Search Results (554)

Background/Objectives: Antibiotics are commonly used for acne treatment. However, increasing bacterial resistance has prompted interest in natural antimicrobial agents, such as thymol (THY), as alternative therapies. This study investigated the effectiveness of Leciplex cationic nanovesicles encapsulating thymol (LPX-THY) as a promising topical acne management strategy. Methods: Leciplex nanovesicles were assembled using soy phosphatidylcholine (SPC) and cationic surfactants and characterized in terms of particle size, zeta potential, entrapment efficiency, morphology, in vitro release, and ex vivo skin permeation. The optimized formulation was subsequently incorporated into Carbopol/HPMC gel base and evaluated in terms of viscosity, in vitro release, ex vivo skin permeation, in vitro antimicrobial study, and in vivo assessment in a rat model. Results: Optimal THY-LPX nanovesicles made of SPC and Dimethyldidodecylammonium bromide DDAB in a 1:1 molar ratio showed circular outline with particle size, zeta potential, and entrapment efficiency of 187.7 ± 1.78 nm, 36.97 ±0.21 mV, and 60.5 ± 2.3%, respectively. THY-LPX gel demonstrated minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) at a concentration of 156.25 µg·mL⁻¹ against Staphylococcus aureus, a clear absence of biofilm coating under SEM, and substantial red fluorescence, indicating reduction in viable bacteria under a confocal laser microscope. In vivo study showed enhanced anti-inflammatory effect evidenced by substantial ear skin thickness reduction; 72.7% for THY-LPX gel-treated rats compared to 41.7% and 20% for THY gel and blank LPX gel-treated groups, respectively. Histopathological investigation further confirmed reduced inflammatory response in rats treated with optimized THY-LPX gel. Conclusions: The developed THY-LPX gel serves as a potential topical delivery platform of THY for acne therapy. Full article

Acne is a common inflammatory skin condition that significantly impacts quality of life. Standard treatments often cause skin irritation or contribute to antibiotic resistance. Cannabidiol (CBD) has demonstrated anti-inflammatory and sebum-regulating properties; however, its application is limited by poor solubility and stability. This study investigated the physicochemical properties of a CBD-loaded hyaluronic acid–graft-poly(N-isopropylacrylamide) nanogel (Hy-CBD). The biological activities of Hy-CBD, including its anti-inflammatory and antioxidant effects, were also evaluated. In addition, an exploratory clinical study was conducted to assess the safety and efficacy of the formulation in 22 Asian participants with inflammatory acne. In this open-label, non-randomized study, participants applied the gel twice daily for seven days. Assessments of skin tolerance, lesion size, redness, and pigmentation were performed at baseline, Day 2, and Day 7 using clinical examination and imaging analysis. The Hy-CBD gel was clinically tolerated, with no evidence of comedogenic or acnegenic potential. By Day 7, inflammatory lesion size was reduced by 46%, with significant improvements in redness and post-inflammatory pigmentation. All participants reported a subjective reduction in acne severity and expressed satisfaction with the treatment outcomes. These findings suggest that the Hy-CBD gel is a safe and promising delivery system for acne management. Nevertheless, larger randomized controlled studies are required to validate these preliminary findings. Full article

