Association of hidradenitis suppurativa with periodontitis: A narrative review

Hidradenitis suppurativa (HS) and periodontitis are chronic inflammatory diseases that share characteristics such as systemic inflammation with elevated common cytokines, dysbiosis in their etiopathogenesis, and common risk factors. These similarities could suggest an association between the two conditions. Therefore, the objective of this narrative review was to explore this potential connection. A narrative review was conducted using the PubMed and Epistemonikos databases. The results showed that cutaneous dysbiosis in HS is characterized by a reduction in commensal microbiota and an increase in the presence of anaerobic bacteria, particularly Prevotella spp. and Porphyromonas spp. In the case of periodontitis, dysbiosis promotes the translocation of Gram-negative bacteria, such as Porphyromonas gingivalis, into the bloodstream, contributing to a systemic inflammatory response. Both diseases are associated with elevated levels of pro-inflammatory cytokines, including IL-17, TNF-α, and IFNγ, and share significant risk factors such as obesity and smoking. Clinical studies have reported a notably higher prevalence of periodontitis in patients with HS and similarities in subgingival microbiome composition. A retrospective cohort study highlighted an increased risk of developing periodontitis in patients with HS at 3- and 5-year follow-ups.