Association between obesity and the risk of skin and soft tissue infections in European populations: A systematic review.

BACKGROUND

Obesity is highly prevalent in Europe and may increase susceptibility to skin and soft tissue infections (SSTIs), yet European evidence has not been synthesized systematically.

OBJECTIVES

To determine whether obesity increases the risk of SSTIs among European adults and summarize related epidemiologic evidence.

METHODS

Following Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 registered CRD420251081476, five databases (PubMed, Scopus, Web of Science, Embase, HMIC) were searched for English-language studies published between 2005 and 2025. Eligible studies included European adults (≥18 years) with obesity, defined as body mass index ≥30 kg/m². Risk of bias was assessed using Newcastle-Ottawa Scale and Joanna Briggs Institute tools.

RESULTS

A total of 20 studies were included. Most reported a positive association between obesity and increased risk of cellulitis, erysipelas, boils/abscesses, postpartum wound infection, or hidradenitis suppurativa. Several studies showed dose-response patterns with increasing body mass index. Hidradenitis suppurativa accounted for a large proportion of the evidence base and was considered separately from classical acute SSTIs.

CONCLUSION

Obesity is consistently associated with higher risk of several SSTI-related outcomes in European adults. Standardized outcome definitions and prospective studies are needed, alongside trials evaluating whether weight reduction lowers SSTI incidence or recurrence.