Dietary patterns in western patients with hidradenitis suppurativa: a cross-sectional study using the rapid prime diet quality screener

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that predominantly affects intertriginous regions such as the axillary, inguinal, anogenital, and submammary areas. The exact pathogenesis remains unclear, but inflammation, genetics, obesity, diet, microbiome alterations, and hormonal imbalances are believed to contribute to its development and progression.

HS is associated with significant morbidity, impacting patients' quality of life, social functioning, and leading to depression or suicidal ideation in some cases. Obesity, with a BMI of ≥25, is considered an important risk factor for HS, as it induces inflammation and exacerbates disease activity. Diet, too, is increasingly recognized as playing a central role in HS pathogenesis and clinical manifestation.

High-fat and high-sugar diets are thought to worsen HS symptoms by upregulating pro-inflammatory cytokines, while a Mediterranean diet (MD) and elimination diets, such as those excluding dairy and gluten, may reduce HS severity. This study aimed to evaluate the dietary patterns of Western patients with HS using the Rapid Prime Diet Quality Screener (rPDQS) and compare these findings with a historical healthy reference group representative of the Western diet.

The study enrolled 71 patients, aged 18 and above, with HS at the HS outpatient clinic of the Department of Dermatology, Venereology, and Allergy at the Medical University Innsbruck, Austria. The rPDQS, a validated and concise food frequency instrument, was used to assess overall dietary quality, and individual food frequency items were analyzed to identify dietary categories in HS patients.