Amyloidosis in hidradenitis suppurativa: a cross‐sectional study and review of the literature

Abstract

Summary Background Coexistence of hidradenitis suppurativa (HS) and amyloidosis has been anecdotally described, but the association between these conditions is yet to be firmly established. Aim To study the association between HS and amyloidosis using a large‐scale computerized database, and to perform a literature review to characterize all reported patients with coexistent HS and amyloidosis. Methods A cross‐sectional study was conducted comparing the prevalence of amyloidosis among patients with HS and age‐, sex‐ and ethnicity‐matched healthy controls (HCs). Additionally, a review of literature was performed to summarize all reported cases with a dual diagnosis of both conditions. Results In total, 4417 patients with HS and 22 085 controls were included in the study. The prevalence of amyloidosis was increased in patients with HS compared with the HC group [n = 7 (0.2%) vs. n = 2 (0.0%), respectively; OR = 17.5; 95% CI 3.6–84.4; P < 0.001]. In a multivariate analysis, HS was still associated with amyloidosis (OR = 11.2; 95% CI 1.3–94.5; P = 0.03). The literature review identified nine patients who developed amyloidosis during the course of HS, with 44.4% eventually having renal failure. ‬Favourable outcomes were reported in patients managed by tumour necrosis factor (TNF)‐α inhibitors. Conclusion This study establishes the association between HS and amyloidosis. Screening for amyloidosis may be considered in patients with HS with a relevant clinical picture, mainly proteinuria. TNF‐α inhibitors may be preferred in patients with a dual diagnosis of these conditions.

Secukinumab may be remedy for systemic amyloidosis findings secondary to hidradenitis suppurativa

“… 2‐10 Recently, Kridin et al retrospectively investigated 4417 patients with HS and found that 7 patients had amyloidosis. However, no information has been given about the type of amyloidosis and which organ has amyloid accumulation 1 . In case reports, the period to diagnose amyloidosis after HS onset has been reported to vary between 3 and 51 years.…”

“…HS has been related to various cutaneous and systemic complications, such as chronic pain, anemia, hypoproteinaemia, lymphedema, squamous cell carcinoma, and amyloid A (AA) amyloidosis. 1 AA amyloidosis occurs due to amyloid deposited in various organs which is an acute-phase protein produced as secondary to chronic inflammatory diseases and it is a rare complication of HS. Amyloid storage usually starts from the kidneys and can also involve the heart, joints and nerves in AA amyloidosis.…”

“…Hidradenitis suppurativa (HS) is a chronic relapsing inflammatory disease of follicular epithelium, characterized by recurrent and painful nodules, abscesses, sinus tracts, and scars. HS has been related to various cutaneous and systemic complications, such as chronic pain, anemia, hypoproteinaemia, lymphedema, squamous cell carcinoma, and amyloid A (AA) amyloidosis 1 . AA amyloidosis occurs due to amyloid deposited in various organs which is an acute‐phase protein produced as secondary to chronic inflammatory diseases and it is a rare complication of HS.…”

Hidradenitis suppurativa and amyloidosis: a possible association with the pyrin inflammasome

“…We read with great interest the recent article by Kridin et al 1 . in Clinical and Experimental Dermatology .…”

“…We read with great interest the recent article by Kridin et al 1 in Clinical and Experimental Dermatology. In that cross-sectional study, seven cases of amyloidosis (0.2%) were reported from a predominantly Jewish sample of 4417 patients with hidradenitis suppurativa (HS).…”