Association Of Hidradenitis Suppurativa Research Articles

Association of hidradenitis suppurativa (HS) with waist circumference: A bidirectional two-sample Mendelian randomization study of HS with metabolic syndrome.

Observational studies have suggested an associations between hidradenitis suppurativa (HS) and metabolic syndrome (MetS) and its components. However, it remains unclear whether the relationship is causal or not. Our study aimed to investigate the causal association of HS with MetS and its components. We performed a bidirectional, two-sample Mendelian randomization study using summary-level data from the most comprehensive genome-wide association studies of HS (n = 362 071), MetS (n = 291 107), waist circumference (n = 462 166), hypertension (n = 463 010) fasting blood glucose (FBG, n = 200 622), triglycerides (n = 441 016), and high-density lipoprotein cholesterol (HDL-C, n = 403 943). Genetic instrumental variables were constructed by identifying single nucleotide polymorphisms associated with the corresponding factors. The random-effects inverse-variance weighted method was applied as the primary method. The results showed that genetically predicted HS was positively associated with waist circumference risk in both directions. High waist circumference increased the risk of HS (odds ratio [OR] 4.147; 95% confidence interval [CI] 2.610-6.590; p = 1.746 × 10-9). In addition, HS was also affected by waist circumference (OR 1.009; 95% CI 1.006-1.012; p = 3.08 × 10-7). No causal relationships were found between HS and MetS or its components other than waist circumference. The findings highlight the importance of early intervention for obesity in HS patients. Further studies are needed to determine the pathophysiology of HS associated with MetS and its components.

A history of asthma is associated with susceptibility to hidradenitis suppurativa: a population-based longitudinal study.

The association of hidradenitis suppurativa (HS) and asthma remains to be investigated. To assess the bidirectional association between HS and asthma. A population-based study was conducted to compare HS patients (n = 6779) with age-, sex-, and ethnicity-matched control subjects (n = 33,259) with regard to the incidence of new onset and the prevalence of preexisting asthma. Adjusted hazard ratios (HRs) and adjusted odds ratios (ORs) were calculated. The prevalence of preexisting asthma was higher in patients with HS relative to controls (9.6% vs. 6.9%, respectively; P < 0.001). The odds of HS were 1.4-fold greater in patients with a history of asthma (fully adjusted OR 1.41; 95% CI 1.27-1.55; P < 0.001). The incidence rate of new-onset asthma was estimated at 9.0 (95% CI 6.3-12.7) and 6.2 (95% CI 5.1-7.5) cases per 10,000 person-years among patients with HS and controls, respectively. The risk of asthma was not statistically different in patients with HS and controls (fully adjusted HR 1.53; 95% CI 0.98-2.38; P = 0.062). Relative to other patients with HS, those with HS and comorbid asthma were younger at the onset of HS (30.7 [14.7] vs. 33.3 [15.1], respectively; P < 0.001) and had a comparable risk of all-cause mortality (adjusted HR 0.86; 95% CI 0.44-1.68; P = 0.660). A history of asthma confers susceptibility to subsequent development of HS. This observation is of importance for clinicians managing both patients with HS and asthma. Further research is warranted to elucidate the pathomechanism underlying this finding.

Association of hidradenitis suppurativa and liver disease: A systematic review and meta-analysis

