Comorbidity Burden With HS
Comorbidities associated with hidradenitis suppurativa (HS) can affect multiple organ systems beyond the skin and may include an inflammatory component. Types of comorbidities include1-3:
Comorbidities with HS may require multidisciplinary collaboration as part of a holistic approach to management.2 It is important to identify risk factors, screen patients, and partner with appropriate specialists.
DID YOU KNOW?
HS Has a Higher Comorbidity Burden Than Psoriasis
In a cross-sectional analysis that included 5306 patients with HS, researchers compared electronic health record data of people with HS to healthy controls and people with psoriasis. The Charlson Comorbidity Index (CCI), a validated standardized measure of global comorbidity, was used to measure and compare comorbidity burden. The CCI score is widely used to help predict the risk of mortality across patient populations.13
In the HS cohort, a significant proportion of patients (13.5%) had an overall mean CCI score of ≥5, compared to 9.3% of patients with psoriasis.13
HS patients with CCI scores of at least 5 had nearly 5 times the odds of 5-year mortality than patients with CCI scores of 0.13
Importance of an HS Care Team
HS specialists in dermatology, psychologists, wound care specialists, and others may be necessary as part of the holistic management of HS.14
View Damage Under the Skin
Ultrasound research shows evidence of severe activity under the skin before comparable damage is visible on the surface.15,16
REFERENCES
1. Porter ML, Kimball AB. Clinical presentation of hidradenitis suppurativa. In: Kimball AB, Jemec GBE, eds. Hidradenitis Suppurativa: A Disease Primer. Switzerland: Springer International Publishing AG; 2017:9-18. 2. Cartron A, Driscoll MS. Comorbidities of hidradenitis suppurativa: a review of the literature. Int J Womens Dermatol. 2019;5(5):330-334. 3. Garg A, Strunk A, Midura M, Papagermanos V, Pomerantz H. Prevalence of hidradenitis suppurativa among patients with Down syndrome: a population-based cross-sectional analysis. Br J Dermatol. 2018;178(3):697-703. 4. Reddy S, Strunk A, Jemec GBE, Garg A. Incidence of myocardial infarction and cerebrovascular accident in patients with hidradenitis suppurativa. JAMA Dermatol. 2020;156(1):65-71. 5. Miller IM, Ellervik C, Vinding GR, et al. Association of metabolic syndrome and hidradenitis suppurativa. JAMA Dermatol. 2014;150(12):1273-1280. 6. Egeberg A, Gislason GH, Hansen PR. Risk of major adverse cardiovascular events and all-cause mortality in patients with hidradenitis suppurativa. JAMA Dermatol. 2016;152(4):429-434. 7. Deckers IE, Benhadou F, Koldijk MJ, et al. Inflammatory bowel disease is associated with hidradenitis suppurativa: results from a multicenter cross-sectional study. J Am Acad Dermatol. 2017;76(1):49-53. 8. Yadav S, Singh S, Edakkanambeth Varayil J, et al. Hidradenitis suppurativa in patients with inflammatory bowel disease: a population-based cohort study in Olmsted County, Minnesota. Clin Gastroenterol Hepatol. 2016;14(1):65-70. 9. Richette P, Molto A, Viguier M, et al. Hidradenitis suppurativa associated with spondyloarthritis — results from a multicenter national prospective study. J Rheumatol. 2014;41(3):490-494. 10. Vazquez BG, Alikhan A, Weaver AL, Wetter DA, Davis MD. Incidence of hidradenitis suppurativa and associated factors: a population-based study of Olmsted County, Minnesota. J Invest Dermatol. 2013;133(1):97-103. 11. Tannenbaum R, Strunk A, Garg A. Association between hidradenitis suppurativa and lymphoma. JAMA Dermatol. 2019;155(5):624-625. 12. Napolitano M, Megna M, Timoshchuk EA, et a. Hidradenitis suppurativa: from pathogenesis to diagnosis and treatment. Clin Cosmet Investig Dermatol. 2017;10:105-115. 13. Reddy S, Strunk A, Garg A. Comparative overall comorbidity burden among patients with hidradenitis suppurativa. JAMA Dermatol. 2019;155(7):797-802. 14. Lockwood SJ, Prens LM, Porter ML, Kimball AB. Treatment of hidradenitis suppurativa. In: Kimball AB, Jemec GBE, eds. Hidradenitis Suppurativa: A Disease Primer. Switzerland: Springer International Publishing AG; 2017:39-51. 15. Jemec GBE. Hidradenitis suppurativa. N Engl J Med. 2012;366(2):158-164.16. Wortsman X, Castro A, Figueroa A. Color doppler ultrasound assessment of morphology and types of fistulous tracts in hidradenitis suppurativa (HS). J Am Acad Dermatol. 2016;75(4):760-767.
