A link between smoking behaviors and the risk of hidradenitis suppurativa in diabetic patients

Introduction Hidradenitis suppurativa (HS) is a chronic, inflammatory skin condition characterized by painful, recurrent abscesses and tunnels under the skin. It is influenced by a complex interplay of genetic, environmental, and metabolic factors. Smoking, diabetes mellitus, obesity, and other metabolic disorders have been identified as risk factors for HS, potentially exacerbating the severity and progression of the condition. Given the higher prevalence of HS in individuals with type 2 diabetes mellitus (T2DM), understanding modifiable risk factors such as smoking is crucial for improving patient outcomes. Objectives To investigate the association between changes in smoking intensity and the risk of HS in patients with T2DM, with the goal of elucidating how smoking contributes to the development or worsening of HS in this high-risk population. Methods This retrospective cohort study analyzed data from the Korean National Health Insurance Service, comprising 1,705,427 participants. The study examined smoking status, changes in smoking intensity, and the incidence of HS in individuals with T2DM, adjusting for potential confounders such as age, gender, and comorbid conditions. Results The study found a 23.6% increased risk of HS in individuals who continued smoking compared to nonsmokers (adjusted hazard ratio (aHR), 1.236; 95% confidence interval (CI), 1.075–1.421). Additionally, participants with increased cigarette consumption had a 28.5% higher risk of HS compared to nonsmokers (aHR, 1.285; 95% CI, 1.048–1.577). However, no significant differences were observed in the association between changes in smoking intensity and the risk of HS when stratified by BMI. Conclusions This study highlights the association between smoking and the increased risk of HS in individuals with T2DM, underscoring the importance of smoking cessation as a potential strategy for mitigating HS risk in at-risk DM populations. Additional research is needed to further explore the mechanisms by which smoking exacerbates HS in T2DM and to identify effective interventions for this group.