Background: Acne vulgaris affects up to 80% of individuals aged 11–30 years and frequently results in permanent scarring with significant psychosocial impact. This prospective single-arm case series evaluated the safety and high-frequency ultrasound-assessed morphological changes in a combined protocol integrating subcision, PEGDE-crosslinked hyaluronic acid supplemented with calcium hydroxyapatite (CaHA), and fractional 1470 nm diode laser therapy in patients with facial atrophic acne scars. Methods: Twenty patients (aged 18–42 years, Fitzpatrick phototypes I–II) with moderate-to-severe atrophic acne scars underwent subcision of fibrotic adhesions using a 22G cannula combined with a single subcutaneous injection of 2 mL PEGDE-crosslinked hyaluronic acid with CaHA microparticles on day 0, followed by two sessions of fractional 1470 nm diode laser therapy on days 7 and 28. Scar depth and diameter were assessed using high-frequency ultrasound (48 MHz) at baseline and on days 28, 49, 77, and 139. Results: All participants completed the protocol without serious adverse events. High-frequency ultrasound demonstrated progressive reductions in mean scar depth (from 0.35 to 0.05 mm; −86%) and scar diameter (from 4.27 to 1.06 mm; −75%) by day 139, with reductions continuing beyond the active treatment phase. In linear mixed-effects models accounting for within-patient clustering of the two lesions assessed per participant, the reductions in both depth and diameter were statistically significant at every follow-up timepoint relative to baseline (all p < 0.001). These ultrasound findings were not corroborated by a control group, blinded assessment, validated clinical grading, or patient-reported outcomes. Conclusions: In this single-arm case series, the combined subcision, PEGDE-crosslinked HA–CaHA filler, and fractional 1470 nm diode laser protocol was well tolerated and associated with progressive, sustained reductions in high-frequency ultrasound-measured scar depth and diameter. As an uncontrolled, unblinded study without validated clinical grading or patient-reported outcomes, these findings are preliminary and require confirmation in larger, controlled trials. Full article

In dairy cows, teat keratinization occurs where keratinized tissue rings form around teat tips (opening). Manifesting as skin damage in mechanically milked dairy cows, keratinization presents as dry, rough, pale, or milky-white keratinous protrusions around teat orifices and progresses via the combined effects of mechanical stress, management practices, host genetics, environmental influences, and nutritional metabolism. The teat hole is the first physiological barrier protecting the mammary glands from external pathogen invasion. Most mastitis cases are caused by pathogens invading the mammary tissues from the teat end, thereby significantly impacting mammary gland health. Thus, there are no safe, effective, economical, and standardized treatment protocols for terminal teat hyperkeratosis in dairy cows. To address this, we treated keratinization lesions using pharmacological interventions and evaluated their efficacy in 91 cows at a large commercial dairy farm in Heilongjiang Province. Urea ointment, salicylic acid ointment, and 5% azelaic acid acne cream exerted therapeutic or alleviating effects toward teat keratosis, whereas retinoic acid ointment demonstrated poor therapeutic efficacy. In a three-daily application regimen, the optimal treating dose was 0.3 g. These findings provide a scientific basis for the clinical management of hyperkeratosis in large-scale dairy farms and the development of related veterinary therapeutics. Full article