To the Editor: Hidradenitis suppurativa (HS) is a chronic inflammatory disease with significant morbidity. Studies have suggested an association between HS and metabolic syndrome,1Ergun T. Hidradenitis suppurativa and the metabolic syndrome.Clin Dermatol. 2018; 36: 41-47https://doi.org/10.1016/j.clindermatol.2017.09.007Abstract Full Text Full Text PDF PubMed Scopus (32) Google Scholar a risk factor for numerous liver pathologies. However, whether HS is independently associated with liver disease remains unclear.2Durán-Vian C. Arias-Loste M.T. Hernández J.L. et al.High prevalence of non-alcoholic fatty liver disease among hidradenitis suppurativa patients independent of classic metabolic risk factors.J Eur Acad Dermatol Venereol. 2019; 33: 2131-2136https://doi.org/10.1111/jdv.15764Crossref PubMed Scopus (16) Google Scholar,3Jung J.M. Lee K.H. Kim Y.J. et al.Assessment of overall and specific cancer risks in patients with hidradenitis suppurativa.JAMA Dermatol. 2020; 156: 844-853https://doi.org/10.1001/jamadermatol.2020.1422Crossref PubMed Scopus (13) Google Scholar Herein, we aim to resolve this discrepancy through a systematic review and meta-analysis of the literature. MEDLINE and Embase were searched from inception to October 4, 2021, using keywords “hidradenitis” and “liver disease” according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines (International prospective register of systematic reviews (PROSPERO) CRD42021228708). Of 246 records, 6 case-control, 1 cross-sectional, and 2 cohort studies, published between 2001 and 2022, were included, totaling 42,791 patients with HS (Fig 1). According to the Newcastle-Ottawa scale, all studies were rated “high” quality (Supplementary Data, available via Mendeley at https://www.doi.org/10.17632/z46my2brw6.1). Patients with HS had increased prevalence (38.5% to 72.9%) and odds (2.79-7.75) of nonalcoholic fatty liver disease (NAFLD) when adjusting for confounders, such as age, body mass index, smoking, diabetes, hypertension, dyslipidemia, and metabolic syndrome. The wide ranges reported are likely due to heterogenous screening and diagnostic criteria for NAFLD, with varying degrees of sensitivity and specificity across studies. Notably, NAFLD severity may be correlated with HS severity, as one study found that patients with severe HS had increased prevalence of liver disease (3.6% vs 1.5%, P < .05). Patients with HS also had increased prevalence of other types of hepatobiliary disease. Across studies, increased prevalence (0.5% vs 0.4%, P < .001) and odds (odds ratio = 1.27, 95% confidence interval = 1.04-1.54, P = .02) of alcoholic fatty liver disease were reported. Additionally, increased odds of hepatitis B were found across studies (odds ratio = 1.47, 95% confidence interval = 1.12-1.93, P = .005). HS was not associated with increased odds of gallstones, hepatitis A, hepatitis C, or increased risk of biliary or liver cancer across studies. Although patients with liver disease are known to be at risk for advanced fibrosis and hepatocellular carcinoma, an association between HS and cirrhosis, biliary cancer, and liver cancer was not found across a small number of studies. However, these findings may be influenced by survival bias, especially considering the increased all-cause mortality in patients with HS.4Reddy S. Strunk A. Garg A. All-cause mortality among patients with hidradenitis suppurativa: a population-based cohort study in the United States.J Am Acad Dermatol. 2019; 81: 937-942https://doi.org/10.1016/j.jaad.2019.06.016Abstract Full Text Full Text PDF PubMed Scopus (12) Google Scholar Further high-quality studies are required to investigate these associations. The association between HS and liver pathology is hypothesized to result from chronic systemic inflammation. Patients with HS have increased levels of adipokines (leptin and adiponectin),5Malara A. Hughes R. Jennings L. et al.Adipokines are dysregulated in patients with hidradenitis suppurativa.Br J Dermatol. 2018; 178: 792-793https://doi.org/10.1111/bjd.15904Crossref PubMed Scopus (25) Google Scholar which regulate hepatic fat accumulation, and proinflammatory cytokines (interleukin-1β, interleukin-6, interleukin-23, and tumor necrosis factor α), which stimulate hepatic inflammation, cell necrosis and apoptosis, and induction of fibrosis, leading to the potential development and progression of liver disease.1Ergun T. Hidradenitis suppurativa and the metabolic syndrome.Clin Dermatol. 2018; 36: 41-47https://doi.org/10.1016/j.clindermatol.2017.09.007Abstract Full Text Full Text PDF PubMed Scopus (32) Google Scholar,2Durán-Vian C. Arias-Loste M.T. Hernández J.L. et al.High prevalence of non-alcoholic fatty liver disease among hidradenitis suppurativa patients independent of classic metabolic risk factors.J Eur Acad Dermatol Venereol. 2019; 33: 2131-2136https://doi.org/10.1111/jdv.15764Crossref PubMed Scopus (16) Google Scholar Limitations include a lack of ethnic diversity across studies and the paucity of studies investigating the association of certain hepatic conditions and HS, with some outcomes only being investigated by single studies. Patients with HS should be informed of their possible increased risk of liver disease, particularly NAFLD, alcoholic fatty liver disease, and hepatitis B. Age-appropriate screening and counseling on modifiable risk factors such as weight management, smoking cessation, and alcohol intake may be beneficial. Appropriate liver workup, including liver enzymes, function tests, and imaging, should also be considered in patients with HS presenting with symptoms suggestive of liver disease. None disclosed.

Association of Hidradenitis Suppurativa and Ulcerative Colitis in a 14-Year-Old Patient

Association of Hidradenitis Suppurativa and Ulcerative Colitis in a 14-Year-Old Patient

Association of hidradenitis suppurativa with autoimmune disease and autoantibodies.

