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Autoimmune, Autoinflammatory Disease and Cutaneous Malignancy Associations with Hidradenitis Suppurativa: A Cross-Sectional Study

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Abstract

Background

Hidradenitis suppurativa (HS) is a debilitating cutaneous disease characterized by severe painful inflammatory nodules/abscesses. At present, data regarding the epidemiology and pathophysiology of this disease are limited.

Objective

To define the prevalence and comorbidity associations of HS.

Methods

This was a cross-sectional study of EPICTM Cosmos© examining over 180 million US patients. Prevalences were calculated by demographic and odds ratios (OR) and identified comorbidity correlations.

Results

All examined metabolism-related, psychological, and autoimmune/autoinflammatory (AI) diseases correlated with HS. The strongest associations were with pyoderma gangrenosum [OR 26.56; confidence interval (CI): 24.98–28.23], Down syndrome (OR 11.31; CI 10.93–11.70), and polycystic ovarian syndrome (OR 11.24; CI 11.09–11.38). Novel AI associations were found between HS and lupus (OR 6.60; CI 6.26–6.94) and multiple sclerosis (MS; OR 2.38; CI 2.29–2.48). Cutaneous malignancies were largely not associated in the unsegmented cohort; however, among Black patients, novel associations with melanoma (OR 2.39; CI 1.86–3.08) and basal cell carcinoma (OR 2.69; CI 2.15–3.36) were identified.

Limitations

International Classification of Diseases (ICD)-based disease identification relies on coding fidelity and diagnostic accuracy.

Conclusion

This is the first study to identify correlations between HS with melanoma and basal cell carcinoma (BCC) among Black patients as well as MS and lupus in all patients with HS.

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Authors and Affiliations

  1. Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health, 240 E 38th Street, 13th Floor, New York, NY, 10016, USA

    Hilliard T. Brydges, Ogechukwu C. Onuh, Rebecca Friedman, Joy Barrett, Catherine P. Lu & Ernest S. Chiu

  2. Ronald O. Perelman Department of Dermatology at NYU Grossman School of Medicine, New York, NY, USA

    Avrom S. Caplan

  3. New York University School of Global Public Health, New York, NY, USA

    Rebecca A. Betensky

  4. Mayo Clinic Dermatology, Rochester, MN, USA

    Afsaneh Alavi

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E.C., A.A., A.C., R.B., and C.P. were involved in critically reviewing the study design and proposal as well as supervising the work. H.B. performed data collection and analysis. R.B. validated the analysis approach and findings. H.B., O.O., R.F., and J.B. contributed to the literature review and data collection, and H.B., O.O., and R.F. drafted the manuscript and designed the figures. All authors contributed to the critical review of the manuscript including, text and figure review, editing, and final approval.

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Brydges, H.T., Onuh, O.C., Friedman, R. et al. Autoimmune, Autoinflammatory Disease and Cutaneous Malignancy Associations with Hidradenitis Suppurativa: A Cross-Sectional Study. Am J Clin Dermatol (2024). https://doi.org/10.1007/s40257-024-00844-5

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