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Recent Advances in Acne, Rosacea and Hidradenitis Suppurativa
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Recent Advances in Acne, Rosacea and Hidradenitis Suppurativa

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Dermatology".

Deadline for manuscript submissions: 30 July 2025 | Viewed by 7856

Special Issue Editors

Dr. Aikaterini I. Liakou

E-Mail Website
Guest Editor
1st Department of Dermatology and Venereology, Andreas Sygros Hospital, University of Athens Medical School, 161 21 Athina, Greece
Interests: hidradenitis suppurativa; alopecia; acne; aesthetic dermatology; veneorology; allergic diseases
Prof. Dr. Alexandros Stratigos

E-Mail Website
Guest Editor
1st Department of Dermatology and Venereology, Andreas Sygros Hospital, University of Athens Medical School, 161 21 Athina, Greece
Interests: dermatology; oncology; melanoma; hidradenitis

Special Issue Information

Dear Colleagues,

Acne, rosacea and hidradenitis suppurativa are now common chronic inflammatory skin diseases. Clinical manifestations include papules, pustules, nodules, cysts and scars. It is most common in teenagers but can affect people of all ages. These conditions can lead to reduced self-esteem, anxiety and depression in patients, and pain can pose a challenge to an individual’s emotional health and well-being. The disease progresses, persists and is difficult to treat, adding to the burden on patients.

Various therapeutic interventions are available, including topical medications, oral therapies, biological treatments, surgery and laser and light therapy. We welcome papers in the form of original articles or reviews that provide exciting new insights into acne, rosacea and hidradenitis suppurativa, including but not limited to clinical activities related to diagnosis, treatment and management.

Dr. Aikaterini I. Liakou
Prof. Dr. Alexandros Stratigos
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • acne
  • rosacea
  • hidradenitis suppurativa
  • inflammatory skin diseases
  • papules
  • pustules
  • nodules
  • cysts
  • scars
  • topical medications
  • oral therapies
  • biological treatments
  • surgery
  • laser and light therapy
  • challenges
  • diagnosis
  • treatment
  • management
  • challenges

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Published Papers (6 papers)

