@article{3123706,
    title = "Low and high body mass index in hidradenitis suppurativa patients—different subtypes?",
    author = "Theut Riis, P. and Saunte, D.M. and Benhadou, F. and del Marmol, V. and Guillem, P. and El-Domyati, M. and Abdel-Wahab, H. and Antoniou, C. and Dessinioti, C. and Gürer, M.A. and Beksaç, B. and Szepietowski, J.C. and Matusiak, L. and Emtestam, L. and Lapins, J. and Riad, H. and Doss, N. and Massa, A.F. and Hamzavi, I. and Nicholson, C. and Dolenc-Voljc, M. and Kim, K.H. and Ohn, J. and Zouboulis, C.C. and Karagiannidis, I. and Mokos, Z.B. and Durinec, P. and Jemec, G.B.E.",
    journal = "Journal of the European Academy of Dermatology and Venereology",
    year = "2018",
    volume = "32",
    number = "2",
    pages = "307-312",
    publisher = "Wiley-Blackwell Publishing Ltd",
    issn = "0926-9959, 1468-3083",
    doi = "10.1111/jdv.14599",
    keywords = "adult;  Article;  body mass;  controlled study;  cross-sectional study;  descriptive research;  disease severity;  exploratory research;  family history;  female;  human;  major clinical study;  male;  obesity;  prediction;  priority journal;  rash;  smoking;  suppurative hidradenitis;  young adult;  classification;  comparative study;  complication;  genetics;  onset age;  protection;  risk factor;  severity of illness index;  suppurative hidradenitis, Adult;  Age of Onset;  Body Mass Index;  Cross-Sectional Studies;  Female;  Hidradenitis Suppurativa;  Humans;  Male;  Obesity;  Protective Factors;  Risk Factors;  Severity of Illness Index;  Smoking;  Young Adult",
    abstract = "Introduction: Overweight is a well-established risk factor for hidradenitis suppurativa (HS). In this cross-sectional study, we compare HS patients with a high body mass index (BMI) with HS patients with a low BMI to investigate differences in disease characteristics. Materials and method: Patients were recruited from 17 dermatological centres from four continents. A total of 246 patients with a BMI below 25 were compared to 205 patients with a BMI of above 35. Results: Patients with a high BMI suffered more severe disease (Hurley, physician global assessment, number of areas affected and patient-reported severity (PRS), P < 0.001 for all). There was no difference in smoking (P = 0.783) nor in family history (P = 0.088). In both low and high BMI patients, early onset of HS was a predictor of positive family history (P < 0.001, for each). For low BMI patients, an increase in BMI significantly increased PRS (P < 0.001). For patients with a high BMI, number of pack-years significantly increased PRS (P = 0.001). Cluster analysis of eruption patterns was location specific for low BMI patients but severity specific for high BMI patients. Discussion: Patients with a low and high BMI could represent two clinically different subtypes. We suggest a non-linear relationship between BMI and impact of HS. As patients go from a low BMI patient to a high BMI patient (or from high to low), eruption patterns and risk factors may change. © 2017 European Academy of Dermatology and Venereology"
}