Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder characterized by recurrent nodules, abscesses, and sinus tracts that can be debilitating and significantly impair quality of life. Small studies and case reports have suggested a possible association between HS and inflammatory bowel disease (IBD).
We performed a case–control study to further characterize IBD patients with HS in terms of smoking status, BMI, sites affected by HS, IBD type and features, and IBD medication history.
A total of 38 patients with HS and IBD were identified and matched on age, gender, and IBD type to 136 controls with IBD but not HS. Clinical characteristics of interest were obtained through extensive review of the electronic health record.
Among patients with HS and IBD, the most common sites affected by HS were the inguinal, perianal, and axillary regions. Relative to patients with IBD alone, patients with HS and IBD were nearly six times more likely to be current smokers (p < 0.01) and nearly 11 times more likely to be obese (p < 0.01). Patients with HS and Crohn’s were significantly more likely to have ileocolonic and perianal disease than patients with CD only (OR 8.31, 95% CI 2.90–23.80 and OR 2.85, 95% CI 1.19–6.81, respectively; p < 0.01 for both).
Relative to patients with IBD who do not develop HS, patients with IBD and HS are more likely to be overweight or obese, to be former or current smokers, and to have ileocolonic and/or perianal disease.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Price excludes VAT (USA)
Tax calculation will be finalised during checkout.
Jemec GB. Clinical practice. Hidradenitis suppurativa. N Engl J Med. 2012;366:158–164.
Alikhan A, Lynch PJ, Eisen DB. Hidradenitis suppurativa: a comprehensive review. J Am Acad Dermatol. 2009;60:539–563.
van der Zee HH, de Winter K, van der Woude CJ, et al. The prevalence of hidradenitis suppurativa in 1093 patients with inflammatory bowel disease. Br J Dermatol. 2014;171:673–675.
Egeberg A, Jemec GB, Kimball AB, et al. Prevalence and risk of inflammatory bowel disease in patients with hidradenitis suppurativa. J Invest Dermatol. 2017;137:1060–1064.
Kelly G, Hughes R, McGarry T, et al. Dysregulated cytokine expression in lesional and nonlesional skin in hidradenitis suppurativa. Br J Dermatol. 2015;173:1431–1439.
Schlapbach C, Hanni T, Yawalkar N, et al. Expression of the IL-23/Th17 pathway in lesions of hidradenitis suppurativa. J Am Acad Dermatol. 2011;65:790–798.
van der Zee HH, de Ruiter L, van den Broecke DG, et al. Elevated levels of tumour necrosis factor (TNF)-α, interleukin (IL)-1β and IL-10 in hidradenitis suppurativa skin: a rationale for targeting TNF-α and IL-1β. Br J Dermatol. 2011;164:1292–1298.
Matusiak L, Bieniek A, Szepietowski JC. Increased serum tumour necrosis factor-alpha in hidradenitis suppurativa patients: is there a basis for treatment with anti-tumour necrosis factor-alpha agents? Acta Dermatol Venereol. 2009;89:601–603.
Kamal N, Cohen BL, Buche S, et al. Features of patients with Crohn’s disease and hidradenitis suppurativa. Clin Gastroenterol Hepatol. 2016;14:71–79.
Yadav S, Singh S, Varayil JE, et al. Hidradenitis suppurativa in patients with inflammatory bowel disease: a population-based cohort study in Olmstead County, Minnesota. Clin Gastroenterol Hepatol. 2016;14:65–70.
van der Zee HH, Horvath B, Jemec GB, et al. The association between hidradenitis suppurativa and Crohn’s disease: in search of the missing pathogenic link. J Invest Dermatol. 2016;136:1747–1748.
Catana CS, Neagoe IB, Cozma V, et al. Contribution of the IL-17/IL-23 axis to the pathogenesis of inflammatory bowel disease. World J Gastroenterol. 2015;21:5823–5830.
van der Zee HH, van der Woude CJ, Florencia EF, et al. Hidradenitis suppurativa and inflammatory bowel disease: are the associated? Results of a pilot study. Br J Dermatol. 2010;162:195–197.
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;76:49–53.
Yount RJ, Vries JK, Councill CD. The medical archival system: an information retrieval system based on distributed parallel processing. Inf Process Manage. 1991;27:379–389.
This project was supported in part by the National Institutes of Health through Grant Number UL1-TR-001857.
Conflict of interest
The authors have no conflicts of interest to disclose.
This manuscript represents original work and is not under consideration by any other journal. All authors approved the manuscript and this submission.
Electronic supplementary material
Below is the link to the electronic supplementary material.
About this article
Cite this article
Lukach, A.J., Saul, M.I., Ferris, L.K. et al. Risk Factors for Hidradenitis Suppurativa in Patients with Inflammatory Bowel Disease. Dig Dis Sci 63, 755–760 (2018). https://doi.org/10.1007/s10620-018-4919-5