal-title":"Int. J. Dermatol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"e13853","DOI":"10.1111\/srt.13853","article-title":"Hidradenitis suppurativa and cardiovascular diseases: A bidirectional Mendelian randomization study","volume":"30","author":"Zhou","year":"2024","journal-title":"Ski. Res. Technol."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1159\/000513044","article-title":"Implications of Hidradenitis Suppurativa Phenotypes in Cardiovascular Risk and Treatment Decisions: A Retrospective Cohort Study","volume":"237","year":"2021","journal-title":"Dermatology"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1001\/jamadermatol.2024.3779","article-title":"Genetic Susceptibility to Hidradenitis Suppurativa and Predisposition to Cardiometabolic Disease","volume":"161","author":"Nielsen","year":"2025","journal-title":"JAMA Dermatol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1007\/s40257-024-00844-5","article-title":"Autoimmune, Autoinflammatory Disease and Cutaneous Malignancy Associations with Hidradenitis Suppurativa: A Cross-Sectional Study","volume":"25","author":"Brydges","year":"2024","journal-title":"Am. J. Clin. Dermatol."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1159\/000514582","article-title":"Association between Hidradenitis Suppurativa and Inflammatory Arthritis: A Systematic Review and Meta-Analysis","volume":"237","author":"Almuhanna","year":"2021","journal-title":"Dermatology"},{"key":"ref_85","first-page":"606","article-title":"High Prevalence of Back Pain and Axial Spondyloarthropathy in Patients with Hidradenitis Suppurativa","volume":"232","author":"Christou","year":"2017","journal-title":"Dermatology"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"e15194","DOI":"10.1111\/exd.15194","article-title":"Prevalence and Predictors of Inflammatory Arthritis in Hidradenitis Suppurativa","volume":"33","author":"Sy","year":"2024","journal-title":"Exp. Dermatol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1007\/s12026-021-09221-4","article-title":"Hidradenitis suppurativa and rheumatoid arthritis: Evaluating the bidirectional association","volume":"69","author":"Kridin","year":"2021","journal-title":"Immunol. Res."},{"key":"ref_88","doi-asserted-by":"crossref","unstructured":"D\u2019Onghia, M., Ciaffi, J., Calabrese, L., Tognetti, L., Cinotti, E., Rubegni, P., Frediani, B., and Ursini, F. (2024). Fibromyalgia and Skin Disorders: A Systematic Review. J. Clin. Med., 13.","DOI":"10.3390\/jcm13154404"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1111\/bjd.20954","article-title":"New insights in hidradenitis suppurativa from a population-based Dutch cohort: Prevalence, smoking behaviour, socioeconomic status and comorbidities","volume":"186","author":"Prens","year":"2022","journal-title":"Br. J. Dermatol."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1016\/j.jaad.2019.11.068","article-title":"Association between hidradenitis suppurativa, depression, anxiety, and suicidality: A systematic review and meta-analysis","volume":"83","author":"Patel","year":"2020","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1001\/jamadermatol.2019.0759","article-title":"Depression and Anxiety in Adults With Hidradenitis Suppurativa: A Systematic Review and Meta-analysis","volume":"155","author":"Machado","year":"2019","journal-title":"JAMA Dermatol."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"e71","DOI":"10.1192\/j.eurpsy.2021.2249","article-title":"A systematic review on shared biological mechanisms of depression and anxiety in comorbidity with psoriasis, atopic dermatitis, and hidradenitis suppurativa","volume":"64","author":"Fabrazzo","year":"2021","journal-title":"Eur. Psychiatry"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1038\/nri.2015.5","article-title":"The role of inflammation in depression: From evolutionary imperative to modern treatment target","volume":"16","author":"Miller","year":"2016","journal-title":"Nat. Rev. Immunol."},{"key":"ref_94","doi-asserted-by":"crossref","unstructured":"Hoffman, L.K., Tomalin, L.E., Schultz, G., Howell, M.D., Anandasabapathy, N., Alavi, A., Su\u00e1rez-Fari\u00f1as, M., and Lowes, M.A. (2018). Integrating the skin and blood transcriptomes and serum proteome in hidradenitis suppurativa reveals complement dysregulation and a plasma cell signature. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0203672"},{"key":"ref_95","first-page":"e169870","article-title":"Tertiary lymphoid structures sustain cutaneous B cell activity in hidradenitis suppurativa","volume":"9","author":"Lowe","year":"2024","journal-title":"JCI Insight"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1093\/bjd\/ljad305","article-title":"Metformin has anti-inflammatory effects and induces immunometabolic reprogramming via multiple mechanisms in hidradenitis suppurativa","volume":"189","author":"Petrasca","year":"2023","journal-title":"Br. J. Dermatol."},{"key":"ref_97","doi-asserted-by":"crossref","unstructured":"Rode, M., Nenoff, K., Wirkner, K., Horn, K., Teren, A., Regenthal, R., Loeffler, M., Thiery, J., Aigner, A., and Pott, J. (2022). Impact of medication on blood transcriptome reveals off-target regulations of beta-blockers. