Leukocyte Profile in Peripheral Blood and Neutrophil-Lymphocyte Ratio in Hidradenitis Suppurativa: A Comparative Cross-Sectional Study of 462 Cases

Abstract

Background: Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease. Increasing evidence suggests that HS involves dysfunctional immune responses in both the adaptive and the innate immune system. The recently proposed association of HS with metabolic syndrome may further add to the inflammatory state in HS. Objective: To investigate the status of inflammation and leukocyte profile in the peripheral blood of HS patients. Materials and Methods: Using a comparative cross-sectional study design, we investigated blood samples of high-sensitivity C-reactive protein (hs-CRP) and leukocyte profile in hospital-treated HS patients (HS-HOSP), self-reported population-based HS patients (HS-POP) and population controls. Results: Our study comprised 32 individuals in the HS-HOSP group, 430 in the HS-POP group, and 20,780 controls. The median hs-CRP for the HS-HOSP group was 5.1 mg/l (quartile range 2.6-8.2), 2.2 mg/l (1.0-4.3) for the HS-POP group and 1.3 mg/l (0.7-2.9) for the controls. An age-sex-adjusted analysis revealed a significantly higher hs-CRP for both HS groups compared to controls (p < 0.0001). When performing age-sex-adjusted analysis, both HS groups had significantly higher odds of leukocytosis when compared to controls with an odds ratio for the HS-HOSP group of 4.38 (95% CI = 2.18-8.80; p < 0.0001) and 1.95 (95% CI = 1.58-2.42; p < 0.0001) for the HS-POP group. The age-sex-adjusted leukocyte differential count yielded significantly higher neutrophil (p < 0.0001) and monocyte (p = 0.0014, p = 0.0004) levels in the HS groups compared with controls. Conclusion: The hs-CRP levels associated with HS appear to be intermediate (2.2-5.1 mg/l), implying systemic inflammation rather than infection. The peripheral blood leukocytosis in HS was dominated by neutrophils and monocytes.

Serum Anticytokine Autoantibody Levels Are Not Increased in Hidradenitis Suppurativa: A Case-Control Pilot Study

“…The highly elevated levels of the anti-inflammatory cytokine IL-10 should therefore most likely be seen as an inadequate physiological response to the inflammatory drive seen in HS [10,11] .…”

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.…”

“…2 The main objectives of these registers are to (i) gather data on the demographics and clinical characteristics of the psoriasis patient population; (ii) monitor safety and real-world effectiveness of conventional and biological systemic treatments, drug survival, predictors of response and treatment patterns; and (iii) provide long-term data on treatment in terms of disease activity and health-related quality of life (HRQoL). 2 In this issue of the BJD Hjalte et al 3 report on their observational study of 583 patients from the Swedish National Psoriasis Register (PsoReg). Patients were followed for up to 9 years, making this one of the longest biological treatment follow-up databases.…”

“…Patients were followed for up to 9 years, making this one of the longest biological treatment follow-up databases. 3 Main clinical outcomes included a disease severity measure, Psoriasis Area and Severity Index (PASI), and two HRQoL measures, Dermatology Life Quality Index (DLQI) and EuroQol-5D (EQ-5D). According to their results, the improvement achieved in all clinical end points 3-5 months after the initiation of biological therapy was sustained over the following years.…”

“…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. Two limitations of the study should be acknowledged.…”