Comorbid diseases of hidradenitis suppurativa: a 15-year population-based study in Olmsted County, Minnesota, USA
Corresponding Author
Olayemi Sokumbi MD
Departments of Dermatology and Laboratory Medicine & Pathology, Mayo Clinic, Jacksonville, FL, USA
Correspondence
Olayemi Sokumbi, md
Departments of Dermatology and Laboratory Medicine & Pathology
Mayo Clinic
4500 San Pablo Rd
Jacksonville, FL 32224
USA
E-mail: [email protected]
Search for more papers by this authorDavid O. Hodge MS
Division of Biomedical Statistics, Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL, USA
Search for more papers by this authorSophia A. Ederaine BS
Student, Mayo Clinic Alix School of Medicine, Arizona Campus, Scottsdale, AZ, USA
Search for more papers by this authorAfsaneh Alavi MD
Department of Dermatology, Mayo Clinic, Rochester, MN, USA
Search for more papers by this authorAli Alikhan MD
Department of Dermatology, Sutter Medical Foundation, Sacramento, CA, USA
Search for more papers by this authorCorresponding Author
Olayemi Sokumbi MD
Departments of Dermatology and Laboratory Medicine & Pathology, Mayo Clinic, Jacksonville, FL, USA
Correspondence
Olayemi Sokumbi, md
Departments of Dermatology and Laboratory Medicine & Pathology
Mayo Clinic
4500 San Pablo Rd
Jacksonville, FL 32224
USA
E-mail: [email protected]
Search for more papers by this authorDavid O. Hodge MS
Division of Biomedical Statistics, Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL, USA
Search for more papers by this authorSophia A. Ederaine BS
Student, Mayo Clinic Alix School of Medicine, Arizona Campus, Scottsdale, AZ, USA
Search for more papers by this authorAfsaneh Alavi MD
Department of Dermatology, Mayo Clinic, Rochester, MN, USA
Search for more papers by this authorAli Alikhan MD
Department of Dermatology, Sutter Medical Foundation, Sacramento, CA, USA
Search for more papers by this authorConflict of interest: None.
Funding source: This study was made possible using the resources of the Rochester Epidemiology Project, which is supported by the National Institute on Aging of the National Institutes of Health under Award Number R01AG034676. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Abstract
Background
Like other chronic, inflammatory skin disorders, hidradenitis suppurativa (HS) is increasingly recognized to be associated with various medical disorders.
Objective
Using the Rochester Epidemiology Project (REP), we sought to conduct the first American population-based study examining the association between HS and various comorbid conditions.
Methods
From the REP database, we identified patients diagnosed with HS from 2003 through 2018 who were residents of Olmsted County, Minnesota, USA, along with age- and gender-matched controls. The frequency of a wide variety of comorbid conditions was compared between the groups.
Results
A total of 1160 patients with HS were identified during the study period. Compared with age- and gender-matched controls, patients with HS had a significantly higher frequency of several medical conditions, including depression, anxiety, hyperlipidemia, acne conglobata, dissecting cellulitis, pilonidal cysts, polycystic ovary syndrome, diabetes, chronic kidney disease, psoriasis, atopic dermatitis, obesity, and disordered substance use, among others.
Limitations
Our study was limited by its retrospective design.
Conclusions
Providers caring for patients with HS should consider these results, along with those of similar studies, and obtain a thorough history, comprehensive physical examination, and, potentially, laboratory testing and referral to other specialists.
Supporting Information
| Filename | Description |
|---|---|
| ijd16228-sup-0001-TableS1.docxWord 2007 document , 27.1 KB |
Table S1. Comorbidities for females by case vs. control. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
References
- 1Alikhan A, Lynch PJ, Eisen DB. Hidradenitis suppurativa: a comprehensive review. J Am Acad Dermatol 2009; 60; 539-61; quiz 62-3.
- 2Alavi A, Anooshirvani N, Kim WB, et al. Quality-of-life impairment in patients with hidradenitis suppurativa: a Canadian study. Am J Clin Dermatol 2015; 16: 61–65.