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0266897"},{"key":"ref_98","first-page":"341","article-title":"Serum levels of serum amyloid A, interleukin-6 and C-reactive protein correlate with severity of hidradenitis suppurativa","volume":"158","author":"Srour","year":"2023","journal-title":"Ital. J. Dermatol. Venerol."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1177\/1099800418772161","article-title":"Mechanisms and Measurement of Changes in Gene Expression","volume":"20","author":"Singh","year":"2018","journal-title":"Biol. Res. Nurs."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1111\/bjd.14338","article-title":"Ustekinumab in hidradenitis suppurativa: Clinical results and a search for potential biomarkers in serum","volume":"174","author":"Blok","year":"2016","journal-title":"Br. J. Dermatol."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1093\/bjd\/ljaf012","article-title":"High-throughput proteomics identifies inflammatory proteins associated with disease severity and genetic ancestry in patients with hidradenitis suppurativa","volume":"192","author":"Dimitrion","year":"2025","journal-title":"Br. J. Dermatol."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"2197","DOI":"10.1016\/j.jid.2021.02.742","article-title":"In-Depth Analysis of the Hidradenitis Suppurativa Serum Proteome Identifies Distinct Inflammatory Subtypes","volume":"141","author":"Navrazhina","year":"2021","journal-title":"J. Investig. Dermatol."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"e348","DOI":"10.1111\/jdv.19611","article-title":"The serum proteome of pyoderma gangrenosum is more expansive than that of hidradenitis suppurativa","volume":"38","author":"Flora","year":"2024","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_104","doi-asserted-by":"crossref","unstructured":"de Oliveira, A.S.L.E., Bloise, G., Moltrasio, C., Coelho, A., Agrelli, A., Moura, R., Tricarico, P.M., Jamain, S., Marzano, A.V., and Crovella, S. (2022). Transcriptome Meta-Analysis Confirms the Hidradenitis Suppurativa Pathogenic Triad: Upregulated Inflammation, Altered Epithelial Organization, and Dysregulated Metabolic Signaling. Biomolecules, 12.","DOI":"10.3390\/biom12101371"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"e15145","DOI":"10.1111\/exd.15145","article-title":"Comparative Transcriptome Analysis of Acne vulgaris, Rosacea, and Hidradenitis Suppurativa Supports High Dose Dietary Zinc as a Therapeutic Agent","volume":"33","author":"Li","year":"2024","journal-title":"Exp. Dermatol."},{"key":"ref_106","first-page":"9","article-title":"Understanding the Relationship Between Smoking and Hidradenitis Suppurativa: Acta dermatovenerologica Croatica: ADC","volume":"28","year":"2020","journal-title":"Acta Dermatovenerol. Croat."},{"key":"ref_107","first-page":"e1305","article-title":"The influence of body mass index and smoking on the severity of hidradenitis suppurativa in the Slovenian population","volume":"37","author":"Falabella","year":"2023","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"2457","DOI":"10.1016\/S0140-6736(24)00591-9","article-title":"Bimekizumab: Dual inhibition as a promising tool in the management of hidradenitis suppurativa","volume":"403","author":"Molinelli","year":"2024","journal-title":"Lancet"},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1007\/s00403-024-03121-x","article-title":"The use of biologics and JAK inhibitors in the management of moderate to severe Hidradenitis Suppurativa treatment: A scoping review","volume":"316","author":"Guermazi","year":"2024","journal-title":"Arch. Dermatol. Res."},{"key":"ref_110","first-page":"159","article-title":"Hidradenitis Suppurativa from a Multi-Omic Scope","volume":"29","author":"Saus","year":"2024","journal-title":"J. Cutan. Med. Surg."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"i22","DOI":"10.1093\/bjd\/ljae399","article-title":"Leveraging genotypes and phenotypes to implement precision medicine in hidradenitis suppurativa management","volume":"192","author":"Petukhova","year":"2025","journal-title":"Br. J. Dermatol."},{"key":"ref_112","unstructured":"Ge, S.X., Son, E.W., and Yao, R. (2025, January 05). iDEP 2018. Available online: https:\/\/bioinformatics.sdstate.edu\/idep\/."},{"key":"ref_113","unstructured":"Elizarraras, J., Yuxing, L., Shi, Z., and Zhang, B. (2025, February 23). WEB-Based GEne SeT AnaLysis Toolkit 2024. Available online: https:\/\/www.webgestalt.org\/."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"W168","DOI":"10.1093\/nar\/gkad393","article-title":"Enrichr-KG: Bridging enrichment analysis across multiple libraries","volume":"51","author":"Evangelista","year":"2023","journal-title":"Nucleic Acids Res."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/26\/16\/7704\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:27:03Z","timestamp":1760034423000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/26\/16\/7704"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,9]]},"references-count":114,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["ijms26167704"],"URL":"https:\/\/doi.org\/10.3390\/ijms26167704","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,9]]}}}