Semaglutide in patients with hidradenitis suppurativa and obesity.

BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory dermatosis strongly associated with obesity and metabolic dysfunction. GLP-1 receptor agonists (GLP-1 RAs), such as semaglutide, promote weight loss and exhibit anti-inflammatory properties, but evidence regarding their effects in HS remains limited. OBJECTIVE: To evaluate the effects of 6 months of semaglutide treatment at doses >1mg/week on anthropometric, dermatologic, metabolic, inflammatory, and quality-of-life outcomes in patients with HS and obesity. METHODS: We conducted a prospective, open-label cohort study including 20 adults with HS and obesity. Anthropometric, morphofunctional, dermatologic (Hurley stage, DLQI, pain VAS), psychological (BDI), metabolic, and inflammatory parameters were assessed at baseline and after 6 months. RESULTS: After 6 months, body weight (-21.4kg), BMI, waist circumference, blood pressure, and preperitoneal and subcutaneous fat were significantly reduced (all p<0.05). Dermatologic outcomes improved markedly: Hurley stage decreased in all patients, DLQI improved (-8.8), pain VAS decreased (-4.1), and BDI improved (-12.9; all p<0.001). Metabolic and inflammatory markers also improved. After adjustment for weight change, improvements in DLQI, pain, depressive symptoms, Hurley stage, vitamin D, CRP, and cortisol remained significant. CONCLUSIONS: Semaglutide treatment in patients with HS and obesity improved weight, body composition, metabolic and inflammatory profiles, and dermatologic and psychological status. Several clinical and inflammatory benefits persisted after adjustment for weight loss.