{"id":4835,"date":"2023-03-29T20:37:18","date_gmt":"2023-03-29T18:37:18","guid":{"rendered":"https:\/\/www.jphres.org\/?p=4835"},"modified":"2023-04-02T13:53:27","modified_gmt":"2023-04-02T11:53:27","slug":"mediterranean-diet-lifestyle-and-quality-of-life-in-sardinian-patients-affected-with-hidradenitis-suppurativa","status":"publish","type":"page","link":"https:\/\/www.jphres.us.com\/index.php\/jphres\/article\/view\/2706\/","title":{"rendered":"Mediterranean diet, lifestyle and quality of life in Sardinian patients affected with Hidradenitis suppurativa"},"content":{"rendered":"<div class=\"item doi\"><span class=\"value\"><a href=\"https:\/\/doi.org\/10.4081\/jphr.2021.2706\">https:\/\/doi.org\/10.4081\/jphr.2021.2706<\/a><\/span><\/div>\n<ul class=\"item authors\">\n<li><span class=\"name\"><strong>Fernanda Velluzzi<\/strong><br \/>\n<\/span><span class=\"affiliation\">Department of Medical Sciences and Public Health, Obesity Unit, University of Cagliari, Italy.<\/span><\/li>\n<li><span class=\"name\"><strong>Jasmine Anedda<\/strong><br \/>\n<\/span><span class=\"affiliation\">Department of Medical Sciences and Public Health, Dermatology Unit, University of Cagliari, Italy.<\/span><\/li>\n<li><span class=\"name\"><strong>Silvia Pisanu<\/strong><br \/>\n<\/span><span class=\"affiliation\">Department of Medical Sciences and Public Health, Obesity Unit, University of Cagliari, Italy.<\/span><span class=\"orcid\"><a href=\"https:\/\/orcid.org\/0000-0001-7042-6275\" target=\"_blank\" rel=\"noopener\">\u00a0https:\/\/orcid.org\/0000-0001-7042-6275<\/a><\/span><\/li>\n<li><span class=\"name\"><strong>Massimo Dell&#8217;Antonia<\/strong><br \/>\n<\/span><span class=\"affiliation\">Department of Medical Sciences and Public Health, Dermatology Unit, University of Cagliari, Italy.<\/span><span class=\"orcid\"><a href=\"https:\/\/orcid.org\/0000-0003-0250-5750\" target=\"_blank\" rel=\"noopener\">\u00a0https:\/\/orcid.org\/0000-0003-0250-5750<\/a><\/span><\/li>\n<li><span class=\"name\"><strong>Andrea Deledda<\/strong><br \/>\n<\/span><span class=\"affiliation\">Department of Medical Sciences and Public Health, Obesity Unit, University of Cagliari, Italy.<\/span><span class=\"orcid\"><a href=\"https:\/\/orcid.org\/0000-0001-6925-7515\" target=\"_blank\" rel=\"noopener\">\u00a0https:\/\/orcid.org\/0000-0001-6925-7515<\/a><\/span><\/li>\n<li><span class=\"name\"><strong>Alessandro Boi<\/strong><br \/>\n<\/span><span class=\"affiliation\">Department of Medical Sciences and Public Health, Obesity Unit, University of Cagliari, Italy.<\/span><\/li>\n<li><span class=\"name\"><strong>Caterina Ferreli<\/strong><br \/>\n<\/span><span class=\"affiliation\">Department of Medical Sciences and Public Health, Dermatology Unit, University of Cagliari, Italy.<\/span><span class=\"orcid\"><a href=\"https:\/\/orcid.org\/0000-0002-8223-6791\" target=\"_blank\" rel=\"noopener\">\u00a0https:\/\/orcid.org\/0000-0002-8223-6791<\/a><\/span><\/li>\n<li><span class=\"name\"><strong>Laura Atzori<\/strong><br \/>\n<\/span><span class=\"affiliation\">Department of Medical Sciences and Public Health, Dermatology Unit, University of Cagliari, Italy.<\/span><span class=\"orcid\"><a href=\"https:\/\/orcid.org\/0000-0002-8105-1402\" target=\"_blank\" rel=\"noopener\">\u00a0https:\/\/orcid.org\/0000-0002-8105-1402<\/a><\/span><\/li>\n<\/ul>\n<div class=\"item abstract\">\n<h3 class=\"label\">ABSTRACT<\/h3>\n<p><strong>Background:<\/strong>\u00a0Hidradenitis Suppurativa is a chronic inflammatory skin disease with a strong negative impact on physical and psychological health. Obesity, especially visceral adiposity, but also smoking or unhealthy nutritional habits, have been reported to be significantly associated with hidradenitis suppurativa.<br \/>\n<strong><br \/>\nDesign and Method:<\/strong>\u00a0Case-control study in 35 patients of both sexes affected with hidradenitis suppurativa, and 35 healthy subjects matched for sex, age, and geographic origin (Sardinia, Italy).