{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T07:21:08Z","timestamp":1773040868616,"version":"3.50.1"},"reference-count":39,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,2,27]],"date-time":"2025-02-27T00:00:00Z","timestamp":1740614400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Background: COVID-19 disease has been associated with flares or new onsets of various autoinflammatory diseases such as psoriasis and atopic dermatitis. Our aim is to investigate the occurrence and risk factors of flares or new onsets of Hidradenitis Suppurativa (HS) following COVID-19 disease. Methods: A retrospective cohort study was performed including 310 patients with HS following COVID-19 disease. Data on the rate of HS flares, new lesions, time of flare onset, and flare duration were recorded. Demographics, clinical characteristics, and treatment parameters were compared between patients with and without HS flares. Results: HS flares developed in 69 (22.2%) patients, with 14 experiencing their first episode. The median period between COVID-19 and flare onset was 17 days, with a median flare duration of 14 days. For new HS onset, the median period was 9.5 days, and the median duration was 13 days. Biologic treatment was less common in patients with flares (7.2% vs. 23.2%, p = 0.003), and fewer patients with flares were vaccinated (81.1% vs. 99.1%, p &lt; 0.001). Multivariable analysis showed lower risk for flares in those receiving biologics (aOR = 0.14, p = 0.002) and those who were vaccinated (aOR = 0.02, p &lt; 0.001). Conclusions: COVID-19 may trigger HS flares and new onset, with biologic treatment and vaccination offering protection.<\/jats:p>","DOI":"10.3390\/microorganisms13030542","type":"journal-article","created":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T06:45:42Z","timestamp":1740725142000},"page":"542","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Risk Factors for Flares and New Lesions of Hidradenitis Suppurativa Following COVID-19 Disease: A Retrospective Cohort Study of 310 Patients in Greece"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3936-8374","authenticated-orcid":false,"given":"Aikaterini I.","family":"Liakou","sequence":"first","affiliation":[{"name":"1st Department of Dermatology-Venereology, \u201cAndreas Sygros\u201d Hospital, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3695-0759","authenticated-orcid":false,"given":"Andreas G.","family":"Tsantes","sequence":"additional","affiliation":[{"name":"Laboratory of Haematology and Blood Bank Unit, \u201cAttikon\u201d Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece"},{"name":"Microbiology Department, \u201cSaint Savvas\u201d Oncology Hospital, 11522 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evangelia-Konstantina","family":"Bompou","sequence":"additional","affiliation":[{"name":"1st Department of Dermatology-Venereology, \u201cAndreas Sygros\u201d Hospital, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magdalini","family":"Kalamata","sequence":"additional","affiliation":[{"name":"1st Department of Dermatology-Venereology, \u201cAndreas Sygros\u201d Hospital, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Efthymia","family":"Agiasofitou","sequence":"additional","affiliation":[{"name":"1st Department of Dermatology-Venereology, \u201cAndreas Sygros\u201d Hospital, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soultana","family":"Vladeni","sequence":"additional","affiliation":[{"name":"1st Department of Dermatology-Venereology, \u201cAndreas Sygros\u201d Hospital, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angeliki","family":"Dragoutsou","sequence":"additional","affiliation":[{"name":"1st Department of Dermatology-Venereology, \u201cAndreas Sygros\u201d Hospital, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantina A.","family":"Tsante","sequence":"additional","affiliation":[{"name":"Laboratory of Haematology and Blood Bank Unit, \u201cAttikon\u201d Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1082-5674","authenticated-orcid":false,"given":"Petros","family":"Ioannou","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Crete, 71003 