- 3Goldburg SR, Strober BE, Payette MJ. Hidradenitis suppurativa: epidemiology, clinical presentation, and pathogenesis. J Am Acad Dermatol 2020; 82: 1045–1058.
- 4Kirby JS, Miller JJ, Adams DR, et al. Health care utilization patterns and costs for patients with hidradenitis suppurativa. JAMA Dermatol 2014; 150: 937–944.
- 5Reddy S, Strunk A, Garg A. Comparative overall comorbidity burden among patients with Hidradenitis Suppurativa. JAMA Dermatol 2019; 155: 797–802.
- 6Kohorst JJ, Kimball AB, Davis MD. Systemic associations of hidradenitis suppurativa. J Am Acad Dermatol 2015; 73: S27–S35.
- 7Kimball AB, Sundaram M, Gauthier G, et al. The comorbidity burden of Hidradenitis Suppurativa in the United States: a claims data analysis. Dermatol Ther (Heidelb) 2018; 8: 557–569.
- 8Shlyankevich J, Chen AJ, Kim GE, et al. Hidradenitis suppurativa is a systemic disease with substantial comorbidity burden: a chart-verified case-control analysis. J Am Acad Dermatol 2014; 71: 1144–1150.
- 9Porter ML, Kimball AB. Comorbidities of hidradenitis suppurativa. Semin Cutan Med Surg 2017; 36: 55–57.
- 10Melton LJ 3rd. History of the Rochester epidemiology project. Mayo Clin Proc 1996; 71: 266–274.
- 11Rocca WA, Yawn BP, St Sauver JL, et al. History of the Rochester epidemiology project: half a century of medical records linkage in a US population. Mayo Clin Proc 2012; 87: 1202–1213.
- 12St Sauver JL, Grossardt BR, Yawn BP, et al. Data resource profile: the Rochester epidemiology project (REP) medical records-linkage system. Int J Epidemiol 2012; 41: 1614–1624.
- 13St Sauver JL, Grossardt BR, Leibson CL, et al. Generalizability of epidemiological findings and public health decisions: an illustration from the Rochester epidemiology project. Mayo Clin Proc 2012; 87: 151–160.
- 14St. Sauver JL, Grossardt BR, Yawn BP, et al. Use of a medical records linkage system to enumerate a dynamic population over time: the Rochester epidemiology project. Am J Epidemiol 2011; 173: 1059–1068.
- 15Shahi V, Alikhan A, Vazquez BG, et al. Prevalence of hidradenitis suppurativa: a population-based study in Olmsted County, Minnesota. Dermatology 2014; 229: 154–158.
- 16 United States Census Bureau. Quick facts: Olmsted County, Minnesota. In, Vol. 2021. 2019.
- 17Zouboulis CC, Del Marmol V, Mrowietz U, et al. Hidradenitis Suppurativa/acne Inversa: criteria for diagnosis, severity assessment, classification and disease evaluation. Dermatology 2015; 231: 184–190.
- 18Vazquez BG, Alikhan A, Weaver AL, et al. Incidence of hidradenitis suppurativa and associated factors: a population-based study of Olmsted County, Minnesota. J Invest Dermatol 2013; 133: 97–103.
- 19Jemec GB, Heidenheim M, Nielsen NH. The prevalence of hidradenitis suppurativa and its potential precursor lesions. J Am Acad Dermatol 1996; 35: 191–194.
- 20Mebazaa A, Ben Hadid R, Cheikh Rouhou R, et al. Hidradenitis suppurativa: a disease with male predominance in Tunisia. Acta Dermatovenerol Alp Pannonica Adriat 2009; 18: 165–172.
- 21Lee JH, Kwon HS, Jung HM, et al. Prevalence and comorbidities associated with hidradenitis suppurativa in Korea: a nationwide population-based study. J Eur Acad Dermatol Venereol 2018; 32: 1784–1790.
- 22Canoui-Poitrine F, Revuz JE, Wolkenstein P, et al. Clinical characteristics of a series of 302 French patients with hidradenitis suppurativa, with an analysis of factors associated with disease severity. J Am Acad Dermatol 2009; 61: 51–57.