<br \/>\n<strong><br \/>\nResults:<\/strong>\u00a0Several anthropometric measures (body mass index, waist circumference, body composition), lifestyle (Mediterranean diet adherence, and physical activity level), and the perceived physical and mental health status were evaluated in case and controls. Hidradenitis patients showed significantly higher values of body mass index, waist circumference, body composition, fat mass, and lower values of physical and mental health status compared to controls, while both groups showed a similar moderate physical activity level which can be assumed to counteract the negative effects of obesity or poor nutritional pattern in hidradenitis patients. However, none of the evaluated variables were correlated with the severity of the disease, assessed by means of the Hurley stage system or the Sartorius score. Instead, the Sartorius score showed a positive correlation with the duration of hidradenitis, mainly imputable to the diagnostic delay and the consequent long lasting inflammatory status.<br \/>\n<strong><br \/>\nConclusions:\u00a0<\/strong>Although nutritional factors and lifestyle can be important and modifiable factors in the hidradenitis suppurativa course, the detrimental effect of chronic inflammation and delayed management are clearly prevalent and heavily influence the disease burden.<\/p>\n<h3 class=\"label\">REFERENCES<\/h3>\n<div class=\"value\">\n<p>Sellheyer K, Krahl D. &#8220;Hidradenitis suppurativa&#8221; is acne inversa! An appeal to (finally) abandon a misnomer. Int J Dermatol 2005;44:535. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1111\/j.1365-4632.2004.02536.x\">https:\/\/doi.org\/10.1111\/j.1365-4632.2004.02536.x<\/a><\/p>\n<p>Bazex J, Bayle P, San B. Hidradenitis suppurativa is acne inversa. Int J Dermatol 2007;46:330. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1111\/j.1365-4632.2007.02872.x\">https:\/\/doi.org\/10.1111\/j.1365-4632.2007.02872.x<\/a><\/p>\n<p>Ingram JR. Hidradenitis suppurativa: Pathogenesis, clinical features, and diagnosis. Accessed on April 29, 2021. Available from: In:\u00a0<a href=\"https:\/\/www.uptodate.com\/contents\/hidradenitis-suppurativa-pathogenesis-clinical-features-and-diagnosis\">https:\/\/www.uptodate.com\/contents\/hidradenitis-suppurativa-pathogenesis-clinical-features-and-diagnosis<\/a><\/p>\n<p>Kouris A, Platsidaki E, Christodoulou C. Quality of life and psychosocial implications in patients with Hidradenitis Suppurativa. Dermatology 2016;232:687.<\/p>\n<p>Montero-Vilchez T, Diaz-Calvillo P, Rodriguez-Pozo JA, et al. The burden of hidradenitis suppurativa signs and symptoms in quality of life: Systematic review and meta-analysis. Int J Environ Res Public Health 2021;18:6709. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.3390\/ijerph18136709\">https:\/\/doi.org\/10.3390\/ijerph18136709<\/a><\/p>\n<p>Nguyen TV, Damiani G, Orenstein LAV, et al. Hidradenitis suppurativa: an update on epidemiology, phenotypes, diagnosis, pathogenesis, comorbidities and quality of life. J Eur Acad Dermatol Venereol 2021;35:50-61. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1111\/jdv.16677\">https:\/\/doi.org\/10.1111\/jdv.16677<\/a><\/p>\n<p>Margesson LJ, Danby FW. Hidradenitis suppurativa. Best Pract Res Clin Obstet Gynaecol 2014; 28:1013-27. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1016\/j.bpobgyn.2014.07.012\">https:\/\/doi.org\/10.1016\/j.bpobgyn.2014.07.012<\/a><\/p>\n<p>Marzano AV, Genovese G, Casazza G, et al. Evidence for a &#8216;window of opportunity&#8217; in hidradenitis suppurativa treated with adalimumab: a retrospective, real-life multicentre cohort study. Br J Dermatol 2021;184:133-40. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1111\/bjd.18983\">https:\/\/doi.org\/10.1111\/bjd.18983<\/a><\/p>\n<p>Prens E, Deckers I. Pathophysiology of hidradenitis suppurativa: An update. J Am Acad Dermatol 2015;73:S8-11. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1016\/j.jaad.2015.07.045\">https:\/\/doi.org\/10.1016\/j.jaad.2015.07.045<\/a><\/p>\n<p>Kohorst JJ, Kimball AB, Davis DB. Systemic associations of hidradenitis suppurativa. J Am Acad Dermatol 2015; 3:S27-35. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1016\/j.jaad.2015.07.055\">https:\/\/doi.org\/10.1016\/j.jaad.2015.07.055<\/a><\/p>\n<p>Bettoli V, Naldi L, Cazzaniga S, et al. Overweight, diabetes and disease duration influence clinical severity in hidradenitis suppurativa-acne inversa: evidence from the national Italian registry. Br J Dermatol 2016;174:195-7. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1111\/bjd.13864\">https:\/\/doi.org\/10.1111\/bjd.13864<\/a><\/p>\n<p>Choi F, Lehmer L, Ekelem C, Mesinkovska NA. Dietary and metabolic factors in the pathogenesis of hidradenitis suppurativa: a systemic review, Int J Dermatol 2020;59:143-53. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1111\/ijd.14691\">https:\/\/doi.org\/10.1111\/ijd.14691<\/a><\/p>\n<p>Miller IM, Rytgaard H, Mogensen UB, et al. Body composition and basal metabolic rate in Hidradenitis Suppurativa: a Danish population-based and hospital-based cross-sectional study. J Eur Acad Dermatol Venereol 2016;30:980-8. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1111\/jdv.13522\">https:\/\/doi.org\/10.1111\/jdv.13522<\/a><\/p>\n<p>Alikhan A, Lynch PJ, Eisen DB. Hidradenitis suppurativa: A comprehensive review. J Am Acad Dermatol 2009;60:539\u201361. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1016\/j.jaad.2008.11.911\">https:\/\/doi.org\/10.1016\/j.jaad.2008.11.911<\/a><\/p>\n<p>Cazzaniga S, Pezzolo E, Bettoli V, et al. Characterization of hidradenitis suppurativa phenotypes: a multidimensional latent class analysis of the National Italian Registry IRHIS. J Invest Dermatol 2021;141:1236-42. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1016\/j.jid.2020.08.032\">https:\/\/doi.org\/10.1016\/j.jid.2020.08.032<\/a><\/p>\n<p>Napolitano M, Megna M, Timoshchuk EA, et al. Hidradenitis suppurativa: From pathogenesis to diagnosis and treatment. Clin Cosmet Investig Dermatol 2017;10:105\u201315. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.2147\/CCID.S111019\">https:\/\/doi.org\/10.2147\/CCID.S111019<\/a><\/p>\n<p>Fabbrocini G, Ruina G, Giovanardi G, et al. Hidradenitis suppurativa in a large cohort of Italian patients: Evaluation of the burden of disease. Dermatology 2021. Online ahead of print. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1159\/000517412\">https:\/\/doi.org\/10.1159\/000517412<\/a><\/p>\n<p>Scheinfeld, N. Hidradenitis suppurativa: A practical review of possible medical treatments based on over 350 hidradenitis patients. Dermatol Online J 2013;19:1. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.5070\/D35VW402NF\">https:\/\/doi.org\/10.5070\/D35VW402NF<\/a><\/p>\n<p>Sivanand A, Gulliver WP, Josan CK, et al. Weight loss and dietary interventions for hidradenitis suppurativa: a systematic review.Cutan Med Surg 2020;24:64-72. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1177\/1203475419874412\">https:\/\/doi.org\/10.1177\/1203475419874412<\/a><\/p>\n<p>Barrea L, Fabbrocini G, Annunziata G, et al. Role of nutrition and adherence to the mediterranean diet in the multidisciplinary approach of hidradenitis suppurativa: Evaluation of nutritional status and its association with severity of disease. Nutrients 2018;11:57. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.3390\/nu11010057\">https:\/\/doi.org\/10.3390\/nu11010057<\/a><\/p>\n<p>Diolintzi A, Panagiotakos DB, Sidossis LS. From Mediterranean diet to Mediterranean lifestyle: a narrative review. Public Health Nutr 2019;22:2703-13. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1017\/S1368980019000612\">https:\/\/doi.org\/10.1017\/S1368980019000612<\/a><\/p>\n<p>Ovadja ZN, Schuit MM, van der Horst CMAM, Lapid O. Inter- and intrarater reliability of Hurley staging for hidradenitis suppurativa. Br J Dermatol 2019;181:344-9. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1111\/bjd.17588\">https:\/\/doi.org\/10.1111\/bjd.17588<\/a><\/p>\n<p>Sartorius K, Emtestam L, Jemec GB, Lapins J. Objective scoring of hidradenitis suppurativa reflecting the role of tobacco smoking and obesity. Br J Dermatol 2009;161:831-9. