Hidradenitis suppurativa associated with systemic lupus erythematosus

David, Chen Ben; Bragazzi, Nicola Luigi; Watad, Abdulla; Sharif, Κassem; Whitby, Aaron; Amital, Howard; Adawi, Mohammad

doi:10.1097/md.0000000000010186

Cited by 12 publications

(6 citation statements)

References 23 publications

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“…Interestingly, other rheumatologic conditions have been reported in patients with HS, such as systemic lupus erythematous. In a 2018 case report (Ben David et al, 2018), a 40-year-old female patient with SLE presented with recurrent abscesses and nodules on the extremities and was ultimately diagnosed with HS. Thus, HS may coexist with other autoimmune conditions, suggesting a common disease etiology.…”

Section: Resultsmentioning

confidence: 99%

Comorbidities of hidradenitis suppurativa: A review of the literature

Cartron

Driscoll

2019

International Journal of Women's Dermatology

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BackgroundHidradenitis suppurativa (HS) is a chronic inflammatory skin condition that affects the follicular portion of folliculopilosebaceous units. It causes painful nodules, abscesses, and draining sinus tracts throughout multiple regions of the body. HS primarily affects women; the overall HS prevalence in women is three times that in men. Although cutaneous disease itself causes substantial morbidity, recent evidence has shown that HS is a systemic inflammatory disease with multiple associated comorbidities.ObjectiveA review of the literature was conducted to elucidate existing information on this topic to assist in clinical decision-making for dermatologists.MethodsA review of the literature using the PubMed database was conducted with the search term “hidradenitis suppurativa comorbidities”. The search was conducted from March 3, 2019 to March 20, 2019, and yielded 55 articles, case reports, and reviews.ResultsMetabolic and cardiovascular comorbidities were the most commonly associated with HS. HS has a significant comorbidity burden beyond the skin, including metabolic, cardiovascular, endocrine, gastrointestinal, rheumatologic, and psychiatric disorders, which collectively decrease the quality of life of patients.ConclusionsDermatologists should be aware of these associations to encourage appropriate screening and referral for management of these disorders.

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Section: Resultsmentioning

confidence: 99%

Comorbidities of hidradenitis suppurativa: A review of the literature

Cartron

Driscoll

2019

International Journal of Women's Dermatology

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“…The connection between HS and other immune‐mediated diseases, such as psoriasis, acne conglobata, pilonidal cysts, pyoderma gangrenosum, alopecia areata, vitiligo and thyroid dysfunction, has been suggested 115,150–152 . Anecdotal reports of HS and systemic lupus erythematosus or interstitial neutrophilic pneumonia exist; yet, this signal is too low‐powered to establish an association 153,154 . Two studies demonstrated a higher frequency of pathogenic MEFV mutations, which is responsible for familial Mediterranean disease, in HS compared with the public 94,155 .…”

Section: Comorbiditiesmentioning

confidence: 99%

Hidradenitis suppurativa: an update on epidemiology, phenotypes, diagnosis, pathogenesis, comorbidities and quality of life

