Serum amyloid A and C-reactive protein levels and erythrocyte sedimentation rate are important indicators in hidradenitis suppurativa

  • Neslihan AkdoganEmail author
  • Sibel Dogan
  • Pinar Incel-Uysal
  • Erdem Karabulut
  • Canan Topcuoglu
  • Basak Yalcin
  • Nilgun Atakan
Original Paper


Hidradenitis suppurativa (HS) is a chronic disabling inflammatory disease of the follicular unit especially affecting apocrine gland-bearing skin areas. Little is known about systemic inflammatory complications of the disease. This study aimed to evaluate systemic inflammation in patients with HS by assessing serum amyloid A protein (SAA) and C-reactive protein (CRP) levels and erythrocyte sedimentation rate (ESR) and to identify potential risk factors for HS. Forty-four patients (M/F: 28/16) and 44 age- and sex-matched controls (M/F: 28/16) were enrolled. Demographic, clinical, laboratory, and therapeutic data, including smoking status, body mass index (BMI), waist circumference (WC), serum fasting lipid profile, fasting blood glucose, SAA, and CRP levels, and ESR were assessed. Associations were investigated by univariate and multivariate analyses. Patients with HS showed significantly higher levels of pack-years of cigarette smoking, weight, BMI, and WC (P = 0.01, P < 0.001, P = 0.001) and elevated SAA and CRP levels and ESR (P = 0.008, P = 0.01 and P < 0.001). SAA and CRP levels and ESR were significantly associated with Hurley staging in patients with HS (P = 0.03, P = 0.003, P = 0.02). Multivariate logistic regression analysis revealed that each unit increase in the ESR increased the HS risk by 1.08-fold (95% CI 1.02–1.13). HS is significantly associated with SAA, CRP, and ESR. Among these inflammatory parameters, ESR was an independent risk factor for HS. We recommend assessment of SAA, CRP, and ESR as biomarkers that reflect the disease severity in HS patients likely to develop complications.


Hidradenitis suppurativa Serum amyloid A C-reactive protein Erythrocyte sedimentation rate 



Hidradenitis suppurativa


C-reactive protein


Erythrocyte sedimentation rate


Body mass index


Waist circumference


Amyloid A


Systolic blood pressure


Diastolic blood pressure


Serum lipid profile


Total cholesterol


High-density lipoprotein cholesterol


Low-density lipoprotein cholesterol


Very low-density lipoprotein cholesterol




Fasting blood glucose


Familial Mediterranean fever



We kindly thank Hacettepe University editing service for meticulous editing of the manuscript.


This work was supported by Turkish Dermatology Society on January 24, 2019 (Grant number 2019-10).

Compliance with ethical standards

Conflict of interest

The authors have no conflict of interest to declare.

Ethical approval

The study protocol was approved by the Medical Ethics Committee of Ankara Numune Training and Research Hospital (code E-18-2316, December 15, 2018). All study procedures were done in accordance with the ethical principles of the 1964 Declaration of Helsinki, and all the participants provided written informed consent.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Dermatology and Venereology, School of MedicineHacettepe UniversityAnkaraTurkey
  2. 2.Department of Dermatology and Venereology, Ankara Numune Training and Research HospitalUniversity of Health SciencesAnkaraTurkey
  3. 3.Department of Biostatistics, School of MedicineHacettepe UniversityAnkaraTurkey
  4. 4.Department of Medical Biochemistry, Ankara Numune Training and Research HospitalUniversity of Health SciencesAnkaraTurkey

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