Background and Objectives: Janus kinase (JAK) inhibitors have expanded the therapeutic options for moderate-to-severe atopic dermatitis (AD). The possibility of dose modulation with abrocitinib (100 and 200 mg) and upadacitinib (15 and 30 mg), both selective JAK1 inhibitors, represents a potential clinical advantage, allowing dose escalation in cases of insufficient response and dose de-escalation in the setting of poor tolerability or during maintenance treatment. However, real-world data remain limited, and the rationale for dose adjustment is not always standardized. This study aimed to describe, using a real-world database, the frequency, timing, and reasons for dose modifications of these agents. Materials and Methods: We retrospectively analyzed the clinical data of 212 patients with moderate-to-severe AD treated with abrocitinib (n = 47) or upadacitinib (n = 165). Dose adjustments, including dose escalation and dose de-escalation, were recorded together with their timing and clinical reasons. Results: In the abrocitinib group, 34/47 patients (72.3%) initiated treatment at 100 mg, whereas 13/47 patients (27.7%) started at 200 mg. Six patients (12.8%) underwent a dose adjustment. One patient (2.1%) switched from 200 to 100 mg because of complete AD remission and concomitant menstrual cycle alterations, whereas five patients (10.6%) underwent dose escalation from 100 to 200 mg because of incomplete disease control. Among the six abrocitinib-treated patients who underwent dose adjustment, achievement of IGA 0/1 after dose modification was documented in all cases. In the upadacitinib group, 93/165 patients (56.4%) started at 15 mg, whereas 72/165 patients (43.6%) started at 30 mg. Overall, 44/165 patients (26.7%) underwent at least one dose adjustment, accounting for a total of 50 dose modifications: 27 escalations from 15 to 30 mg and 23 de-escalations from 30 to 15 mg. Among patients initiating treatment at 15 mg, 23/93 patients (24.7%) increased the dose to 30 mg after a median of 33.1 weeks because of suboptimal disease control. Among those starting at 30 mg, 21/72 patients (29.2%) reduced the dose to 15 mg after a median of 44.3 weeks. Of these, 12/21 patients (57.1%) reduced the dose because of adverse events, including herpetic infections and acne, whereas the remaining patients de-escalated because of optimal disease control. Some patients underwent multiple dose modifications: four followed a 30→15→30 mg sequence, with re-escalation after 13.2 weeks because of suboptimal disease control, and two followed a 15→30→15 mg sequence, with dose reduction after approximately 26.7 weeks because of herpes zoster. Overall, 29/44 patients achieved IGA 0/1 within 16 weeks and 38/44 within 32 weeks after dose modification. Conclusions: In this real-world cohort, dose adjustments of selective JAK1 inhibitors were frequently performed in patients with moderate-to-severe AD, particularly among those treated with upadacitinib. Dose escalation was mainly used to address suboptimal disease control, whereas dose de-escalation was performed in the setting of adverse events or optimal disease control. The availability of two dosing regimens may allow treatment intensity to be adapted to individual disease severity, response, and tolerability, supporting a personalized approach to AD management. Full article

The skin microbiome is essential for epidermal barrier integrity and immune homeostasis. This review explores the therapeutic shift in dermo-cosmetics toward probiotic, prebiotic, synbiotic, and postbiotic strategies for managing wound healing, “inflammaging”, and chronic dermatoses like acne, atopic dermatitis (AD), psoriasis, and rosacea. Mechanisms include gut–skin axis modulation, competitive pathogen exclusion, and the suppression of inflammatory pathways (e.g., NF-κB). While live probiotics demonstrate high clinical efficacy, their formulation is severely hindered by standard cosmetic preservatives and manufacturing thermal stress. Consequently, evidence suggests inanimate postbiotics have emerged as promising, stable alternatives, which may offer antimicrobial and tissue-repairing benefits without strict cold-chain requirements. However, the industry faces significant regulatory ambiguity and “probiotic-washing”, with most commercial products mislabeling postbiotic lysates as live cultures. Advancing this field requires standardized sampling protocols and transparent labeling. Ultimately, precision dermatology is likely to be driven by AI-assisted microbiome profiling, synthetic biology, and advanced delivery matrices (e.g., electrospun nanofibers, alginate microencapsulation), transforming skincare from reactive treatments into proactive, targeted ecological management. Full article

Background: A novel day–night facial serum regimen combining antioxidants, hydration-enhancing agents, and bioactive compounds has been developed to address skin aging. Objective: The aim is to explore changes in skin aging parameters and assess the safety and tolerability of a day-and-night facial serum combination. Methods: In this single-arm, non-randomized, prospective, open-label study, 30 participants aged 35–55 years applied a day facial serum (DFS) and a night facial serum (NFS) for 8 weeks. Objective assessments included skin texture and depression (Antera 3D^®), elasticity and firmness (Cutometer^®), hydration (Corneometer^®), TEWL (Tewameter^®), melanin index (Mexameter^®), and brightness (Colorimeter^®). Evaluations were performed at baseline, at 1 month and 2 months after treatment start, and at 1 month post-treatment. Results: Thirty participants (Fitzpatrick III–IV) completed the study. Significant improvements in skin texture (p = 0.002) and reduction in skin depression (−22.7%, p < 0.001) were observed after 2 months. Skin firmness increased significantly at 1 month (p < 0.001) and remained elevated post-treatment (p = 0.008). The melanin index decreased at 1 month (p = 0.048), while hydration declined after discontinuation (p = 0.016). TEWL showed a significant overall time effect; however, no Bonferroni-adjusted pairwise comparison versus baseline was significant. No significant changes were observed in elasticity or brightness. Mild transient burning was the most common adverse event. Other reported adverse events included acne, miliaria rubra, oiliness, and mild itching; all were non-serious and did not result in treatment discontinuation. Conclusions: The combined DFS and NFS regimen was well tolerated and was associated with favorable changes in skin texture and firmness. Transient local reactions, particularly mild burning sensation, were commonly reported but did not result in treatment discontinuation. Further controlled studies are warranted to confirm these observations. Full article

