Analysis Suggests Possible 'Oral–Gut–Skin Axis' in HS
Key Takeaways
Hidradenitis suppurativa (HS) lesions are enriched with anaerobic Gram-negative bacteria, unlike acne, which remains characterized by a dominance of Cutibacterium.
Oral and gut microbiome changes suggest a coordinated oral–gut–skin axis, particularly in HS.
Researchers noted that disease-specific microbial patterns may inform future microbiome-targeted therapies for HS.
New microbiome research comparing acne and hidradenitis suppurativa (HS) across multiple anatomical sites shows unique microbial signatures that may aid researchers in explaining the chronic HS phenotype.
The study authors analyzed lesional and nonlesional skin, buccal mucosa, and fecal samples from 28 patients with HS, 29 patients with acne, and 40 controls. They then characterized microbial communities using 16S rRNA V3–V4 sequencing and then utilizing quantitative polymerase chain reaction (qPCR) to validate key findings.
According to the data, HS lesions showed significant enrichment of anaerobic Gram-negative taxa, including Prevotella, Porphyromonas, and Fusobacterium. Acne lesions were dominated by Cutibacterium and Pseudomonas. Oral microbiome diversity was increased in both acne and HS vs. controls, with HS samples showing a distinct enrichment of Prevotella and Veillonella. Patients with HS (but not acne) also had reduced gut microbial diversity. Subsequent correlation analyses showed synchronized microbial shifts in the oral, gut, and skin compartments, suggesting interaction. The authors noted that qPCR analyses confirmed elevated concentrations of key anaerobic organisms in HS.
"By directly comparing acne and HS across multiple anatomical sites, our study helps differentiate general inflammatory microbiome changes from those more specific to HS," the authors wrote. "The findings also suggest a potential oral–gut–skin microbial axis that may contribute to the chronic and destructive phenotype of HS, providing insights that could inform future microbiome-targeted therapeutic approaches."
Source: Chen W, et al. Experimental Dermatology. 2025. Doi:10.1111/exd.70198