Heraklion, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleni","family":"Chatzidimitriou","sequence":"additional","affiliation":[{"name":"1st Department of Dermatology-Venereology, \u201cAndreas Sygros\u201d Hospital, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4459-435X","authenticated-orcid":false,"given":"Ourania","family":"Kotsafti","sequence":"additional","affiliation":[{"name":"1st Department of Dermatology-Venereology, \u201cAndreas Sygros\u201d Hospital, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Samonis","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Crete, 71003 Heraklion, Greece"},{"name":"First Department of Medical Oncology, Metropolitan Hospital of Neon Faliron, 18547 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4766-8238","authenticated-orcid":false,"given":"Georgia","family":"Vrioni","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6102-6579","authenticated-orcid":false,"given":"Stefanos","family":"Bonovas","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy"},{"name":"IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander I.","family":"Stratigos","sequence":"additional","affiliation":[{"name":"1st Department of Dermatology-Venereology, \u201cAndreas Sygros\u201d Hospital, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2603","DOI":"10.1056\/NEJMoa2034577","article-title":"Safety and efficacy of the BNT162b2 mRNA COVID-19 vaccine","volume":"383","author":"Polack","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"102524","DOI":"10.1016\/j.autrev.2020.102524","article-title":"Could Sars-coronavirus-2 trigger autoimmune and\/or autoinflammatory mechanisms in genetically predisposed subjects?","volume":"19","author":"Caso","year":"2020","journal-title":"Autoimmun. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1097\/BOR.0000000000000776","article-title":"COVID-19 and autoimmune diseases","volume":"33","author":"Liu","year":"2021","journal-title":"Curr. Opin. Rheumatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e15113","DOI":"10.1111\/dth.15113","article-title":"COVID-19 and exacerbation of dermatological diseases: A review of the available literature","volume":"34","author":"Aram","year":"2021","journal-title":"Dermatol. Ther."},{"key":"ref_5","first-page":"e25987","article-title":"Psoriasis Flares in Patients with COVID-19 Infection or Vaccination: A Case Series","volume":"14","author":"Shah","year":"2022","journal-title":"Cureus"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1159\/000508528","article-title":"Thyroid Disease and Active Smoking May Be Associated with More Severe Hidradenitis Suppurativa: Data from a Prospective Cross Sectional Single-Center Study","volume":"237","author":"Liakou","year":"2021","journal-title":"Dermatology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1111\/exd.14214","article-title":"What causes hidradenitis suppurativa?\u201415 years after","volume":"29","author":"Zouboulis","year":"2020","journal-title":"Exp. Dermatol."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Liakou, A.I., Kontochristopoulos, G., Agiasofitou, E., Tsantes, A.G., Papadakis, M., Marnelakis, I., Tsante, K.A., Kapsiocha, A., Katoulis, A., and Gregoriou, S. (2021). Colchicine Improves Clinical Outcomes and Quality of Life in Hidradenitis Suppurativa Patients: A Retrospective Study. J. Clin. Med., 10.","DOI":"10.3390\/jcm10204742"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"835","DOI":"10.4103\/ijd.ijd_622_21","article-title":"Perception and knowledge of hidradenitis suppurativa in Greece: A Cross-Sectional Study of 1301 Individuals","volume":"67","author":"Shivani","year":"2022","journal-title":"Indian J. Dermatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1111\/exd.14339","article-title":"Anti-COVID-19 measurements for hidradenitis suppurativa patients","volume":"30","author":"Bettoli","year":"2021","journal-title":"Exp. Dermatol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2026","DOI":"10.1111\/ced.15306","article-title":"Management of patients with hidradenitis suppurativa during COVID-19 vaccination: An experience from Southern Italy","volume":"47","author":"Martora","year":"2022","journal-title":"Clin. Exp. Dermatol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Geldof, J., Truyens, M., Sabino, J., Ferrante, M., Lambert, J., Lapeere, H., Hillary, T., Van