Introduction: Chronic wounds and pathologic scars remain a persistent challenge in plastic surgery. Conventional treatments can be costly and inconsistent, prompting interest in regenerative approaches that utilize autologous tissue. Emulsified fat produces nanofat through mechanical processing and contains adipose-derived stem cells, stromal vascular fractions, extracellular matrix proteins, cytokines and growth factors. The purpose of this systematic review is to evaluate the use of autologous nanofat for wound healing and scar management, with emphasis on preparation techniques, treatment indications, and outcomes. Methods: A comprehensive PubMed search with no date restrictions was conducted in January 2026 using MeSH terms and keywords related to nanofat and wound-healing applications. Studies were screened independently by two reviewers using the Rayyan platform. Eligible studies evaluated nanofat for wound healing in human or animal subjects; non-English articles, studies not involving nanofat, editorials, and conference abstracts were excluded. The extracted data included study characteristics, participant numbers, treatment details, indications, adjunct therapies, follow-up duration, outcomes, and complications. Studies were grouped by clinical application, with individual reports included in multiple categories when relevant. Results: The search identified 53 records, of which 22 studies met the inclusion criteria after screening. These included 20 human and two animal studies spanning randomized controlled trials (n = 3), prospective trials (n = 6), retrospective analyses (n = 6), case series (n = 4), and case reports (n = 3). Mechanical emulsification was the predominant autologous nanofat preparation method (91%), often combined with filtration or centrifugation. Clinical indications in human studies were diverse, most commonly including scar treatment (n = 14) (acne, burns, depressed, and post-surgical), followed by chronic wounds (n = 3) and reconstructive applications (n = 3). Nanofat was administered via injection in 86% of studies (n = 19), typically using fine-gauge needles or microcannulas with intradermal or subdermal placement, while three studies used non-injection approaches such as topical, membrane, or dressing-based delivery. Scar or aesthetic parameters, measured using VSS, POSAS, physician grading, photography, pigmentation analysis, or clinical appearance, were evaluated in 73% of studies (n = 16), and all reported improvement in variables such as pigmentation, pliability, thickness, texture, or overall appearance. Wound-healing endpoints were assessed in 36% (n = 8), with 100% (n = 8) demonstrating accelerated healing, improved epithelialization, or defect closure. Patient-reported outcomes, including satisfaction or quality of life, were measured in 32% (n = 7), and all showed improvement. Objective imaging modalities (e.g., 3D imaging, ultrasound, angiography, digital analysis) were used in 23% (n = 5), each confirming structural or physiologic improvement. Histologic or biomolecular analyses were performed in 27% (n = 6) and uniformly demonstrated regenerative changes, such as increased angiogenesis, collagen remodeling, or growth factor expression. Treatment was well tolerated, with 77% of studies (n = 17) reporting minimal or no complications and only transient mild adverse effects, including mild pain, bruising, erythema, and edema. Conclusions: Current evidence suggests that autologous nanofat is a promising regenerative therapy for wound healing and scar modulation. Across diverse clinical applications, nanofat has been associated with improved tissue quality, enhanced healing, and favorable patient-reported outcomes, with minimal complications. The mechanical processing of autologous tissue may also involve fewer regulatory concerns compared with more extensively manipulated cellular products. Full article