- 23Cartron A, Driscoll MS. Comorbidities of hidradenitis suppurativa: a review of the literature. Int J Womens Dermatol 2019; 5: 330–334.
- 24Rodriguez-Zuniga MJM, Garcia-Perdomo HA, Ortega-Loayza AG. Association between Hidradenitis Suppurativa and metabolic syndrome: a systematic review and meta-analysis. Actas Dermosifiliogr (Engl Ed) 2019; 110: 279–288.
- 25Phan K, Charlton O, Smith SD. Hidradenitis suppurativa and diabetes mellitus: updated systematic review and adjusted meta-analysis. Clin Exp Dermatol 2019; 44: e126–e132.
- 26Shalom G, Freud T, Harman-Boehm I, et al. Hidradenitis suppurativa and metabolic syndrome: a comparative cross-sectional study of 3207 patients. Br J Dermatol 2015; 173: 464–470.
- 27Miller IM, Ellervik C, Vinding GR, et al. Association of metabolic syndrome and hidradenitis suppurativa. JAMA Dermatol 2014; 150: 1273–1280.
- 28Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: findings from the third national health and nutrition examination survey. JAMA 2002; 287: 356–359.
- 29Hughes R, Knudsen E, Kirthi S, et al. Framingham risk assessment in hidradenitis suppurativa. Br J Dermatol 2017; 176: 1404–1406.
- 30Lim ZV, Oon HH. Management of Hidradenitis Suppurativa in patients with metabolic comorbidities. Ann Dermatol 2016; 28: 147–151.
- 31Sabat R, Chanwangpong A, Schneider-Burrus S, et al. Increased prevalence of metabolic syndrome in patients with acne inversa. PLoS One 2012; 7: e31810.
- 32Kromann CB, Ibler KS, Kristiansen VB, et al. The influence of body weight on the prevalence and severity of hidradenitis suppurativa. Acta Derm Venereol 2014; 94: 553–557.
- 33Thomas CL, Gordon KD, Mortimer PS. Rapid resolution of hidradenitis suppurativa after bariatric surgical intervention. Clin Exp Dermatol 2014; 39; 315-7; quiz 7-8.
- 34Golbari NM, Lee Porter M, Kimball AB. Response to: remission of hidradenitis suppurativa after bariatric surgery. JAAD Case Rep 2018; 4: 278–279.
- 35Gallagher C, Kirthi S, Burke T, et al. Remission of hidradenitis suppurativa after bariatric surgery. JAAD Case Rep 2017; 3: 436–437.
- 36Tzellos T, Zouboulis CC, Gulliver W, et al. Cardiovascular disease risk factors in patients with hidradenitis suppurativa: a systematic review and meta-analysis of observational studies. Br J Dermatol 2015; 173: 1142–1155.
- 37Diamanti-Kandarakis E, Kouli CR, Bergiele AT, et al. A survey of the polycystic ovary syndrome in the Greek Island of Lesbos: hormonal and metabolic profile. J Clin Endocrinol Metab 1999; 84: 4006–4011.
- 38March WA, Moore VM, Willson KJ, et al. The prevalence of polycystic ovary syndrome in a community sample assessed under contrasting diagnostic criteria. Hum Reprod 2010; 25: 544–551.
- 39Garg A, Neuren E, Strunk A. Hidradenitis Suppurativa is associated with polycystic ovary syndrome: a population-based analysis in the United States. J Invest Dermatol 2018; 138: 1288–1292.
- 40Kraft JN, Searles GE. Hidradenitis suppurativa in 64 female patients: retrospective study comparing oral antibiotics and antiandrogen therapy. J Cutan Med Surg 2007; 11: 125–131.
- 41Miller IM, Vinding G, Sorensen HA, et al. Thyroid function in hidradenitis suppurativa: a population-based cross-sectional study from Denmark. Clin Exp Dermatol 2018; 43: 899–905.
- 42Gonzalez-Lopez MA, Blanco R, Mata C, et al. Coexistence of Hidradenitis Suppurativa with autoimmune thyroiditis: report of three cases. Dermatology 2016; 232: 162–164.