ObjectiveThere is thought to be an association between hidradenitis suppurativa (HS) and autoimmune diseases. This retrospective longitudinal cohort study looked to identify whether certain autoimmune diseases or autoantibody specificities are more closely associated with HS than others and whether such associations are related to the severity of HS.MethodsPatients were identified using the SlicerDicer search tool in Epic from 1 January 2010 to 15 August 2020. Search criteria included HS diagnosis by ICD-10 code (L73.2) and at least one visit to the dermatology department. Charts were reviewed to determine HS disease severity, treatment modalities, presence of autoimmune disease and autoantibody positivity.ResultsSix hundred and twenty-seven patients were identified. Most patients were female (75.3%) and had obese BMIs (71.1%), but there were no significant demographic differences between HS patients with and without autoimmune diseases. One hundred and one (16.1%) patients in the total cohort had at least one autoimmune disease, most commonly thyroid disease, lupus, psoriasis and IBD. Two hundred and twelve patients were also tested for the presence of autoantibodies. The most common positive autoantibody, found in 54 patients (28.4%), was ANA. Fifty-four patients with more severe HS disease manifestations required biologic medications to treat their HS. Neither HS severity nor biologic treatment was associated with presence of autoimmune disease or positive autoantibodies.ConclusionIn a large cohort of patients with HS followed longitudinally, autoimmune disorders (especially lupus, psoriasis and IBD) and presence of autoantibodies were more commonly observed than expected in the normal population.

Hidradenitis suppurativa and rheumatoid arthritis: evaluating the bidirectional association

Despite some common pathogenic themes, the association of hidradenitis suppurativa (HS) and rheumatoid arthritis (RA) has been poorly investigated. We aimed to evaluate the bidirectional association between HS and RA. A population-based study was conducted to compare HS patients (n = 6779) with age-, sex- and ethnicity-matched control subjects (n = 33,260) with regard to the incidence of new-onset and the prevalence of preexisting RA. Adjusted hazard ratios (HRs) and adjusted odds ratios (ORs) were estimated. The prevalence of preexisting RA was greater among patients with HS relative to controls (0.5% vs 0.3%. respectively; p = 0.019). The odds of being diagnosed with HS were 1.6-fold higher in patients with a history of RA (fully-adjusted OR, 1.66; 95% CI, 1.11–2.49; p = 0.014). The incidence rate of new-onset RA was estimated at 4.3 (95% CI, 2.5–6.8) and 2.4 (95% CI, 1.8–3.2) cases per 10,000 person-years among patients with HS and controls, respectively. The risk of RA was comparable between patients with HS and controls (fully-adjusted HR, 1.45; 95% CI, 0.77–2.72; p = 0.249). Compared to other patients with HS, those with HS and comorbid RA were older, had a higher prevalence of diabetes mellitus, hypertension, and hyperlipidemia, and had a comparable risk of all-cause mortality. In conclusions, a preexisting diagnosis of RA predisposes individuals to develop HS. Clinicians managing patients with HS and RA should be aware of this association. Further research is required to delineate the underlying pathomechanism of this observation.

Association of hidradenitis suppurativa with Crohn's disease.

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder characterized by recurrent nodules, abscesses, and sinus tracts. Crohn’s disease (CD) is characterized by inflammation of the entire digestive tract and belongs to the group of inflammatory bowel diseases, and there are many extraintestinal manifestations, among which hidradenitis suppurativa is one of the rare extraintestinal manifestations. There appears to be a strong association between CD and HS based on clinical and histological similarities (sinus tract development, granulomatous inflammation, and scarring), intersections in pathogenesis (genetic loci, immune dysregulation mechanisms, and microbiome changes), and commonality in treatment. In this review, we summarize recent studies on the association between HS and CD.

Correlation of Increased Total Serum Immunoglobulin E Levels and Hidradenitis Suppurativa

Abstract Introduction: Hidradenitis suppurativa is a chronic inflammatory skin disease with a typical formation of inflamed nodules, abscesses, and sinus tracts usually in the axillary, inguinal, and anogenital region. We decided to investigate the possible association of hidradenitis suppurativa and total IgE elevation and to explore the patients’ characteristics which can be related to high IgE levels. Methods: We performed a retrospective observational study which included 67 patients with moderate-to-severe stage of hidradenitis suppurativa followed up in our outpatient dermatology department. Total IgE, IgA, IgG, IgM, and CRP serum levels were measured. A personal and family history was taken. We asked them about allergic diseases and cigarette smoking and determined the basic parameters such as the weight and height of the patients. Results: Elevated total IgE levels were noticed in 21 patients (31.3%), of which 6 had a history of allergic disorder. Three of them had allergic rhinoconjunctivitis and the other three were suffering from atopic dermatitis. The mean total IgE level was 203.0 IU/ml with a maximum value of 1,954 IU/ml. Analysis of the factors, such as cigarette smoking, sex, elevated CRP, body mass index, and the number of affected areas, did not show an association with increased IgE levels. Conclusion: Our study showed a higher mean value of total IgE in patients with moderate to severe hidradenitis suppurativa than in the general population. However, we did not confirm an association with any characteristics of the patients. Limitations of this work include a small number of patients and a lack of the control group, therefore further and more extensive studies are needed to support these results.