Acne is a prevalent chronic inflammatory skin disorder with a high recurrence rate, in which Propionibacterium acnes (P. acnes) plays a key pathogenic role by colonizing subepidermal pilosebaceous units. The stratum corneum limits drug penetration, rendering conventional topical therapies ineffective. Herein, we report a detachable sustained-release microneedle system named Bacitracin@Hyaluronic Acid–Zein Microneedle (Bac@HA-ZMN) for localized antibacterial delivery in acne therapy. This microneedle patch consists of a dissolvable HA base and zein-based indwelling microneedle tips loaded with bacitracin (Bac) against P. acnes. Mechanical testing showed an average fracture force of 1.6 N per needle tip (n = 100), sufficient for skin insertion. The needle tips enabled Bac delivery to a depth of approximately 500 μm. In vitro transdermal studies demonstrated a cumulative release of 76.1% within 96 h, significantly higher than that of the control group (14.2%). In a murine acne model, the Bac@HA-ZMN treatment group showed a significantly smaller lesion area than the control group, and the immunohistochemical positive expression areas of the inflammatory factors IL-8, MMP-2, and TNF-α were reduced to 0.79%, 4.12%, and 2.14%, respectively, which was caused by the inhibitory effect of Bac on P. acnes. These results demonstrated Bac@HA-ZMN as a promising localized, sustained antibacterial delivery platform for acne treatment. Full article

Background/Objectives: Provisional restorations are essential in prosthodontic treatment, and reliable intraoral repair is clinically important during extended interim use. This in vitro study evaluated the effects of organic solvent pretreatment on surface characteristics and shear bond strength (SBS) of CAD/CAM provisional restorative materials fabricated by milling, stereolithography (SLA), and digital light processing (DLP). Methods: Three materials were assigned to five surface treatment conditions: no solvent (control), isopropyl alcohol (IPA), tetrahydrofuran (THF), acetonitrile (ACN), and pyridine (PYR). After pretreatment, separate specimens were used for surface analysis and SBS testing. Surface roughness was measured by atomic force microscopy using arithmetic mean height (S_a) and root mean square height (S_q), and surface morphology was examined by scanning electron microscopy (SEM). For SBS testing, specimens were repaired using a universal adhesive and a flowable resin composite, followed by failure mode analysis. Data were analyzed using two-way ANOVA and Tukey’s post hoc test (α = 0.05). Results: Material type, solvent treatment, and their interaction significantly affected SBS, S_a, and S_q. The DLP material showed the highest SBS overall, with no significant differences among treatments. In the SLA material, ACN resulted in the lowest SBS, whereas PYR showed the highest mean value. In the milled material, THF, ACN, and PYR produced significantly higher SBS than the control and IPA groups. Conclusions: Within the limitations of this study, the effect of organic solvent pretreatment on repair performance was substrate-dependent. Full article