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1111\/j.1365-2133.2009.09198.x\">https:\/\/doi.org\/10.1111\/j.1365-2133.2009.09198.x<\/a><\/p>\n<p>NHLBI Obesity Education Initiative. The practical guide to the identification, evaluation and treatment of overweight and obesity in adults. NIH; 2000.<\/p>\n<p>Panagiotakos DB, Pitsavos C, Arvaniti F, Stefanadis C. Adherence to the Mediterranean food pattern predicts the prevalence of hypertension, hypercholesterolemia, diabetes and obesity, among healthy adults; the accuracy of the MedDietScore. Prev Med 2007;44:335-40. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1016\/j.ypmed.2006.12.009\">https:\/\/doi.org\/10.1016\/j.ypmed.2006.12.009<\/a><\/p>\n<p>Craig CL, Marshall AL, Sj\u00f6str\u00f6m M, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 2003;35:1381-95. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1249\/01.MSS.0000078924.61453.FB\">https:\/\/doi.org\/10.1249\/01.MSS.0000078924.61453.FB<\/a><\/p>\n<p>Gandek B, Ware JE, Aaronson NK, et al. Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project. International quality of life assessment. J Clin Epidemiol 1998;51:1171-8. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1016\/S0895-4356(98)00109-7\">https:\/\/doi.org\/10.1016\/S0895-4356(98)00109-7<\/a><\/p>\n<p>Ingram JR. The epidemiology of hidradenitis suppurativa. Br J Dermatol 2020;183:990-8. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1111\/bjd.19435\">https:\/\/doi.org\/10.1111\/bjd.19435<\/a><\/p>\n<p>Fabbrocini G, De Vita V, Donnarumma M, et al. South Italy: A privileged perspective to Understand the relationship between hidradenitis suppurativa and overweight\/obesity. Skin Appendage Disord 2016;2:52-56. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1159\/000447716\">https:\/\/doi.org\/10.1159\/000447716<\/a><\/p>\n<p>Watanabe M. Obesity treatment within the Italian national healthcare system tertiary care centers: what can we learn? Eat Weight Disord 2021;26:771-8. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1007\/s40519-020-00936-1\">https:\/\/doi.org\/10.1007\/s40519-020-00936-1<\/a><\/p>\n<p>Wolk K, Join-Lambert O, Sabat R. Aetiology and pathogenesis of hidradenitis suppurativa. Br J Dermatol 2020;183:999-1010. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1111\/bjd.19556\">https:\/\/doi.org\/10.1111\/bjd.19556<\/a><\/p>\n<p>Sabat R, Jemec GBE, Matusiak \u0141, et al. Hidradenitis suppurativa. Nat Rev Dis Primers 2020;6:18. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1038\/s41572-020-0149-1\">https:\/\/doi.org\/10.1038\/s41572-020-0149-1<\/a><\/p>\n<p>Shalom G, Freud T, Harman-Boehm I, et al. Hidradenitis suppurativa and metabolic syndrome: a comparative cross-sectional study of 3207 patients. Br J Dermatol 2015;173:464-70. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1111\/bjd.13777\">https:\/\/doi.org\/10.1111\/bjd.13777<\/a><\/p>\n<p>Wu Y, Ma Y, Xu T, et al. Nicotine enhances staphylococcus epidermidis biofilm formation by altering the bacterial autolysis, extracellular DNA releasing, and polysaccharide intercellular adhesin production. Front Microbiol 2018;9:2575. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.3389\/fmicb.2018.02575\">https:\/\/doi.org\/10.3389\/fmicb.2018.02575<\/a><\/p>\n<p>Konig A, Lehmann C, Rompel R, Happle R. Cigarette smoking as a triggering factor of hidradenitis suppurativa. Dermatology 1999;198:261\u20134 DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1159\/000018126\">https:\/\/doi.org\/10.1159\/000018126<\/a><\/p>\n<p>Garg A, Papagermanos V, Midura M, Strunk A. Incidence of hidradenitis suppurativa among tobacco smokers: a population-based retrospective analysis in the U.S.A. Br J Dermatol 2018;178:709-14. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1111\/bjd.15939\">https:\/\/doi.org\/10.1111\/bjd.15939<\/a><\/p>\n<p>Danby FW. Diet in the prevention of hidradenitis suppurativa (acne inversa). J Am Acad Dermatol 2015;73:S52-4. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1016\/j.jaad.2015.07.042\">https:\/\/doi.org\/10.1016\/j.jaad.2015.07.042<\/a><\/p>\n<p>Cannistr\u00e0 C, Finocchi V, Trivisonno A, Tambasco D. New perspectives in the treatment of hidradenitis suppurativa: surgery and brewer&#8217;s yeast-exclusion diet. Surgery 2013;154:1126-30. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1016\/j.surg.2013.04.018\">https:\/\/doi.org\/10.1016\/j.surg.2013.04.018<\/a><\/p>\n<p>Fernandez JM, Marr KD, Hendricks AJ, et al. Alleviating and exacerbating foods in hidradenitis suppurativa. Dermatol Ther 2020;33:e14246. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1111\/dth.14246\">https:\/\/doi.org\/10.1111\/dth.14246<\/a><\/p>\n<p>Pisanu S, Palmas V, Madau V, et al. Impact of a moderately hypocaloric Mediterranean diet on the gut microbiota composition of Italian obese patients. Nutrients 2020;12:2707. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.3390\/nu12092707\">https:\/\/doi.org\/10.3390\/nu12092707<\/a><\/p>\n<p>Palmas V, Pisanu S, Madau V, et al. Gut microbiota markers associated with obesity and overweight in Italian adults. Sci Rep 2021;11:5532. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1038\/s41598-021-84928-w\">https:\/\/doi.org\/10.1038\/s41598-021-84928-w<\/a><\/p>\n<p>Deledda A, Annunziata G, Tenore GC, et al. Diet-derived antioxidants and their role in inflammation, obesity and gut microbiota modulation. Antioxidants (Basel) 2021;10:708. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.3390\/antiox10050708\">https:\/\/doi.org\/10.3390\/antiox10050708<\/a><\/p>\n<p>Patterson R, McNamara E, Tainio M, et al. Sedentary behaviour and risk of all-cause, cardiovascular and cancer mortality, and incident type 2 diabetes: a systematic review and dose response meta-analysis. Eur J Epidemiol 2018;33:811-29. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1007\/s10654-018-0380-1\">https:\/\/doi.org\/10.1007\/s10654-018-0380-1<\/a><\/p>\n<p>Warburton DER, Bredin SSD. Health benefits of physical activity: a systematic review of current systematic reviews Curr Opin Cardiol 2017;32:541-56. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1097\/HCO.0000000000000437\">https:\/\/doi.org\/10.1097\/HCO.0000000000000437<\/a><\/p>\n<p>Shaw KA, Gennat HC, O&#8217;Rourke P, Del Mar C. Exercise for overweight or obesity. Cochrane Database Syst Rev 2006;4:CD003817. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1002\/14651858.CD003817.pub3\">https:\/\/doi.org\/10.1002\/14651858.CD003817.pub3<\/a><\/p>\n<p>Pisanu S, Deledda A, Loviselli A, et al. Validity of accelerometers for the evaluation of energy expenditure in obese and overweight individuals: A systematic review. J Nutr Metab 2020;2020:2327017. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1155\/2020\/2327017\">https:\/\/doi.org\/10.1155\/2020\/2327017<\/a><\/p>\n<p>Schrader AM, Deckers IE, van der Zee HH, et al. Hidradenitis suppurativa: a retrospective study of 846 Dutch patients to identify factors associated with disease severity. J Am Acad Dermatol 2014;71:460\u20137. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1016\/j.jaad.2014.04.001\">https:\/\/doi.org\/10.1016\/j.jaad.2014.04.001<\/a><\/p>\n<p>Canoui-Poitrine F, Revuz JE, Wolkenstein P, et al. Clinical characteristics of a series of 302 French patients with hidradenitis suppurativa, with an analysis of factors associated with disease severity. J Am Acad Dermatol 2009;61:51\u20137. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1016\/j.jaad.2009.02.013\">https:\/\/doi.org\/10.1016\/j.jaad.2009.02.013<\/a><\/p>\n<p>Myers J, Kokkinos P, Nyelin E. Physical activity, cardiorespiratory fitness, and the metabolic syndrome. Nutrients 2019;11:1652. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.3390\/nu11071652\">https:\/\/doi.org\/10.3390\/nu11071652<\/a><\/p>\n<p>Saunte DM, Boer J, Stratigos A, et al. Diagnostic delay in hidradenitis suppurativa is a global problem. Br J Dermatol 2015;173:1546\u20139. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1111\/bjd.14038\">https:\/\/doi.org\/10.1111\/bjd.14038<\/a><\/p>\n<p>Kokolakis G, Wolk K, Schneider-Burrus S, et al. Delayed diagnosis of hidradenitis suppurativa and its effect on patients and healthcare system. Dermatology 2020;236:421-30. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1159\/000508787\">https:\/\/doi.org\/10.1159\/000508787<\/a><\/p>\n<p>Omine T, Miyagi T, Hayashi K, et al. Clinical characteristics of hidradenitis suppurativa patients in Okinawa, Japan: Differences between East Asia and Western countries. J Dermatol 2020;47:855-62. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1111\/1346-8138.15411\">https:\/\/doi.org\/10.1111\/1346-8138.15411<\/a><\/p>\n<p>Kouris A, Platsidaki E, Christodoulou C, et al. Quality of life and psychosocial implications in patients with hidradenitis suppurativa. Dermatology 2016;232:687-91. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1159\/000453355\">https:\/\/doi.org\/10.1159\/000453355<\/a><\/p>\n<p>Sampogna F, Fania L, Mastroeni S, et al. Age-specific physical and mental health status in Italian patients with hidradenitis suppurativa: a comparison with the general population Arch Dermatol Res 2021;313:41-47. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1007\/s00403-020-02063-4\">https:\/\/doi.org\/10.1007\/s00403-020-02063-4<\/a><\/p>\n<p>Sampogna F, Campana I, Fania L, et al. Pain as defining feature of health status and prominent therapeutic target in patients with hidradenitis suppurativa. J Clin Med 2021;10:3648. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.3390\/jcm10163648\">https:\/\/doi.org\/10.3390\/jcm10163648<\/a><\/p>\n<p>Machado MO, Stergiopoulos V, Maes M, et al. Depression and anxiety in adults with hidradenitis suppurativa: a systematic review and meta-analysis. JAMA Dermatol 2019;155:939\u201345. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1001\/jamadermatol.2019.0759\">https:\/\/doi.org\/10.1001\/jamadermatol.2019.0759<\/a><\/p>\n<p>Sampogna F, Fania L, Mastroeni S, et al. Correlation between depression, quality of life and clinical severity in patients with hidradenitis suppurativa. Acta Derm Venereol 2020;100:adv00319. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.2340\/00015555-3647\">https:\/\/doi.org\/10.2340\/00015555-3647<\/a><\/p>\n<p>Weiss F, Barbuti M, Carignani G, et al. Psychiatric aspects of obesity: A narrative review of pathophysiology and psychopathology. J Clin Med 2020;9:2344. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.3390\/jcm9082344\">https:\/\/doi.org\/10.3390\/jcm9082344<\/a><\/p>\n<p>Pinna F, Sardu C, Orr\u00f9 W, et al. Psychopathology, psychosocial factors and obesity. Riv Psichiatr 2016;51:30-6.<\/p>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>https:\/\/doi.org\/10.4081\/jphr.2021.2706 Fernanda Velluzzi Department of Medical Sciences and Public Health, Obesity Unit, University of Cagliari, Italy. Jasmine Anedda Department of Medical Sciences and Public Health, Dermatology Unit, University of Cagliari, Italy. Silvia Pisanu Department of Medical Sciences and Public Health, Obesity Unit, University of Cagliari, Italy.\u00a0https:\/\/orcid.org\/0000-0001-7042-6275 Massimo Dell&#8217;Antonia Department of Medical Sciences and Public Health, &#8230; <a title=\"Mediterranean diet, lifestyle and quality of life in Sardinian patients affected with Hidradenitis suppurativa\" class=\"read-more\" href=\"https:\/\/www.jphres.us.com\/index.php\/jphres\/article\/view\/2706\/\" aria-label=\"More on Mediterranean diet, lifestyle and quality of life in Sardinian patients affected with Hidradenitis suppurativa\">Read more<\/a><\/p>\n","protected":false},"author":3,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"open","ping_status":"open","template":"","meta":{"footnotes":""},"class_list":["post-4835","page","type-page","status-publish"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Mediterranean diet, lifestyle and quality of life in Sardinian patients affected with Hidradenitis suppurativa - Journal of Public Health