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Research

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20 pages, 876 KiB  
Article
The Role of Sex in Body Composition Differences in Hidradenitis Suppurativa: Insights from Bioelectrical Impedance Analysis
by Zuzanna Piętowska-Marczak, Katarzyna Krefft-Trzciniecka, Alicja Pakiet and Danuta Nowicka
J. Clin. Med. 2025, 14(8), 2760; https://doi.org/10.3390/jcm14082760 - 17 Apr 2025
Viewed by 307
Abstract
Background: Hidradenitis suppurativa (HS) is a rare, debilitating, chronic inflammatory skin disease. This study aimed to investigate differences in body composition between patients with hidradenitis suppurativa (HS) and healthy controls, with a particular focus on sex-specific disparities, while also exploring secondary associations [...] Read more.
Background: Hidradenitis suppurativa (HS) is a rare, debilitating, chronic inflammatory skin disease. This study aimed to investigate differences in body composition between patients with hidradenitis suppurativa (HS) and healthy controls, with a particular focus on sex-specific disparities, while also exploring secondary associations with muscle health and quality of life. Methods: Body composition was measured using a bioanalyzer and compared between HS individuals (n = 53) and controls (n = 50). Results: The mean BMI was significantly higher in the HS group than in the controls (median 29.6 vs. median 22.1; p < 0.001, effect size −0.581). The patients with HS had a significantly higher fat mass (mean 26.2 ± 22.7 vs. 16.3 ± 6.0; p < 0.001, effect size −0.400), level of visceral fat (median 9 vs. 2; p < 0.001, effect size −0.473), percentage of total body water (mean 45.9 ± 12.3 vs. 31.9 ± 14.3; p < 0.001, effect size −0.508), skeletal muscle index (median 8.9 vs. 7.3; p < 0.001, effect size −0.445), and bone mass (median 3.2 vs. 2.5; p < 0.001, effect size −0.421); at the same time, they had a significantly lower predicted muscle mass (median 19.8 vs. 47.3; p < 0.001, effect size −0.740) and percentage of skeletal muscle mass (mean 38.2 ± 7.8 vs. 42.3 ± 5.5; p = 0.008, effect size −0.263) in comparison to the controls. The HS group was also characterized by a higher metabolic age (median 65 vs. 21 years; p < 0.001, effect size −0.760) and basal metabolic rate (median 1927 vs. 1489 kcal; p < 0.001, effect size −0.444). Conclusions: Patients with HS exhibit a distinctive pattern in body composition parameters when compared to healthy controls, which may hold significant potential for enhancing diagnostic accuracy and monitoring disease progression. This study highlighted sex-specific differences in body composition, emphasizing the need to consider biological sex in the pathophysiology and clinical evaluation of HS. Further research is needed to explore the clinical utility of body composition analysis in disease progression, therapeutic response, and personalized management. Full article
(This article belongs to the Special Issue Recent Advances in Acne, Rosacea and Hidradenitis Suppurativa)
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25 pages, 7066 KiB  
Article
Unraveling the Skin Microbiome in Hidradenitis Suppurativa: Implications for Treatment and Disease Progression
by Corina Ioana Cucu, Călin Giurcăneanu, Mara Madalina Mihai, Teodora Andronic, Ioan Ancuta, Mircea Ioan Popa, Ioana Sabina Macovei and Liliana Gabriela Popa
J. Clin. Med. 2025, 14(7), 2424; https://doi.org/10.3390/jcm14072424 - 2 Apr 2025
Viewed by 556
Abstract
Background: Hidradenitis suppurativa (HS) is a chronic, disabling, and disfiguring inflammatory disease with a complex, incompletely elucidated pathogenesis. The role of skin dysbiosis in the development and progression of HS has not yet been clarified. Methods: We performed an observational, prospective culture-based study [...] Read more.
Background: Hidradenitis suppurativa (HS) is a chronic, disabling, and disfiguring inflammatory disease with a complex, incompletely elucidated pathogenesis. The role of skin dysbiosis in the development and progression of HS has not yet been clarified. Methods: We performed an observational, prospective culture-based study that included 40 HS patients and analyzed the bacterial load and diversity in HS skin lesions, their correlation with disease severity, and several host and environmental factors. Additionally, we investigated the prevalence of antibiotic resistance and determined the resistance profile of bacterial strains isolated from chronic HS lesions. Results: An impressive number and diversity of bacterial strains were isolated from both superficial and deep HS lesions. 201 aerobic and anaerobic bacterial strains were isolated, polymicrobial growth being detected in the majority of samples. The most frequently isolated bacteria were Staphylococcus epidermidis, Staphylococcus aureus, Staphylococcus lugdunensis, Peptoniphilus spp., and Enterococcus faecalis in superficial lesions and Staphylococcus epidermidis, Staphylococcus aureus, and Corynebacterium tuberculostearicum in deep lesions. A significantly higher bacterial density and diversity was found in male patients, regardless of the affected area and in patients with severe HS. The proportion of bacterial strains resistant to antibiotics was lower in our study (8.95%) compared to the previously reported data. Conclusions: Our findings indicate dysbiosis as a key player in the initiation and maintenance of the inflammatory process in HS. Further large-scale, prospective studies are required to comprehensively characterize the microbiological landscape of HS and shed light on its contribution in the pathogenesis of the disease. Full article
(This article belongs to the Special Issue Recent Advances in Acne, Rosacea and Hidradenitis Suppurativa)
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13 pages, 1322 KiB  
Article
Endotyping Insulin–Glucose Homeostasis in Hidradenitis Suppurativa: The Impact of Diabetes Mellitus and Inflammation
by Nessr Abu Rached, Johannes W. Dietrich, Lennart Ocker, Eggert Stockfleth, Yannik Haven, Daniel Myszkowski and Falk G. Bechara
J. Clin. Med. 2025, 14(7), 2145; https://doi.org/10.3390/jcm14072145 - 21 Mar 2025
Cited by 1 | Viewed by 663
Abstract
Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease often associated with metabolic disorders such as diabetes mellitus. Recent research suggests a link between systemic inflammation and insulin–glucose dysregulation in HS. This study investigates the relationship between insulin–glucose homeostasis, diabetes mellitus and [...] Read more.
Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease often associated with metabolic disorders such as diabetes mellitus. Recent research suggests a link between systemic inflammation and insulin–glucose dysregulation in HS. This study investigates the relationship between insulin–glucose homeostasis, diabetes mellitus and the haptoglobin concentration in HS patients. Methods: We assessed 95 HS patients and 49 controls using validated fasting-based function tests, including the Structural Parameter Inference Approach (SPINA), Homeostasis Model Assessment (HOMA) and Quantitative Insulin Sensitivity Check Index (QUICKI). Results: The HS patients had a significantly higher fasting insulin concentration (97.2 vs. 69.0 pmol/L, p = 0.035), increased insulin resistance (HOMA-IR: 3.47 vs. 2.57, p = 0.016) and impaired insulin sensitivity (SPINA-GR: 1.34 vs. 1.76 mol/s, p = 0.017). In diabetes, the insulin sensitivity was more strongly reduced (SPINA-GR: 0.61 vs. 1.41 mol/s, p = 0.0057) and the insulin resistance increased (HOMA-IR: 7.3 vs. 3.2, p = 0.017). Higher haptoglobin concentrations were accompanied by worse glycaemic control, demonstrating a significantly elevated fasting glucose (5.77 vs. 5.11 mmol/L, p = 0.043) concentration and HbA1c (5.7% vs. 5.4%, p = 0.0081) fraction. Conclusions: Our findings suggest that chronic inflammation in HS contributes to metabolic dysregulation, worsening insulin resistance and glycaemic control, particularly in those with elevated haptoglobin or diabetes. Full article
(This article belongs to the Special Issue Recent Advances in Acne, Rosacea and Hidradenitis Suppurativa)
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12 pages, 1077 KiB  
Article
Hidradenitis Suppurativa Is Associated with an Increased Risk of Adverse Cardiac Events and All-Cause Mortality
by Thomas Z. Rohan, Ramsay Hafer, Teresa Duong, Rishob Dasgupta and Sherry Yang
J. Clin. Med. 2025, 14(4), 1110; https://doi.org/10.3390/jcm14041110 - 9 Feb 2025
Viewed by 999
Abstract
Background: Hidradenitis suppurativa (HS) has been previously associated with greater rates of major adverse cardiac events (MACEs) compared to the general population. This study aims to better elucidate the association between HS, MACEs, and other cardiovascular diseases. Methods: We utilized TriNetX, [...] Read more.
Background: Hidradenitis suppurativa (HS) has been previously associated with greater rates of major adverse cardiac events (MACEs) compared to the general population. This study aims to better elucidate the association between HS, MACEs, and other cardiovascular diseases. Methods: We utilized TriNetX, a global database of electronic health records, to conduct a retrospective cohort study. HS patients were matched on demographic and cardiovascular disease risk factors to both healthy and psoriasis groups as controls. Results: After adjusting for cardiovascular disease risk factors, HS patients had a relative risk (RR) (95% CI) of 2.06 (1.83–2.32) for myocardial infarction, 1.62 (1.44–1.82) for ischemic stroke, 2.21 (2.04–2.40) for heart failure, 1.95 (1.84–2.07) for MACEs, and 2.57 (2.34–2.83) for all-cause mortality compared to healthy controls. When comparing HS patients to matched psoriasis controls, HS patients had an RR of 1.31 (1.17–1.47) for myocardial infarction, 1.04 (0.93–1.16) for ischemic stroke, 1.24 (1.15–1.34) for heart failure, 1.16 (1.09–1.22) for MACEs, and 1.38 (1.27–1.5) for all-cause mortality. Herein, we demonstrate that patients with HS have increased rates of all cardiovascular diseases investigated when compared to healthy and psoriasis controls, even after adjusting for cardiovascular disease risk factors. Conclusions: These findings highlight the potential benefit in screening for and managing modifiable cardiovascular risk factors in HS patients. Full article
(This article belongs to the Special Issue Recent Advances in Acne, Rosacea and Hidradenitis Suppurativa)
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10 pages, 235 KiB  
Article
Association between Inflammatory Markers and Psychometric Scores in Patients with Hidradenitis Suppurativa
by Aikaterini I. Liakou, Nikolaos Rotsiamis, Andreas G. Tsantes, Eleni Routsi, Natalia Rompoti, Petros Ioannou, Alexandra Mpakosi, Lydia Tsamtsouri, Efthymia Agiasofitou, Ourania Kotsafti, Stefanos Bonovas, Alexander Katoulis, Evangelia Papadavid and Dimitris Rigopoulos
J. Clin. Med. 2024, 13(19), 5795; https://doi.org/10.3390/jcm13195795 - 28 Sep 2024
Cited by 1 | Viewed by 1719
Abstract
Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder with a significant impact on the quality of life of affected patients. This study aimed to correlate serum inflammatory markers with specific tools assessing quality of life, emotional well-being, and loneliness, such [...] Read more.
Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder with a significant impact on the quality of life of affected patients. This study aimed to correlate serum inflammatory markers with specific tools assessing quality of life, emotional well-being, and loneliness, such as the Dermatology Life Quality Index (DLQI), Hospital Anxiety and Depression Scale (HADS), and the UCLA Loneliness Scale. Methods: A pilot observational study including 37 patients with HS was conducted. Inflammatory serum markers, including C-reactive protein (CRP) and Erythrocyte Sedimentation Rate (ESR), were evaluated at baseline, 3 months, and 6 months later. Psychometric scores were also evaluated at the same study intervals. Results: DLQI was correlated with ESR at baseline (Spearman’s rho = 0.35, p = 0.03), indicating that poorer quality of life is associated with changes in this serum marker. Disease activity, as reflected by inflammatory markers, was associated with significant psychological burden. Specifically, a worse DLQI score was associated with higher ESR (estimate β = 0.14, 95% confidence interval [CI]: 0.05–0.22; p = 0.001) and higher CRP level (estimate β = 0.25, 95% CI: 0.02–0.48; p = 0.02). Similarly, a worse UCLA score was associated with higher ESR (estimate β = 0.11, 95% CI: 0.02–0.20, p = 0.01). Conclusions: Our study results underline the close relation between systemic inflammatory markers and clinical severity together with psychological burden in HS patients, as indicated by the significant association that was revealed between ESR/CRP and poorer psychometric scores. However, further research is warranted to validate these findings. Full article
(This article belongs to the Special Issue Recent Advances in Acne, Rosacea and Hidradenitis Suppurativa)

