• Author
    Amanda Ruci
  • Discovery PI

    Jeremy Davis MD

  • Project Co-Author

    Andre Naguib Guirguis BS, Yvonne Kong Chung BS, Weston McClain JD

  • Abstract Title

    Clinical Nutrition Interventions and Hidradenitis Suppurativa: A Retrospective Cohort Study on Weight Management and Disease Severity

  • Discovery AOC Petal or Dual Degree Program

    Basic, Clinical, & Translational Research

  • Abstract

    Background: Hidradenitis suppurativa (HS) is a chronic auto-inflammatory skin condition highly associated with obesity and metabolic dysfunction. While lifestyle interventions are increasingly recommended as adjunctive therapy, their efficacy remains unclear.

    Objective: To evaluate the association between clinical nutrition and lifestyle interventions with HS disease severity. These include: dietary modification, supplement use, exercise, weight loss, smoking cessation, pharmacologic therapy, and other procedural interventions.  

    Methods: A retrospective chart review was conducted at UCLA Health reviewing medical records from January 2015 to December 2023. Patients with HS who received weight management or other lifestyle interventions through a UCLA-affiliated clinical nutrition clinic were included in this study. A study specific composite HS severity score (CHSSS) was constructed due to the heterogeneity of data on disease severity for baseline and follow-up visits. Spearman rank correlation was used to assess the association between weight loss percentage and ΔCHSSS. Chi-squared analysis was used to assess the distribution of improvement across weight loss categories.

    Results: Among 139 patients (mean age: 38.0 ± 12.1 years, 84.2% female, mean BMI: 38.13 ± 9.74 kg/m²), a statistically significant negative correlation was identified between weight loss percentage and ΔCHSSS (rs = -0.199, p = 0.019), indicating that greater weight loss was associated with greater improvement in HS severity. Anti-inflammatory, Mediterranean, high protein, and calorie-restricted dietary approaches were all associated with mean improvements in CHSSS. GLP-1 agonists (53.2%) and non-GLP-1 anti-obesity medications (31.7%) were associated with mean ΔCHSSS of -0.26 and -0.33 respectively, indicating modest disease improvement. Menstrual cycle regulation demonstrated the strongest improvement signals (mean ΔCHSSS -0.38, 55.6% improved).

    Conclusions: Clinical nutrition and lifestyle interventions are associated with meaningful improvements in HS severity, supporting the hypothesis that a relationship exists between lifestyle factors and HS disease activity. Routine integration of clinical nutrition and lifestyle interventions for those with HS represents a low-risk, evidence-based adjunctive to chronic HS management.

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