Research<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.jphres.us.com\/index.php\/jphres\/article\/view\/2706\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Mediterranean diet, lifestyle and quality of life in Sardinian patients affected with Hidradenitis suppurativa - Journal of Public Health Research\" \/>\n<meta property=\"og:description\" content=\"https:\/\/doi.org\/10.4081\/jphr.2021.2706 Fernanda Velluzzi Department of Medical Sciences and Public Health, Obesity Unit, University of Cagliari, Italy. Jasmine Anedda Department of Medical Sciences and Public Health, Dermatology Unit, University of Cagliari, Italy. Silvia Pisanu Department of Medical Sciences and Public Health, Obesity Unit, University of Cagliari, Italy.\u00a0https:\/\/orcid.org\/0000-0001-7042-6275 Massimo Dell&#8217;Antonia Department of Medical Sciences and Public Health, ... Read more\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.jphres.us.com\/index.php\/jphres\/article\/view\/2706\/\" \/>\n<meta property=\"og:site_name\" content=\"Journal of Public Health Research\" \/>\n<meta property=\"article:modified_time\" content=\"2023-04-02T11:53:27+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"11 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.jphres.us.com\/index.php\/jphres\/article\/view\/2706\/\",\"url\":\"https:\/\/www.jphres.us.com\/index.php\/jphres\/article\/view\/2706\/\",\"name\":\"Mediterranean diet, lifestyle and quality of life in Sardinian patients affected with Hidradenitis suppurativa - Journal of Public Health Research\",\"isPartOf\":{\"@id\":\"https:\/\/www.jphres.us.com\/#website\"},\"datePublished\":\"2023-03-29T18:37:18+00:00\",\"dateModified\":\"2023-04-02T11:53:27+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/www.jphres.us.com\/index.php\/jphres\/article\/view\/2706\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/www.jphres.us.com\/index.php\/jphres\/article\/view\/2706\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/www.jphres.us.com\/index.php\/jphres\/article\/view\/2706\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Startseite\",\"item\":\"https:\/\/www.jphres.us.com\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Mediterranean diet, lifestyle and quality of life in Sardinian patients affected with Hidradenitis suppurativa\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/www.jphres.us.com\/#website\",\"url\":\"https:\/\/www.jphres.us.com\/\",\"name\":\"Journal of Public Health Research\",\"description\":\"The Journal of Public Health Research is an online Open Access, peer-reviewed journal in the field of public health science. The scope of the journal is to stimulate debate and spreading of knowledge in this area in order to improve public health.\",\"publisher\":{\"@id\":\"https:\/\/www.jphres.us.com\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/www.jphres.us.com\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/www.jphres.us.com\/#organization\",\"name\":\"Journal of Public Health Research\",\"url\":\"https:\/\/www.jphres.us.com\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/www.jphres.us.com\/#\/schema\/logo\/image\/\",\"url\":\"https:\/\/www.jphres.us.com\/wp-content\/uploads\/2022\/10\/Favicon-JPHRES.png\",\"contentUrl\":\"https:\/\/www.jphres.us.com\/wp-content\/uploads\/2022\/10\/Favicon-JPHRES.png\",\"width\":150,\"height\":114,\"caption\":\"Journal of Public Health Research\"},\"image\":{\"@id\":\"https:\/\/www.jphres.us.com\/#\/schema\/logo\/image\/\"},\"sameAs\":[\"https:\/\/www.citefactor.org\/journal\/index\/5410\/journal-of-public-health-research#.ZD-hS-xBx3k\",\"https:\/\/www.scimagojr.com\/journalsearch.php?q=21100790524&amp;amp;tip=sid&amp;amp;clean=0\"]}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Mediterranean diet, lifestyle and quality of life in Sardinian patients affected with Hidradenitis suppurativa - Journal of Public Health Research","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.jphres.us.com\/index.php\/jphres\/article\/view\/2706\/","og_locale":"en_US","og_type":"article","og_title":"Mediterranean diet, lifestyle and quality of life in Sardinian patients affected with Hidradenitis suppurativa - Journal of Public Health Research","og_description":"https:\/\/doi.org\/10.4081\/jphr.2021.2706 Fernanda Velluzzi Department of Medical Sciences and Public Health, Obesity Unit, University of Cagliari, Italy. Jasmine Anedda Department of Medical Sciences and Public Health, Dermatology Unit, University of Cagliari, Italy. Silvia Pisanu Department of Medical Sciences and Public Health, Obesity Unit, University of Cagliari, Italy.