Risk of Atopic Diseases in Patients with Hidradenitis Suppurativa: A Systematic Review and Meta-Analysis of Observational Studies

Abstract

Background Hidradenitis suppurativa (HS) and allergic diseases were considered to have different immune pathways involved. However, available evidences seemed to be inconsistent and the association was not well-developed yet. Objective To perform a systematic review and meta-analysis to evaluate the association between HS and atopic diseases, including asthma, atopic dermatitis, allergic rhinitis and conjunctivitis. Methods Search in databases including PubMed, Embase and Web of Science were performed. Synonyms were determined based on MeSH terms and Emtree. Observational studies with proper comparative arm were selected. For quality evaluation of extracted studies, the Newcastle-Ottawa Scale was utilized. Odds ratio of atopic dermatitis, asthma, allergic rhinitis and conjunctivitis were evaluated in HS patients (comparing with non-HS people). I2 value was applied to evaluate the heterogeneity within studies. Results After appraising 1,654 studies, in total, 12 studies were selected for data extraction. In adjusted models, people with HS is significantly associated with higher risk of having asthma, with a pooled odds ratio of 1.50 (95% CI, 1.24-1.81). Risk of presenting atopic dermatitis in HS patients was also increased, with an odd ratio of 4.10 (95% CI, 2.16-8.18). The association remained its significance in sensitivity models. Evidences were insufficient to support the association between HS and allergic rhinitis and conjunctivitis. Conclusion Current evidence supported that atopic dermatitis and asthma were associated with HS. Physicians should be aware of the reported association while caring people with HS and related screening of allergies comorbidities should be recommended.

Risk of osteoarthritis in patients with hidradenitis suppurativa: a global federated health network analysis

“…Although the pathogenesis of HS has not been fully understood, it was pointed out that sustained inflammatory reaction within dermatological diseases had the potential to trigger systemic immunological involvement, consequently fostering the emergence of comorbidities in various organ systems ( 22 – 24 ). Given these conditions, the issue of HS comorbidities had long been discussed and was acknowledged as intricate, encompassing several different functional problems including allergic status ( 25 ), gastrointestinal dysfunctions ( 26 , 27 ), and renal diseases ( 28 ). Among the comorbidities of HS, integrated pieces of evidence had suggested that spondyloarthritis and rheumatoid arthritis were of high prevalence and incidence in the HS population ( 6 , 29 ).…”

“…Pathogenesis of HS involved the elevation of proinflammatory cytokines that could trigger subsequent immunological cascades (21). Although the pathogenesis of HS has not been fully understood, it was pointed out that sustained inflammatory reaction within dermatological diseases had the potential to trigger systemic immunological involvement, consequently fostering the emergence of comorbidities in various organ systems (22)(23)(24). Given these conditions, the issue of HS comorbidities had long been discussed and was acknowledged as intricate, encompassing several different functional problems including allergic status (25), gastrointestinal dysfunctions (26,27), and renal diseases (28).…”

Hidradenitis suppurativa as a potential risk factor of periodontitis: a multi-center, propensity-score-matched cohort study

“…International Publisher predominant gender difference [1]. In HS patients, involvement of comorbidities in various organ system were commonly observed [2][3][4][5]. This may be attributed to the systemic inflammatory nature of HS pathogenesis.…”

“…According to current evidences, the prevalence ranges from 0.00033% to 4.10% in different studies and populations, with a female-predominant gender difference 1 . In HS patients, involvement of comorbidities in various organ system were commonly observed 2 - 5 . This may be attributed to the systemic inflammatory nature of HS pathogenesis.…”

Association between hidradenitis suppurativa and atopic diseases: a multi-center, propensity-score-matched cohort study

“…These conditions manifest themselves through a dominant immune response of type 2 T (Th2), orchestrated by cytokines such as IL-4 and IL-13 5 . Although HS has historically been associated with distinct inflammatory pathways characterized by cytokines like IL-1β, TNFα, IFN-γ, and IL-17/22, a recent meta-analysis provided evidence regarding the association between HS and atopic dermatitis and asthma, challenging the conventional separation of these conditions 1 , 6 .…”