ASSOCIATION OF HIDRADENITIS SUPPURATIVA AND INFLAMMATORY BOWEL DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

Abstract INTRODUCTION Hidradenitis suppurativa (HS), also known as acne inversa, is a chronic inflammatory skin condition that affects apocrine gland-bearing areas. Previous studies have demonstrated that HS is potentially associated with various autoimmune diseases. However, the relationship between HS and inflammatory bowel disease (IBD) has been unclear. METHODS A comprehensive literature search was conducted in electronic databases, PubMed and Embase, from inception to October 2023. We included published studies that provided estimated effects with a 95% confidence interval (CI) or raw data. The quality of the selected studies was evaluated using the Newcastle-Ottawa Scale. Crohn's disease and ulcerative colitis were analyzed separately. Data from each study were combined using the random-effects model and the generic inverse variance method to calculate the pooled odds ratio (OR) with a 95% confidence interval (CI) and I2 statistics. RESULTS Ten case-control studies involving 26,496,569 individuals (110,648 with HS and 26,385,921 without HS) were included in this meta-analysis. HS was associated with significantly higher risk in the IBD group (Pooled OR 2.18; 95% CI 1.42-3.32; P = 0.0003; I2 = 97%). Additionally, our analysis demonstrated a significant association between HS and ulcerative colitis (Pooled OR 1.49; 95% CI 1.26-1.78; P < 0.00001, I2 = 63%) and between HS and Crohn's disease (Pooled OR 1.79; 95% CI 1.33-2.40; P = 0.0001; I2 = 88%). CONCLUSION Our meta-analysis demonstrated that HS is significantly associated with IBD and IBD subtypes (Crohn's disease and ulcerative colitis). This finding emphasizes the need for awareness when patients with HS present with symptoms associated with IBD. Further studies should be conducted to understand the mechanism of the gut-skin axis in shared immune and inflammatory processes.