Type 1 diabetes, asthma may precede hidradenitis suppurativa diagnosis
A wide-ranging group of 25 diseases and conditions was observed to precede hidradenitis suppurativa diagnosis, shedding light on the temporal relationships associated with this disease, according to a study.
“Hidradenitis suppurativa is a chronic skin disease characterized by recurrent inflamed nodular lesions and is associated with multiple comorbidities,” Rune Kjærsgaard Andersen, MSc, of the department of dermatology at Zealand University Hospital in Roskilde, Denmark, and colleagues wrote. They noted that the disease has been associated with a number of comorbidities, including diabetes, obesity, smoking, depression, anxiety and Crohn’s disease. “Despite the associations, a temporal relationship and causality remain to be determined because most studies have had a cross-sectional design.”
With that in mind, Andersen and colleagues conducted a retrospective registry-based cohort study to assess and characterize disease trajectories of HS. Eligible participants were culled from a nationwide registry and had a diagnosis of HS between Jan. 1, 1994, and April 10, 2018. The analysis of more than 7 million Danish citizens resulted in 14,488 individuals who met diagnostic criteria.
The final cohort was broken down into a group of 11,929 individuals with ICD-10 diagnosis that was 70.3% women with a mean age of 37.72 years at diagnosis (SD = 13.01 years). An additional 2,791 patients were identified through an algorithm by procedural codes and proxy diagnosis. This group was 60.4% women with a mean age of 37.38 years at diagnosis (SD = 15.83). Two hundred thirty-two patients were excluded because they had HS diagnosis and were also identified by the algorithm.
Results showed that 25 temporal diagnoses were commonly associated with HS. Genitourinary conditions, including inflammatory diseases of the vagina and vulva, converged on cutaneous abscesses and preceded HS diagnosis. In addition, respiratory diseases such as asthma and mental or behavioral disorders such as depression all preceded HS diagnosis.
Type 1 diabetes was observed in individuals who went on to develop HS. Alcohol intake, which is associated with systemic inflammation, also carried an association with the development of HS.
After HS diagnosis, a number of conditions were commonly reported to develop, including chronic obstructive pulmonary disease (4.2%; RR = 1.57; P<.001), pneumonia (5.7%; RR = 1.18; P<.001), and acute myocardial infarction (2%; RR = 1.37; P<.001).
“The findings suggest that patients with newly diagnosed HS may have a high frequency of manifest type 1 diabetes and subsequent high risk of acute myocardial infarction, pneumonia and chronic obstructive pulmonary disease,” the researchers wrote.