Joško Miše, MD, Department of Dermatology and Venereology, University Hospital Center Zagreb, School of Medicine, University of Zagreb, Šalata 4 , 10000 Zagreb, Croatia;
Acta Dermatovenerol Croat. 2020 Jul;28(1):9-13.
Hidradenitis suppurativa (HS) is a chronic skin disease affecting hair follicles in intertriginous areas, characterized by deep, recurrent, painful nodules and abscesses, fistulae, sinus tracts, and scarring. With a prevalence of 1-4%, HS is not an uncommon disease. Several risk factors have been linked with the development of HS, such as genetic predisposition, smoking, and obesity, leading to the hypothesis that HS develops as a result of environmental triggers in a genetically susceptible individual. Smoking has been recognized as one of the environmental factors with the most impact on HS. This review aims to provide a comprehensive and holistic view on how smoking habits affect the incidence, severity, treatment, and pathophysiology of HS. A growing body of published literature has reported the association between smoking and HS, despite limitations in proving the causal relationship due to the retrospective design of the available studies. There is a consensus that patients with HS who are active smokers have a higher number of affected body areas than patients with HS who do not smoke or have stopped smoking. Similarly, it is recommended for patients with HS to discontinue tobacco use because of its association with weaker treatment response. Studies on the pathophysiological mechanism of smoking on the skin show that tobacco smoke with many of its chemicals as well as nicotine promote the proinflammatory cytokines found in HS lesions, activate the nicotinic acetylcholine (nAChRs) and aryl hydrocarbon receptors (AHRs), and further suppress Notch signaling pathway.
化脓性汗腺炎（HS）是一种慢性皮肤疾病，影响皱褶部位的毛囊，其特征为深部、复发性、疼痛性结节和脓肿、瘘管、窦道和瘢痕。HS 的患病率为 1%-4%，并不罕见。已有多种危险因素与 HS 的发生相关，如遗传易感性、吸烟和肥胖，这导致了 HS 是由于遗传易感个体暴露于环境触发因素而发展的假说。吸烟已被认为是对 HS 影响最大的环境因素之一。本综述旨在全面综合地探讨吸烟习惯如何影响 HS 的发病、严重程度、治疗和发病机制。尽管由于现有研究的回顾性设计，证明因果关系存在局限性，但越来越多的已发表文献报道了吸烟与 HS 之间的关联。共识认为，与不吸烟或已戒烟的 HS 患者相比，吸烟的 HS 患者受累体区数量更多。同样，建议 HS 患者停止使用烟草，因为吸烟与治疗反应减弱有关。关于吸烟对皮肤的发病机制的研究表明，烟草烟雾及其许多化学物质以及尼古丁可促进 HS 病变中发现的促炎细胞因子，激活烟碱型乙酰胆碱（nAChRs）和芳香烃受体（AHRs），并进一步抑制 Notch 信号通路。
