Hidradenitis suppurativa and electrocardiographic changes: a cross‐sectional population study

Abstract

SummaryBackground Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease, recently associated with metabolic syndrome, subclinical atherosclerosis and increased risk of cardiovascular disease. Objectives To investigate the hitherto unknown electrocardiographic (ECG) changes associated with HS, which have recently been associated with significant cardiovascular burden. Methods Data were obtained from the cross-sectional Danish General Population Study (GESUS). HS diagnosis was based on a validated self-reported questionnaire; 404 individuals met the HS diagnosis criteria and 19 001 controls without HS were identified. Severity of HS was staged according to a modified Hurley score. The ECG parameters of heart rate (HR), PR interval, QRS duration, JTc interval and QTc interval were obtained from 12-lead resting ECGs. We investigated the difference in means by unpaired t-test or ANOVA. Results HR was significantly higher [mean difference 2Á3 beats per min (bpm), 95% confidence interval (CI) 1Á2-3Á4; P < 0Á01] when adjusting for age and sex, but when adjusting for multivariates, there was no significant difference (0Á3 bpm, 95% CI -0Á7 to 1Á4; P = 0Á52). Severe HS was significantly associated with increased HR across all models (2Á9 bpm, 95% CI 0Á7-5Á1; P = 0Á01). Mean QRS duration was significantly shorter in the group with mild HS but not in the groups with moderate and severe HS. Conclusions Mean resting HR in patients with severe HS was significantly higher compared with controls. Given that resting HR is associated with increased risk of all-cause and cardiovascular mortality, and that patients with HS have increased risk of cardiovascular events, this finding is potentially important, easily testable and intervenable.

Proceeding report of the third symposium on Hidradenitis Suppurativa advances (SHSA) 2018

“…The risk of cardiovascular or cerebrovascular death was also significantly higher for the patients with HS. These data were comparable with previous studies …”

Review of Comorbidities of Hidradenitis Suppurativa: Implications for Daily Clinical Practice

“…Reduced quality of life, social isolation [28,29] Sexual dysfunction [31] Depression, anxiety, schizophrenia [29,34,35] Increased antidepressant drug use [36] Increased suicide risk [36] Development of strategies to recognize and treat those psychiatric comorbidities in patients with HS is warranted Older patients, smokers, and patients with depression may benefit from periodic screening for long-term opioid use HS hidradenitis suppurativa, CD Crohn's disease of subclinical atherosclerosis [14]. In a crosssectional Danish general population study, mean resting heart rate in patients with severe HS was significantly higher compared with controls [15]. A population-based cohort study using individual-level linkage of nationwide administrative registers indicated that HS was associated with a significantly increased risk of adverse CV outcomes and all-cause mortality independent of measured confounders [16].…”

Vitiligo and quality of life: the dark face of whiteness

“…This is a crucial step in ensuring high data accuracy compared with data obtained by online or postal surveys. The only limitation of the present study is that the authors chose to use a generic questionnaire (Skindex-29) rather than a vitiligo-specific questionnaire such as the Vitiligo Impact Patient scale 3 or the VITIQoL, 4 which reflect better patient expectations and have the advantage of covering all aspects of the burden of vitiligo in daily life. To conclude, the study by Bae et al 2 is an important step towards confirming the impact of vitiligo on patient QoL.…”

“…It is not uncommon that patients are pessimistic about disease progression, treatment efficacy and their future health. 4,5 Nevertheless, the findings of Hjalte et al suggest that thanks to biologics, patients have been placed on a whole new trajectory regarding disease course and HRQoL. 3 The sustained improvement in HRQoL has been observed by using both a dermatology-specific (DLQI) and a generic (EQ-5D) measure.…”