Prevalence and cutaneous comorbidities of hidradenitis suppurativa in the German working population

The association of hidradenitis suppurativa with other skin diseases has not yet been investigated in larger studies based on dermatological exams. The objectives of this study are to determine the prevalence and cutaneous comorbidities of hidradenitis suppurativa in the German working population. Between 2014 and 2017, 20,112 people in 343 German companies were examined for the presence of clinical features of hidradenitis suppurativa within the framework of a cross-sectional epidemiological study based on whole-body examinations. In addition, all cutaneous comorbidities were recorded. Point prevalence was calculated and the differences between individuals with and without hidradenitis suppurativa were determined by bivariate analysis. All statistical procedures were performed using SPSS 23.0 for Windows. Of 20,112 people examined, mean age was 43.6 ± 10.5 years; 52.3% were male. In total, n = 57 people (0.3%) with hidradenitis suppurativa were identified; 61.4% (n = 35) being male. In addition, non-inflammatory hidradenitis suppurativa-related lesions were found in 674 other individuals. In a bivariate comparison, patients with hidradenitis suppurativa showed significantly more frequently the following cutaneous comorbidities: acne vulgaris, psoriasis, seborrhoeic dermatitis, excoriations, and folliculitis. We determined a point prevalence of hidradenitis suppurativa of 0.3%. Since we have examined the working population, the healthy worker effect, which could have led to underestimation of prevalence, cannot be ruled out. The point prevalence of 0.3% for employed people in Germany and a prevalence of 3.0% for inflammatory and non-inflammatory hidradenitis suppurativa-related lesions show that hidradenitis suppurativa is an important disease for the whole health system.

Hidradenitis suppurativa and the metabolic syndrome

The association of the metabolic syndrome (MetS) and its components with immune-mediated chronic inflammatory disorders has attracted much interest within the last two decades. In addition to the well-established association of psoriasis with MetS, recent data point to an association between MetS and hidradenitis suppurativa, as well. The association of hidradenitis suppurativa with MetS and its components, such as diabetes, obesity, and dyslipidemia, has been consistently identified in controlled studies. This relationship is not only limited to older individuals but also applicable to younger patients and those with mild disease. This review documents the link between these disorders and discusses its practical implications, mainly highlighting the importance of prevention and routine screening for early diagnosis to prevent cardiovascular-related morbidity.

Association of hidradenitis suppurativa and familial Mediterranean fever: A case series of 6 patients

ObjectivesFamilial mediterranean fever (FMF) is the most common monogenic autoinflammatory disease. Hidradenitis suppurativa (HS) is an inflammatory cutaneous disease. Those diseases can occur simultaneously among the same individual. Our objective was to describe the features of patients displaying both FMF and HS. MethodsWe screened the French adult FMF reference center for FMF patients with HS. ResultsSix patients out of 151 (4%) with a median age of 36 years old were concerned. Among them, FMF was symptomatic at a median age of 11.5years old and colchicine was introduced at a median age of 20.5years old. HS was diagnosed at a median age of 31.5years old. An elderly patient displayed AA amyloidosis in the outcome of FMF, with a late diagnosis of HS, with response to anakinra. There was no temporal relation between FMF and HS attacks. Some patients had a persistent inflammatory syndrome under treatment. ConclusionFMF and HS are both inflammatory diseases involving young patients, with HS possibly being an autoinflammatory disease. Although their association seems to be fortuitous, both can induce an important inflammation state that could lead to AA amyloidosis and require a close monitoring of clinical signs and acute-phase reactants. Anakinra was successful in treating the only patient with both HS, FMF and amyloidosis.

Hidradenitis Suppurativa and Pediatric Crohn Disease

Hidradenitis Suppurativa and Pediatric Crohn Disease

The possible association of hidradenitis suppurativa and Down syndrome: is increased amyloid precursor protein expression resulting in impaired Notch signalling the missing link?

The possible association of hidradenitis suppurativa and Down syndrome: is increased amyloid precursor protein expression resulting in impaired Notch signalling the missing link?