Laethem, A., de Vlam, K., and Verschueren, P. (2023). SARS-CoV-2 infection and COVID19 vaccination across eight immune-mediated inflammatory disorders: A prospective, real-life Belgian cohort study\u2014The BELCOMID study. Front. Immunol., 14.","DOI":"10.3389\/fimmu.2023.1126351"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1002\/jmv.27292","article-title":"Autoimmune complications of COVID-19","volume":"94","author":"Yazdanpanah","year":"2022","journal-title":"J. Med. Virol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"102792","DOI":"10.1016\/j.autrev.2021.102792","article-title":"The SARS-CoV-2 as an instrumental trigger of autoimmunity","volume":"20","author":"Dotan","year":"2021","journal-title":"Autoimmun. Rev."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1038\/s41584-020-0448-7","article-title":"Autoimmune and inflammatory diseases following COVID-19","volume":"16","author":"Galeotti","year":"2020","journal-title":"Nat. Rev. Rheumatol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Scholl, L., Rached, N.A., Stockfleth, E., Cramer, P., Ocker, L., Stranzenbach, R., Garcovich, S., Hessam, S., and Bechara, F.G. (2024). Hidradenitis Suppurativa in the SARS-CoV-2 Pandemic: Investigation of Trigger Factors in a Single Center. J. Clin. Med., 13.","DOI":"10.3390\/jcm13144074"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1080\/17474086.2023.2288154","article-title":"Long-term hypercoagulability, endotheliopathy and inflammation following acute SARS-CoV-2 infection","volume":"16","author":"Boccatonda","year":"2023","journal-title":"Expert Rev. Hematol."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Pieralli, F., Pomero, F., Dentali, F., Norbiato, C., Attardo, T., Vicari, S., Magnani, E., Marzilli, M.A., Piccolo, P., and Valerio, A. (2023). Real-world use of remdesivir for the treatment of patients admitted to Italian hospitals with COVID-19: The nationwide retrospective FADOI-RECOVER study. BMC Infect. Dis., 23.","DOI":"10.1186\/s12879-023-08422-6"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"D\u2019Ardes, D., Pontolillo, M., Esposito, L., Masciarelli, M., Boccatonda, A., Rossi, I., Bucci, M., Guagnano, M.T., Ucciferri, C., and Santilli, F. (2020). Duration of COVID-19: Data from an Italian Cohort and Potential Role for Steroids. Microorganisms, 8.","DOI":"10.3390\/microorganisms8091327"},{"key":"ref_20","first-page":"193","article-title":"COVID-19 and autoimmune diseases: A systematic review of reported cases","volume":"17","author":"Saad","year":"2021","journal-title":"Curr. Rheumatol. Rev."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e648","DOI":"10.1111\/jdv.19968","article-title":"Flares and new related lesions of Hidradenitis Suppurativa following COVID-19 vaccination: A retrospective cohort study of 250 patients in Greece","volume":"38","author":"Liakou","year":"2024","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Cocco, G., Pizzi, A.D., Taraschi, A.L., Boccatonda, A., Corvino, A., Ucciferri, C., Falasca, K., Caulo, M., and Vecchiet, J. (2022). Atypical Sites of Lymphadenopathy after Anti-COVID-19 Vaccine: Ultrasound Features. Medicina, 58.","DOI":"10.3390\/medicina58020197"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Cocco, G., Pizzi, A.D., Fabiani, S., Cocco, N., Boccatonda, A., Frisone, A., Scarano, A., and Schiavone, C. (2021). Lymphadenopathy after the Anti-COVID-19 Vaccine: Multiparametric Ultrasound Findings. Biology, 10.","DOI":"10.3390\/biology10070652"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.jdin.2024.09.004","article-title":"COVID-19 infection or vaccination and hidradenitis suppurativa: A systematic review","volume":"18","author":"Osman","year":"2024","journal-title":"JAAD Int."