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Acta Dermatovenerologica Croatica, Vol. 28 No. 1, 2020.

Review article

Understanding the Relationship Between Smoking and Hidradenitis Suppurativa

Zrinka Bukvić Mokos ; Department of Dermatology and Venereology, University Hospital Centre ZagrebSchool of Medicine University of Zagreb, European Reference Network (ERN) – SkinReference Center, Zagreb, Croatia
Joško Miše ; Department of Dermatology and Venereology, University Hospital Centre ZagrebSchool of Medicine University of Zagreb, European Reference Network (ERN) – SkinReference Center, Zagreb, Croatia
Anamaria Balić ; Department of Dermatology and Venereology, University Hospital Centre ZagrebSchool of Medicine University of Zagreb, European Reference Network (ERN) – SkinReference Center, Zagreb, Croatia
Branka Marinović ; Department of Dermatology and Venereology, University Hospital Centre ZagrebSchool of Medicine University of Zagreb, European Reference Network (ERN) – SkinReference Center, Zagreb, Croatia

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Abstract

Hidradenitis suppurativa (HS) is a chronic skin disease
affecting hair follicles in intertriginous areas, characterized by deep,
recurrent, painful nodules and abscesses, fistulae, sinus tracts, and
scarring. With a prevalence of 1-4%, HS is not an uncommon disease.
Several risk factors have been linked with the development of HS,
such as genetic predisposition, smoking, and obesity, leading to the
hypothesis that HS develops as a result of environmental triggers in
a genetically susceptible individual. Smoking has been recognized
as one of the environmental factors with the most impact on HS.
This review aims to provide a comprehensive and holistic view on
how smoking habits affect the incidence, severity, treatment, and
pathophysiology of HS. A growing body of published literature has
reported the association between smoking and HS, despite limitations
in proving the causal relationship due to the retrospective design
of the available studies. There is a consensus that patients with
HS who are active smokers have a higher number of affected body
areas than patients with HS who do not smoke or have stopped
smoking. Similarly, it is recommended for patients with HS to discontinue
tobacco use because of its association with weaker treatment
response. Studies on the pathophysiological mechanism of smoking
on the skin show that tobacco smoke with many of its chemicals
as well as nicotine promote the proinflammatory cytokines found
in HS lesions, activate the nicotinic acetylcholine (nAChRs) and aryl
hydrocarbon receptors (AHRs), and further suppress Notch signaling
pathway.

Keywords

hidradenitis suppurativa, acne inversa, smoking, tobacco, cigarette

Hrčak ID:

246732

URI

https://hrcak.srce.hr/246732

Publication date:

18.1.2020.

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