The role of bacteria in the pathogenesis of hidradenitis suppurativa (HS) remains controversial. Firmicutes is the largest bacterial phylum, and it contains several important and well-known genera, such as Staphylococcus and Streptococcus. Studies1,2 have consistently reported bacteria from this phylum, such as Staphylococcus aureus, coagulase-negative staphylococci, and Enterococcus species, in tissue samples and cultures of purulent drainage from HS lesions. The association between obesity and HS is well known, and obesity has also been linked to an increase in bacteria from the Firmicutes phylum in gut microflora.3- 5 We hypothesized that this change in the microbial milieu that occurs with increasing body mass index (BMI) may expose patients to different bacterial species that promote a more robust inflammatory response in the skin or hair follicles of patients with HS. This study aimed to examine the prevalence of Firmicutes in bacterial cultures of purulent drainage from HS lesions and to explore its potential association with BMI.
Haskin A, Fischer AH, Okoye GA. Prevalence of Firmicutes in Lesions of Hidradenitis Suppurativa in Obese Patients. JAMA Dermatol. 2016;152(11):1276-1278. doi:10.1001/jamadermatol.2016.2337