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"102154","DOI":"10.1016\/j.eclinm.2023.102154","article-title":"Risk of autoimmune diseases following COVID-19 and the potential protective effect from vaccination: A population-based cohort study","volume":"63","author":"Peng","year":"2023","journal-title":"EClinicalMedicine"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Striani, G., Hoxha, A., Lorenzin, M., Cozzi, G., Scagnellato, L., Vangelista, T., Frizzera, F., De Sandre, P., Simioni, P., and Doria, A. (2023). The impact of SARS-CoV-2 infection and vaccination on inflammatory arthritis: A cohort study. Front. Immunol., 14.","DOI":"10.3389\/fimmu.2023.1207015"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1007\/s00296-024-05542-3","article-title":"Breakthrough SARS-CoV-2 infection and disease flares in patients with rheumatoid arthritis: Result from COVAD e-survey study","volume":"44","author":"Santos","year":"2024","journal-title":"Rheumatol. Int."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"103409","DOI":"10.1016\/j.autrev.2023.103409","article-title":"Increased incidence of rheumatoid arthritis after COVID-19","volume":"22","author":"Sarmiento","year":"2023","journal-title":"Autoimmun. Rev."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e1063","DOI":"10.1002\/iid3.1063","article-title":"A systematic review and meta-analysis of investigating the mutual impact of COVID-19 and psoriasis: Focusing on COVID-19 course in psoriasis and the opinion on biologics in this setting","volume":"11","author":"Khosravi","year":"2023","journal-title":"Meta-Analysis Immun. Inflamm. Dis."},{"key":"ref_30","first-page":"e173","article-title":"COVID-19 in patients with cutaneous immune-mediated diseases in The Netherlands: Real-world observational data","volume":"35","author":"Joustra","year":"2021","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Miodo\u0144ska, M., Bogacz, A., Mr\u00f3z, M., Mu\u0107ka, S., and Bo\u017cek, A. (2021). The effect of SARS-CoV-2 virus infection on the course of atopic dermatitis in patients. Medicina, 57.","DOI":"10.3390\/medicina57060521"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Gracia-Ramos, A.E., Martin-Nares, E., and Hernandez-Molina, G. (2021). New onset of autoimmune diseases following COVID-19 diagnosis. Cells, 10.","DOI":"10.3390\/cells10123592"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1093\/infdis\/jiaa363","article-title":"Serum cytokine and chemokine profile in relation to the severity of coronavirus disease 2019 in China","volume":"222","author":"Chi","year":"2020","journal-title":"J. Infect. Dis."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Smatti, M.K., Cyprian, F.S., Nasrallah, G.K., Al Thani, A.A., Almishal, R.O., and Yassine, H.M. (2019). Viruses and autoimmunity: A review on the potential interaction and molecular mechanisms. Viruses, 11.","DOI":"10.3390\/v11080762"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"102695","DOI":"10.1016\/j.autrev.2020.102695","article-title":"SARS-CoV-2, the autoimmune virus","volume":"19","author":"Halpert","year":"2020","journal-title":"Autoimmun. Rev."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1038\/s41577-020-0312-7","article-title":"COVID-19: Risk for cytokine targeting in chronic inflammatory diseases?","volume":"20","author":"Schett","year":"2020","journal-title":"Nat. Rev. Immunol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1002\/jmv.26232","article-title":"The cytokine storm and COVID-19","volume":"93","author":"Hu","year":"2021","journal-title":"J. Med. Virol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1016\/j.det.2021.05.010","article-title":"The Use of Biologics During the COVID-19 Pandemic","volume":"39","author":"Jones","year":"2021","journal-title":"Dermatol. Clin."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1056\/NEJMoa1504370","article-title":"Two Phase 3 Trials of Adalimumab for Hidradenitis Suppurativa","volume":"375","author":"Kimball","year":"2016","journal-title":"N. Engl. J. Med."}],"container-title":["Microorganisms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2607\/13\/3\/542\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:43:55Z","timestamp":1760028235000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2607\/13\/3\/542"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,27]]},"references-count":39,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["microorganisms13030542"],"URL":"https:\/\/doi.org\/10.3390\/microorganisms13030542","relation":{},"ISSN":["2076-2607"],"issn-type":[{"value":"2076-2607","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,27]]}}}