Background/Objectives: The efficacy of topical therapies in dermatology is often limited by the barrier function of the stratum corneum, which restricts drug penetration. Iontophoresis is a non-invasive transdermal delivery technique that uses a low-intensity electrical current to enhance the transport of charged and polar molecules across the skin. It has emerged as a strategy to improve local drug bioavailability while minimizing systemic exposure. We systematically reviewed the clinical evidence on the efficacy, safety, and pharmacologic performance of iontophoresis-assisted topical drug delivery in dermatologic diseases. Methods: This systematic review followed PRISMA guidelines and was prospectively registered in PROSPERO (CRD420251234877). PubMed, Embase, Web of Science, CENTRAL, and ClinicalTrials.gov were searched through 19 November 2025 without language restrictions. Records were screened against predefined eligibility criteria, and data were extracted on study design, participants, dermatologic indications, intervention/comparator, iontophoresis parameters, efficacy outcomes, and adverse events. The risk of bias was assessed using RoB 2 for randomized trials and the JBI checklist for non-randomized studies. Because of substantial clinical and methodological heterogeneity, the findings were synthesized narratively and no meta-analysis was performed. Results: Twenty-one studies published between 1990 and 2025 met the inclusion criteria, including 15 randomized and 6 non-randomized studies. Investigated conditions included psoriasis, eczema, melasma, post-inflammatory hyperpigmentation, herpes labialis, onychomycosis, chronic ulcers, systemic sclerosis-related digital ulcers, acne scarring, and actinic keratosis. Across studies, findings were mixed. The most consistent signals of benefit were observed in pigmentary disorders and infectious diseases, whereas results were more heterogeneous in inflammatory dermatoses and some studies did not show superiority over active comparators. Tolerability was generally favorable, with adverse events limited to mild, reversible local reactions such as erythema, tingling, burning, or transient irritation. No serious treatment-related adverse events were reported. Conclusions: Iontophoresis may represent a useful non-invasive delivery-enhancement strategy in selected dermatologic settings, particularly when topical efficacy is limited by anatomical or physicochemical barriers. However, heterogeneity in protocols, formulations, outcomes, and clinical indications limits direct comparison and does not support broad conclusions of efficacy across all dermatologic conditions. Larger, standardized trials are needed to clarify its therapeutic role, long-term efficacy, and indication-specific benefit. Full article

Intervertebral disc degeneration (IDD) is a fundamental pathological basis of low back pain, yet its pathogenic mechanisms remain incompletely understood. Infection by low-virulence anaerobic bacteria has recently been recognized as a potential etiological factor. In this study, Cutibacterium acnes (C. acnes) was detected in 13.7% of degenerated intervertebral disc (IVD) tissues, and its presence was significantly associated with younger patients and Modic changes. In vitro experiments demonstrated that C. acnes supernatant induces oxidative stress, apoptosis, and extracellular matrix (ECM) degradation in nucleus pulposus (NP) cells in a dose-dependent manner. RNA sequencing and functional validation further indicated that these pathological effects are mediated through activation of the p38 MAPK signaling pathway. Pharmacological inhibition of p38 with the specific inhibitor BIRB-796 effectively reversed the observed cellular damage. Wogonin exhibited negligible cytotoxicity toward NP cells and significantly attenuated C. acnes supernatant-induced oxidative stress, apoptosis, and ECM metabolic imbalance by inhibiting the phosphorylation of p38, JNK, and ERK1/2 within the MAPK pathway. Furthermore, in vivo experiments confirmed that Wogonin alleviated disc height loss, reduced T2-weighted signal attenuation, and mitigated histological damage induced by C. acnes in rat models, thereby restoring the balance between ECM synthesis and degradation. Collectively, this study demonstrates for the first time that C. acnes supernatant exacerbates IDD through activation of the p38 MAPK signaling pathway. It further shows that Wogonin can specifically inhibit this pathway and effectively ameliorate C. acnes-mediated IDD damage in both in vitro and in vivo models. These findings expand the theoretical framework of infection-related mechanisms underlying IDD and identify potential therapeutic targets and candidate agents for the treatment of IDD associated with C. acnes infection. Low back pain is a common health issue affecting populations worldwide, with intervertebral disc degeneration as its core etiology. However, the pathogenic causes in some patients, especially young individuals, remain incompletely understood. This study found that Cutibacterium acnes, a low-virulence bacterium commonly colonizing human skin and mucous membranes, produces metabolic products that can induce damage to the core cells of the intervertebral disc, exacerbate disc degeneration, and this process is associated with the abnormal activation of specific cellular signaling pathways. Through clinical sample detection, cell experiments, and animal model validation, we confirmed that infection with this bacterium is closely related to young patients and specific spinal imaging changes. Meanwhile, we identified Wogonin, a natural compound extracted from Scutellaria baicalensis, which can effectively inhibit the aforementioned abnormal signaling pathways, alleviate cell damage caused by bacterial metabolic products, and improve the pathological state of intervertebral disc degeneration. This study not only reveals the role of low-virulence bacterial infection in intervertebral disc degeneration and provides a new explanation for the pathogenic mechanism in young patients but also offers a natural antibiotic-free candidate for addressing bacterial resistance. It holds significant reference value for the clinical diagnosis and treatment of spinal diseases as well as the development of related drugs. Full article

