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Studies with larger sample size investigating the mycobiome in preclinical HS skin as well as the gut mycobiome are warranted in HS. Although the participating patients had similar therapeutic experiences previously, we were unable to document long-term systematic changes of the skin mycobiome when sampling hair follicles. We thus investigated the skin mycobiome in HS patients and healthy controls using high throughput amplicon sequencing of the highly conserved eukaryotic 18S ribosomal RNA gene. [Extracted from the article]

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease defined by recurrent nodules, tunnels and scarring involving the intertriginous regions. Recent next‐generation sequencing (NGS) studies suggest genera such as Prevotella spp., Peptoniphilus spp. and Porphyromonas spp. are associated with chronic and early HS lesions. However, a systematic investigation of the bacterial microbiome in HS tunnels remains unexplored using NGS. Objective: We aimed to investigate the bacterial composition of the luminal white gelatinous material found in HS tunnels using NGS. Methods: An exploratory study of patients with diagnosis of HS (n = 32) with tunnels. The tunnels were present either in the groin (n = 17) or in the axilla (n = 15). During deroofing of the tunnels, a sterile E‐swab was taken of the luminal gelatinous material. The samples were investigated using NGS targeting 16S ribosomal RNA. Results: The skin microbiome was characterized in 32 HS patients. Overall, five microbiome types were identified: Porphyromonas spp. (type I), Corynebacterium spp., (type II), Staphylococcus spp. (type III), Prevotella spp. (type IV) and Acinetobacter spp (type V). Porphyromonas spp. (type I) and Prevotella spp. (IV) were the most frequent genera found the tunnels. Conclusion: This study points to a potential association between the presence of certain anaerobic bacteria (Porphyromonas spp., Prevotella spp.) and HS tunnels. It may be speculated that these two genera are associated with the pathogenesis in HS either as drivers or as biomarkers. [ABSTRACT FROM AUTHOR]

Background: An aberrant interaction between commensal skin bacteria and the host skin immune system is considered important in the pathogenesis of hidradenitis suppurativa (HS). Objective: In this study, we investigated the antibiotic susceptibility and biofilm‐forming capabilities of S. epidermidis strains isolated from HS patients. Methods: Skin biopsies were taken from active HS lesions such as inflammatory nodules and/or sinuses and non‐involved skin from 26 patients and cultured under optimal microbiological conditions for 24 h. Planktonic growth, biofilm production, antibiotic susceptibility and biofilm eradication by clindamycin, doxycycline, rifampicin and tetracycline were tested including a laboratory control strain of S. epidermidis for reference. Results: Staphylococcus epidermidis was cultured in 16 of 26 HS patients (62%). In total 27 different S. epidermidis isolates were identified; 16 (59%) from non‐involved skin and 11 (41%) from HS lesions. All bacterial strains showed planktonic growth. Twenty‐four of 27 (89%) isolates were strong biofilm producers in vitro. The biofilm‐forming capability varied amongst the strains from non‐involved skin and lesional skin. Twenty‐four strains had an intermediate to resistant antibiotic susceptibility to clindamycin (89%). Rifampicin was the most effective antibiotic at inhibiting planktonic growth and at eradication of biofilm (P < 0.05). Conclusion: We observed a slight increase in S. epidermidis virulence, characterized by resistance to commonly used antibiotics, increased biofilm production and resistance to biofilm eradication. In particular, the reduced sensitivity to tetracycline and clindamycin, two standard antibiotics in the treatment of HS, is alarming. Rifampicin, also important in HS treatment, showed the greatest efficacy at eradicating the biofilm at low MIC concentrations. [ABSTRACT FROM AUTHOR]

Abstract: Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease defined by recurrent nodules, tunnels and scarring involving the intertriginous skin. Patients with HS often report an array of systemic symptoms such as fatigue and malaise. The aetiology of these symptoms remains unclear. Previously, various bacteria have been associated with mature HS lesions, and bacteraemia has been reported in patients with HS using traditional culturing methods. Thus, we hypothesized that a low‐grade bacteraemia contributes to the symptomatology in patients with HS. Objective: To explore the potential presence of bacteraemia in patients with HS and healthy controls. Method: A case–control study. Compositions of bacteria in the blood of 27 moderate to severe HS patients and 26 healthy controls were investigated using next‐generation 16S ribosomal RNA gene sequencing (NGS) and routine anaerobic and aerobic blood culturing. None of the participants received any antibiotics (systemic or topical therapy) within 1 month prior to the study. HS patients with a recent flare were randomly selected by consecutive recruitment of eligible patients from the Department of Dermatology, Zealand University Hospital, Denmark. Healthy controls were recruited from the University of Copenhagen as well as from the healthcare staff. Results: The different bacterial compositions were investigated using NGS and traditional anaerobic and aerobic blood culturing. Our NGS analysis provided a previously unreported characterization of the bacterial composition in peripheral blood from patients with HS and healthy controls. Overall, our data demonstrated that patients with HS do not have a different bacterial composition in their peripheral blood than healthy controls. Conclusion: The study suggests that the self‐reported symptoms in HS such as malaise and fatigue may not be linked to bacteraemia. [ABSTRACT FROM AUTHOR]

The article presents a study which compares the biofilm-forming capabilituies, antibiotic susceptibility and in vitro growth of Staphylococcus (S.) lugdunensis strains from hidradenitis suppurativa (HS) lesions. All strains revealed growth in liquid medium in vitro. Rifampicin was superior to tetracycline, doxycycline and clindamycin in both biofilm eradication and growth inhibition.