Citations

ABSTRACT Background Hidradenitis suppurativa (HS) is an inflammatory condition associated with cysts of the folliculopilosebaceous unit primarily affecting intertriginous areas. HS has been correlated with smoke exposure in the adult population, but there is a knowledge gap in understanding its effect in pediatric and adolescent patients. This study assesses correlations between active and passive smoke exposure and the development of HS in the pediatric and adolescent population. Methods A retrospective case–control study was conducted at Mayo Clinic (2010–2023) of patients diagnosed with HS before the age of 18 years who were age‐, sex‐, and race‐matched to healthy controls in a 1:3 ratio, analyzed using Fisher exact for categorical variables and Kruskal–Wallis for continuous. Results One hundred and seventy‐four cases and 522 controls met inclusion criteria. The prevalence of active and passive smoke exposure was significantly higher in patients with HS compared to controls ( p = 0.001), with passive smoke accounting for 64.6% ( N = 31/48) of smoke exposure in patients with HS. Smoke exposure was associated with a significant increase in the odds of an HS diagnosis, with an odds ratio of 4.8 (95% CI: 3.06–7.61) for passive and/or active exposure, and 1.64 (95% CI: 1.01–2.61) for passive exposure alone. Smoke exposure was associated with a later age of diagnosis than those with no smoke exposure ( p < 0.001). Conclusion Prevalence of active and passive smoke exposure was higher in pediatric and adolescent patients with HS compared to age, sex, and race‐matched healthy controls. Smoke exposure increased the odds of having HS and was associated with a later age at diagnosis.

Objective: Diabetes mellitus affects over 25% of adults aged 65+ in the United States and is associated with a heightened risk of developing diabetic foot ulcers. Accumulation of senescent cells within the wound microenvironment can impair cutaneous repair, and senolytic therapies offer a promising approach to accelerate wound healing. Approach: In this study, topical fisetin, a flavonoid that promotes apoptosis of senescent cells, was evaluated for its impact on diabetic wound repair. Full-thickness excisional wounds were created on the dorsal skin of diabetic (db/db) mice. Animals were randomized to receive either topical vehicle ( n = 12) or fisetin ( n = 12) for three consecutive days per week, and wound healing outcomes were longitudinally assessed. Results: Topical fisetin significantly increased the ratio of healthy dermis to granulation by day 7 ( p = 0.04) and reduced dermal fibrosis by day 21 ( p = 0.03). Fisetin decreased p16+ cells ( p = 0.01) but increased p21+ cells ( p = 0.02) at day 7 in the dermis, indicating varied effects on senescent cells. M1 macrophages (CD80+) were decreased in the fisetin-treated group ( p = 0.05) at day 21, accompanied by a decrease in pro-inflammatory senescence-associated secretory phenotype cytokines, tumor necrosis factor alpha ( p = 0.03), and interleukin-1beta ( p = 0.01) at day 7. Innovation: Fisetin is the first topical seno-modulatory agent shown to enhance wound repair when administered after injury onset. Its favorable safety and efficacy in both modulating senescence and inflammation highlight its potential as a novel therapy for diabetic wounds. Conclusion: Topical fisetin enhances diabetic wound healing by reducing fibrosis and promoting healthy dermal regeneration through senescence and inflammation modulation. Saranya Wyles, MD, PhD

ABSTRACTBackgroundHidradenitis suppurativa (HS) is a chronic inflammatory condition. While obesity is linked to increased HS severity in adults, data on its impact in pediatric HS remain limited. This study investigates the relationships between obesity, HS severity, HS‐related comorbidities, and therapeutic management in pediatric patients.MethodsThis is a retrospective cohort analysis on patients diagnosed with HS before 18 years of age. Data were collected on disease severity, comorbidity development, and treatments. Trends were compared between HS patients with and without obesity and with healthy controls for comorbidity development.ResultsThere was no difference in disease severity using Hurley staging between patients with and without obesity (p = 0.679). Patients with obesity were more likely to be prescribed biologics (p = 0.012), but not other treatments. The risk of developing dyslipidemia, anxiety, depression, and thyroid disease was elevated in pediatric HS patients, even after controlling for BMI (p < 0.001).ConclusionsIn this study, obesity was not associated with HS disease severity in children. However, children with obesity were more likely to be prescribed biologics. HS may independently increase the risk of dyslipidemia, anxiety, depression, and thyroid disease.