Background/Objectives: A matrix system for topical application was developed for a hydrophobic drug model, benzoyl peroxide (BPO), by turning it into its amorphous state to increase its bioavailability. BPO is commonly used to treat acne vulgaris; however, the commercially available products possess several drawbacks including poor absorption due to large crystal size and thus reduced efficacy and skin irritation. Methods: Several polymeric films containing amorphous BPO were successfully prepared for the first time from polymer + plasticizer colloidal dispersions and characterized. Results: The loaded BPO maintained its amorphous state even after 24 months of storage at 5 °C, and drug release could be modulated by adjusting the film compositions. The prepared films were obtained by solvent evaporation, and residual acetone remained below the level of quantification of the analytical method. In addition, the films were thin, flexible, transparent, bioadhesive, and able to remain on the skin for a clinically relevant period. Microscopic imaging confirmed a homogeneous and continuous morphology. Conclusions: The developed formulations may represent promising alternatives for the treatment of acne vulgaris. Full article

Acne vulgaris is a chronic inflammatory disease of the pilosabaceous unit with a multifactorial pathogenesis involving sebaceous gland activity, follicular hyperkeratinization, microbial dysbiosis, and immune dysregulation. Increasing attention has been given to the role of the skin and gut microbiome, as well as the gut–skin axis, although their clinical significance has not yet been fully explained. This review critically evaluates the current evidence regarding the use of probiotics, prebiotics, and synbiotics in the treatment of acne. Available studies suggest that microbiome-targeted interventions may influence inflammatory pathways, microbial composition, and metabolic regulators such as IGF-1 and mTORC1. Some clinical trials indicate improvements in acne severity and skin parameters following oral or local interventions. However, the evidence is heterogeneous and limited by small sample sizes, short study durations, and variability in formulations and outcomes. Therefore, although microbiome-based strategies may have potential as adjunctive therapy, their clinical efficacy remains uncertain. Further, well-designed, large-scale studies are needed to determine their role in dermatological practice. Full article

Hidradenitis suppurativa (HS) is a chronic inflammatory dermatosis characterized by recurrent nodules, abscesses, and sinus tract formation in intertriginous skin. Although HS is increasingly recognized as an autoinflammatory condition rather than a classical infection, antimicrobial therapies remain central to disease management, implicating a potential role for the cutaneous microbiome in disease activity. Recent advances in culture-independent sequencing techniques have enabled more detailed characterization of microbial communities in HS, revealing consistent alterations in microbial composition and diversity. Compared with healthy skin, HS lesions exhibit reduced microbial diversity, depletion of commensal organisms such as Cutibacterium acnes, and enrichment of anaerobic bacteria including Prevotella, Porphyromonas, and Finegoldia. These alterations are more pronounced in chronic, tunnel-forming disease and are frequently associated with biofilm formation, which may contribute to treatment resistance and persistent inflammation. Microbiome changes have also been observed beyond overtly lesional skin, suggesting a broader field effect. Evidence regarding extracutaneous microbial compartments, particularly the gut microbiome, remains limited and heterogeneous, while methodological variability in sampling, sequencing, and treatment exposure continues to complicate cross-study comparisons. Emerging data further suggest that immune-targeted therapies, including biologic and small-molecule agents, may indirectly influence microbial community structure through modulation of the inflammatory milieu. Collectively, the available evidence supports cutaneous dysbiosis as a characteristic feature of HS that may potentially interact bidirectionally with immune dysfunction. Future longitudinal, multi-omic studies integrated with clinical phenotyping will be critical to clarify causal relationships and to determine whether microbiome modulation can be leveraged to improve therapeutic outcomes in HS. Full article