Nguyen

Damiani

Orenstein

et al. 2020

Acad Dermatol Venereol

244

248

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Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that severely impairs patients' quality of life. It is characterized by recurrent painful nodules, abscesses and draining sinus tracts in primarily intertriginous areas. We aimed to review the most up‐to‐date information regarding the epidemiology, clinical presentation, diagnostic studies, pathogenesis, comorbidities and quality of life of patients with hidradenitis suppurativa. We performed a systematic search of Medline, Embase database (from inception to September 2019) and review of bibliographies without restrictions on year or language. HS has an estimated global prevalence of 0.00033–4.1% (but most likely 0.7–1.2% in the European‐US population). Patients still experience a significant diagnostic delay, up to several years. In the absence of pathognomonic tests, the diagnosis of HS is made from clinical observation and the disease narrative. Phenotypic variation renders diagnosis and severity assessment difficult. Ultrasound imaging is an emerging assessment tool for deep‐seated lesions. The Hurley Staging System is still widely used in severity rating. Follicular hyperkeratosis and dilatation, follicular rupture and chronic inflammation with architectural tissue changes have been implicated in the pathogenesis of HS. HS has been associated with metabolic syndrome and other risk factors for cardiovascular disease, diabetes mellitus type II, polycystic ovarian syndrome, depression, suicide and substance use disorders. It has been linked to other immune‐mediated diseases such as inflammatory bowel disease and spondyloarthropathy. Pain, pruritus, malodour, low self‐esteem, sleep and sexual dysfunctions, and poor mental health are chronic symptoms or consequences of uncontrolled disease. HS is an under‐diagnosed and under‐treated disease with a profound negative impact on patients' quality of life. In the light of its associated comorbidities, an interdisciplinary management approach may be needed to ensure the best outcomes.

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“…The pathogenesis of HS is complex, multi-factorial and still poorly understood, with the biological make-up of the individual (especially, genetic polymorphisms, endocrinological drivers and hormones), as well as epigenetic factors and environmental interactions playing a major role [4]. HS is a systemic, autoinflammatory condition [5] since several disorders, including autoimmune/autoinflammatory conditions, have been shown to be associated with HS, like inflammatory bowel disease (IBD) and spondyloarthropathies [6], non-alcoholic fatty liver disease (NAFLD) [7] or neutrophilic interstitial pneumonia [8], among others.…”

Section: Introductionmentioning

confidence: 99%

The Safety and Impact of a Model of Intermittent, Time-Restricted Circadian Fasting (“Ramadan Fasting”) on Hidradenitis Suppurativa: Insights from a Multicenter, Observational, Cross-Over, Pilot, Exploratory Study

et al. 2019

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Hidradenitis suppurativa (HS) is a chronic-relapsing and debilitating disease, which affects the components of the folliculopilosebaceous unit and severely impacts on the perceived health-related quality of life. Among the possible treatments, dietary interventions, such as fasting, have been described to positively impact on HS. However, nothing is known about the effects of circadian, intermittent fasting, such as the Ramadan fasting. A sample of 55 HS patients (24 males (43.6%) and 31 females (56.4%), mean age 39.65 ± 8.39 years, average disease duration 14.31 ± 7.03 years) was recruited in the present study. The “Severity of International Hidradenitis Suppurativa Severity Score System” (IHS4) decreased significantly from 11.00 ± 5.88 (before Ramadan) to 10.15 ± 6.45 (after Ramadan), with a mean difference of −0.85 ± 0.83 (p < 0.0001). At the univariate analyses, the improvement was associated with HS phenotype (with a prominent improvement among those with ectopic type), treatment (with the improvement being higher in patients receiving topical and systemic antibiotics compared to those treated with biologics), the “Autoinflammatory Disease Damage Index” (ADDI), and Hurley scores. At the multivariate regression analysis, only the Hurley score (regression coefficient = 0.70, p = 0.0003) was found to be an independent predictor of change in the IHS4 score after fasting. The improvement in the IHS4 score was not, however, associated with weight loss. In conclusion, the Ramadan fasting proved to be safe and effective in HS patients. Considering the small sample size and the exploratory nature of the present investigation, further studies in the field are warranted, especially longitudinal, prospective and randomized ones.

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Hidradenitis suppurativa associated with systemic lupus erythematosus

Cited by 12 publications

References 23 publications

Comorbidities of hidradenitis suppurativa: A review of the literature

Comorbidities of hidradenitis suppurativa: A review of the literature

Hidradenitis suppurativa: an update on epidemiology, phenotypes, diagnosis, pathogenesis, comorbidities and quality of life

The Safety and Impact of a Model of Intermittent, Time-Restricted Circadian Fasting (“Ramadan Fasting”) on Hidradenitis Suppurativa: Insights from a Multicenter, Observational, Cross-Over, Pilot, Exploratory Study

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