Exploring the Associations Between Mediterranean Diet Adherence and Autoinflammation-Associated Skin Diseases

Autoinflammatory diseases (AIDs) are characterized by abnormal responses of the innate immune system, accompanied by elevations in inflammatory biomarkers, in the absence of a physiologic crisis or infection. Certain monogenic AIDs may present with acneiform or hidradenitis suppurativa-like cutaneous manifestations. In contrast, acne vulgaris, plaque psoriasis and hidradenitis suppurativa are complex, multifactorial inflammatory dermatoses situated along an autoinflammation-associated immunologic spectrum, involving both innate and adaptive immune pathways. There is a growing sphere of research dedicated to exploring dietary patterns as modifiable factors associated with inflammatory disease activity. The Mediterranean diet (MD)-which includes a high consumption of vegetables, whole grains, legumes, fruits, nuts, seeds, fish, wine and extra-virgin olive oil (EVOO)-has gained attention for its potential to modulate pathogenic inflammatory mechanisms. In this review, we summarize the current evidence examining associations between MD adherence and three autoinflammation-associated skin conditions: acne vulgaris, psoriasis and hidradenitis suppurativa. We highlight shared and disease-specific inflammatory pathways while emphasizing the predominance of observational data and the need for further interventional studies to clarify clinical implications.