\u00a0https:\/\/orcid.org\/0000-0001-7042-6275 Massimo Dell&#8217;Antonia Department of Medical Sciences and Public Health, ... Read more","og_url":"https:\/\/www.jphres.us.com\/index.php\/jphres\/article\/view\/2706\/","og_site_name":"Journal of Public Health Research","article_modified_time":"2023-04-02T11:53:27+00:00","twitter_card":"summary_large_image","twitter_misc":{"Est. reading time":"11 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/www.jphres.us.com\/index.php\/jphres\/article\/view\/2706\/","url":"https:\/\/www.jphres.us.com\/index.php\/jphres\/article\/view\/2706\/","name":"Mediterranean diet, lifestyle and quality of life in Sardinian patients affected with Hidradenitis suppurativa - Journal of Public Health Research","isPartOf":{"@id":"https:\/\/www.jphres.us.com\/#website"},"datePublished":"2023-03-29T18:37:18+00:00","dateModified":"2023-04-02T11:53:27+00:00","breadcrumb":{"@id":"https:\/\/www.jphres.us.com\/index.php\/jphres\/article\/view\/2706\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.jphres.us.com\/index.php\/jphres\/article\/view\/2706\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/www.jphres.us.com\/index.php\/jphres\/article\/view\/2706\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Startseite","item":"https:\/\/www.jphres.us.com\/"},{"@type":"ListItem","position":2,"name":"Mediterranean diet, lifestyle and quality of life in Sardinian patients affected with Hidradenitis suppurativa"}]},{"@type":"WebSite","@id":"https:\/\/www.jphres.us.com\/#website","url":"https:\/\/www.jphres.us.com\/","name":"Journal of Public Health Research","description":"The Journal of Public Health Research is an online Open Access, peer-reviewed journal in the field of public health science. The scope of the journal is to stimulate debate and spreading of knowledge in this area in order to improve public health.","publisher":{"@id":"https:\/\/www.jphres.us.com\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.jphres.us.com\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/www.jphres.us.com\/#organization","name":"Journal of Public Health Research","url":"https:\/\/www.jphres.us.com\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/www.jphres.us.com\/#\/schema\/logo\/image\/","url":"https:\/\/www.jphres.us.com\/wp-content\/uploads\/2022\/10\/Favicon-JPHRES.png","contentUrl":"https:\/\/www.jphres.us.com\/wp-content\/uploads\/2022\/10\/Favicon-JPHRES.png","width":150,"height":114,"caption":"Journal of Public Health Research"},"image":{"@id":"https:\/\/www.jphres.us.com\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.citefactor.org\/journal\/index\/5410\/journal-of-public-health-research#.ZD-hS-xBx3k","https:\/\/www.scimagojr.com\/journalsearch.php?q=21100790524&amp;amp;tip=sid&amp;amp;clean=0"]}]}},"_links":{"self":[{"href":"https:\/\/www.jphres.us.com\/index.php\/wp-json\/wp\/v2\/pages\/4835","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.jphres.us.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.jphres.us.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.jphres.us.com\/index.php\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.jphres.us.com\/index.php\/wp-json\/wp\/v2\/comments?post=4835"}],"version-history":[{"count":0,"href":"https:\/\/www.jphres.us.com\/index.php\/wp-json\/wp\/v2\/pages\/4835\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.jphres.us.com\/index.php\/wp-json\/wp\/v2\/media?parent=4835"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}