School of Medicine, University of Missouri, Columbia, MO, USA.
Department of Dermatology, University of Missouri, 1 Hospital Dr., Columbia, MO, 65212, USA.
Am J Clin Dermatol. 2023 May;24(3):343-357. doi: 10.1007/s40257-023-00756-w. Epub 2023 Feb 9.
Hidradenitis suppurativa affects up to 4% of the population worldwide. Many treatment options exist but these come with a significant side-effect profile. Exercise, weight loss, and dietary modifications may be simple inexpensive alternatives and/or adjuncts to treating this disease.
We aimed to summarize published evidence on the effects of dietary, weight loss, and exercise interventions on the clinical course, severity, or subjective improvement of hidradenitis suppurativa and to provide a framework regarding dietary changes and exercise modalities for clinicians treating this disease.
A literature search of Scopus (1993 onwards), PubMed (1986 onwards), and MEDLINE (OVID interface, 1946 onwards) was conducted on 22 October, 2022. Case-control studies, cohort studies, and randomized controlled trials with five or more subjects conducted on adult participants (aged >18 years) were included; case reports, case series, and review papers were excluded.
Fifteen studies involving 2829 patients were included, encompassing nine cohort studies, five cross-sectional studies, and one cross-over study. Patients who were female, lost more than 50 pounds (22.7 kg), or were obese prior to weight loss saw improvement in hidradenitis suppurativa severity with weight loss. There was evidence for beneficial effects of diets, such as the Mediterranean diet that minimizes sugar, highly processed carbohydrates, and dairy, and emphasizes chicken, fruits, and vegetables, in patients with hidradenitis suppurativa. Evidence also supported benefit from oral zinc and vitamin D supplementation.
More evidence is needed in the form of randomized controlled trials or well-designed controlled trials to evaluate the effect of exercise and dietary manipulation on the hidradenitis suppurativa disease course. Overall, there is significant but weak evidence to support improvement in hidradenitis suppurativa severity with weight loss, dietary changes, and micronutrient supplementation. There is no significant evidence to support improvement in hidradenitis suppurativa symptomology with any type of exercise intervention.
This protocol was registered with PROSPERO with the registration number CRD4202235099.
化脓性汗腺炎影响全球多达 4%的人口。有许多治疗选择，但这些都伴随着显著的副作用。运动、减肥和饮食改变可能是治疗这种疾病的简单、廉价的替代方法和/或辅助方法。
我们旨在总结已发表的关于饮食、减肥和运动干预对化脓性汗腺炎临床病程、严重程度或主观改善的影响的证据，并为治疗这种疾病的临床医生提供关于饮食变化和运动方式的框架。
于 2022 年 10 月 22 日对 Scopus（1993 年起）、PubMed（1986 年起）和 MEDLINE（OVID 界面，1946 年起）进行文献检索。纳入了五项或五项以上成年参与者（年龄＞18 岁）进行的病例对照研究、队列研究和随机对照试验；排除了病例报告、病例系列和综述论文。
共纳入了 15 项涉及 2829 名患者的研究，包括 9 项队列研究、5 项横断面研究和 1 项交叉研究。女性患者、减肥超过 50 磅（22.7 公斤）或减肥前肥胖的患者，其化脓性汗腺炎严重程度有所改善。饮食方面有一些有益的证据，例如地中海饮食，它最大限度地减少糖、高度加工的碳水化合物和乳制品，强调鸡肉、水果和蔬菜，在化脓性汗腺炎患者中也是如此。证据还支持口服锌和维生素 D 补充的益处。
需要更多形式的随机对照试验或精心设计的对照试验来评估运动和饮食干预对化脓性汗腺炎病程的影响。总体而言，有大量但证据较弱的证据支持减肥、饮食改变和微量营养素补充可改善化脓性汗腺炎的严重程度。没有证据表明任何类型的运动干预都能改善化脓性汗腺炎的症状。
本方案已在 PROSPERO 上注册，注册号为 CRD4202235099。