- 43Gonzalez-Lopez MA, Hernandez JL, Vilanova I, et al. Thyroid autoimmunity in patients with hidradenitis suppurativa: a case-control study. Clin Exp Dermatol 2017; 42: 642–644.
- 44Ozkur E, Karadag AS, Ustuner P, et al. Clinical and demographic features of hidradenitis suppurativa: a multicentre study of 1221 patients with an analysis of risk factors associated with disease severity. Clin Exp Dermatol 2021; 46: 532–540.
- 45Sherman S, Kridin K, Bitan DT, et al. Hidradenitis suppurativa and atopic dermatitis: a 2-way association. J Am Acad Dermatol 2021; 85: 1473–1479.
- 46Jalenques I, Ciortianu L, Pereira B, et al. The prevalence and odds of anxiety and depression in children and adults with hidradenitis suppurativa: systematic review and meta-analysis. J Am Acad Dermatol 2020; 83: 542–553.
- 47Wright S, Strunk A, Garg A. New-onset depression among children, adolescents, and adults with hidradenitis suppurativa. J Am Acad Dermatol 2020; 83: 1360–1366.
- 48Phan K, Huo YR, Smith SD. Hidradenitis suppurativa and psychiatric comorbidities, suicides and substance abuse: systematic review and meta-analysis. Ann Transl Med 2020; 8: 821.
- 49Patel KR, Lee HH, Rastogi S, et al. Association between hidradenitis suppurativa, depression, anxiety, and suicidality: a systematic review and meta-analysis. J Am Acad Dermatol 2020; 83: 737–744.
- 50Garg A, Papagermanos V, Midura M, et al. Incidence of hidradenitis suppurativa among tobacco smokers: a population-based retrospective analysis in the U.S.A. Br J Dermatol 2018; 178: 709–714.
- 51Acharya P, Mathur M. Hidradenitis suppurativa and smoking: a systematic review and meta-analysis. J Am Acad Dermatol 2020; 82: 1006–1011.
- 52Garg A, Papagermanos V, Midura M, et al. Opioid, alcohol, and cannabis misuse among patients with hidradenitis suppurativa: a population-based analysis in the United States. J Am Acad Dermatol 2018; 79: 495–500 e1.
- 53Aldana PC, Driscoll MS. Is substance use disorder more prevalent in patients with hidradenitis suppurativa? Int J Womens Dermatol 2019; 5: 335–339.
- 54Lesort C, Villani AP, Giai J, et al. High prevalence of cannabis use among patients with hidradenitis suppurativa: results from the VERADDICT survey. Br J Dermatol 2019; 181: 839–841.
- 55Chen WT, Chi CC. Association of Hidradenitis Suppurativa with inflammatory bowel disease: a systematic review and meta-analysis. JAMA Dermatol 2019; 155: 1022–1027.
- 56Phan K, Tatian A, Woods J, et al. Prevalence of inflammatory bowel disease (IBD) in hidradenitis suppurativa (HS): systematic review and adjusted meta-analysis. Int J Dermatol 2020; 59: 221–228.
- 57Lloyd-McLennan AM, Ali S, Kittler NW. Prevalence of inflammatory bowel disease among pediatric patients with hidradenitis suppurativa and the potential role of screening with fecal calprotectin. Pediatr Dermatol 2021; 38: 98–102.
- 58Richette P, Molto A, Viguier M et al. Hidradenitis suppurativa associated with spondyloarthritis -- results from a multicenter national prospective study. J Rheumatol 2014; 41: 490–4.
- 59Egeberg A, Gislason GH, Hansen PR. Risk of major adverse cardiovascular events and all-cause mortality in patients with Hidradenitis Suppurativa. JAMA Dermatol 2016; 152: 429–434.
- 60Bailey AMJ, Oi-Yee Li H, Tan MG, et al. Hidradenitis suppurativa and major adverse cardiac events: a systematic review and meta-analysis. J Am Acad Dermatol 2021; 84: 844–848.
- 61Miller IM, Carlson N, Mogensen UB, et al. A population- and hospital-based cross-sectional study of renal function in Hidradenitis Suppurativa. Acta Derm Venereol 2016; 96: 68–71.
Citing Literature