Review

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11 pages, 1199 KiB  
Review
Deciphering Childhood Rosacea: A Comprehensive Review
by Yu Ri Woo and Hei Sung Kim
J. Clin. Med. 2024, 13(4), 1126; https://doi.org/10.3390/jcm13041126 - 16 Feb 2024
Cited by 3 | Viewed by 2803
Abstract
Childhood rosacea is a lesser known, yet significant, skin condition presenting diagnostic and treatment challenges. Although often underdiagnosed due to unclear diagnostic criteria, it manifests similarly to adult rosacea, with features such as papulopustular, telangiectasia, granulomatous, idiopathic facial aseptic granuloma, and ocular rosacea. [...] Read more.
Childhood rosacea is a lesser known, yet significant, skin condition presenting diagnostic and treatment challenges. Although often underdiagnosed due to unclear diagnostic criteria, it manifests similarly to adult rosacea, with features such as papulopustular, telangiectasia, granulomatous, idiopathic facial aseptic granuloma, and ocular rosacea. The complex pathophysiology involves genetic, immunological, and environmental factors. Distinguishing childhood rosacea from conditions like acne, steroid rosacea, sarcoidosis, and lupus vulgaris is crucial but complicated by the lack of established criteria. Treatment strategies, mainly extrapolated from adult management protocols, include topical therapies, systemic medications, and laser treatments, adapted for pediatric patients. Special attention is given to ocular rosacea, often preceding skin manifestations, necessitating multidisciplinary care. The review underscores the urgent need for clear diagnostic guidelines, increased awareness, and tailored pediatric treatment protocols to improve patient outcomes and mitigate the condition’s evolution into adulthood. Full article
(This article belongs to the Special Issue Recent Advances in Acne, Rosacea and Hidradenitis Suppurativa)
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