Burden, predictors and temporal relationships of comorbidities in patients with hidradenitis suppurativa: a hospital‐based cohort study

Abstract

Aim To examine the burden, predictors and temporal relationships of comorbidities in patients with hidradenitis suppurativa (HS). Methods Information on HS and ten systemic comorbidities was obtained by interview and clinical examination, including blood pressure, body mass index (BMI) and blood samples, in a cohort of consecutive HS outpatients. Results A total of 302 patients were included. About 86.6% had at least one comorbidity. The mean number of comorbidities per patient was 2.1. One or more cardiovascular comorbidities were observed in 76.5% with evidence of substantial unawareness and undertreatment; 48.4% had hypertension, 9.3% had diabetes, 57.7% had dyslipidaemia and 36.7% were obese. About 6.6% had inflammatory bowel disease, 6.3% had arthritis, 29.5% had a psychiatric diagnosis, 5.6% had psoriasis, 7.9% had obstructive lung disease, and 6.6% had polycystic ovary syndrome. These comorbidities occurred at different time points in relation to the onset of HS with evidence of shared as well as differential risk factors. Age (per year), HR = 0.87 (0.79–0.96), P < 0.006, age of onset of HS (per year), HR = 1.26 (1.14–1.40), P < 0.001, male sex, HR = 2.51 (0.88–7.16), P = 0.086, Hurley stage III (vs. Hurley I + II), HR = 3.46 (1.25–9.58), P = 0.017, BMI (per unit), HR = 1.12 (1.04–1.20), P = 0.002, and blood glucose (per unit), HR = 1.27 (1.16–1.39), P < 0.001 were significant predictors for onset of diabetes. Conclusion There is a substantial burden, unawareness and undertreatment of several systemic comorbidities in patients with HS. Comorbidities occur at different time points in relation to the onset of HS. This should lead to higher awareness among treating specialists.

Association between Hidradenitis Suppurativa and Inflammatory Arthritis: A Systematic Review and Meta-Analysis

“…Across the studies, HS was reported predominantly in females, consistent with the literature. Severity of HS has been shown to be associated with male sex [27,32], which may explain why comorbid inflammatory arthritis, which has been linked to HS severity [8,21], has also been reported to occur predominantly in males.…”

“…Of these, 29 were excluded: 6 due to duplicate records, 16 conference abstracts without full text, 6 with irrelevant outcomes, and 1 because no English translation was available. Finally, 18 studies were determined as eligible for systematic review [8,9,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. The flow chart of our search strategy is shown in Figure 1.…”

Hidradenitis suppurativa: an update on epidemiology, phenotypes, diagnosis, pathogenesis, comorbidities and quality of life

“…The connection between HS and other immune‐mediated diseases, such as psoriasis, acne conglobata, pilonidal cysts, pyoderma gangrenosum, alopecia areata, vitiligo and thyroid dysfunction, has been suggested 115,150–152 . Anecdotal reports of HS and systemic lupus erythematosus or interstitial neutrophilic pneumonia exist; yet, this signal is too low‐powered to establish an association 153,154 .…”

Severe Respiratory and Hemodynamic Failures following Successful Spontaneous Pneumothorax Drainage

“…The delay between drainage and REPE and the CT scanner findings were comparable in this patient, although severer for the latter, as in previously described REPE [ 5 ] 5/4/2021 3:39:00 AM. This patient suffered from Verneuil's disease that can be associated with other comorbidities such as chronic lung disease [ 6 ]. Nevertheless, as far as we know, no causal relationship has been showed between this pathology and sudden lung edema or pneumothorax [ 7 ].…”