Treatment of hidradenitis suppurativa: Surgery and yeast (Saccharomyces cerevisiae)–exclusion diet. Results after 6 years

Abstract

BackgroundHidradenitis suppurativa is a complex disorder, the pathogenesis of which is still unsolved. The known association between hidradenitis suppurativa and Crohn’s disease, an autoimmune disease diagnosed with the presence of Anti-Saccharomyces cerevisiae antibodies of the IgG family, suggests that a much more complex mechanism than a simple infectious disorder is involved. The goal of this study is to report patients’ characteristics and the outcome of 6 years of a yeast (Saccharomyces cerevisiae)-exclusion diet and surgery in the treatment of hidradenitis suppurativa. MethodWe analyzed 185 patients with hidradenitis suppurativa with a self-evaluative questionnaire. Thirty-seven patients were treated in our center following our protocol. The other 148 were members of a support group for patients with hidradenitis suppurativa treated by other centers. ResultsIn 80% of patients who had the onset of hidradenitis suppurativa before the age of 30, the female to male ratio was 3.34:1, 74% were active smokers, and 5% also had Crohn’s disease. In the diet group, 70% had an improvement of hidradenitis suppurativa symptomatology, 81% of whom in less than 6 months. Also, 87% of patients demonstrated an immediate recurrence of skin lesions less than a week after consuming a food containing the yeast. Immunologic testing showed intolerance to yeast, wheat, and cow’s milk in 20%, 29%, and 23% of patients, respectively. ConclusionThe analysis confirmed the stabilization and regression of hidradenitis suppurativa with our diet, presumably by decreasing the local and systemic inflammation, leading to a less invasive operative treatment. These new findings seem to link hidradenitis suppurativa to food intolerance and gut dysbiosis.