Hidradenitis Suppurativa Linked to Multiple Comorbidities Before and After Diagnosis

By David Douglas

June 02, 2020

NEW YORK (Reuters Health) - People with the chronic skin disease hidradenitis suppurativa (HS) are at increased risk for comorbidities presenting both before and after HS diagnosis, according to a Danish registry-based study of disease trajectories.

"On a scientific level, it will be of great advantage to know when comorbidities typically manifest in relation to a target disease," Rune Kjaersgaard Andersen of Zealand University Hospital, in Roskilde, told Reuters Health by email. "In our article, the target disease was HS, but the approach would be beneficial for every disease with known comorbidities."

To identify disease trajectories experienced more frequently by people with HS, Andersen and colleagues examined data on the whole Danish population of nearly 7.2 million who were alive between 1994 and 2018.

The team identified more than 14,000 patients with HS and compared the strength of associations between disease co-occurrences to sex-matched and birth-decade-matched controls. They combined disease trajectories into a disease-progression network showing the most frequent disease paths over time.

The set of most common disease trajectories, say the researchers, had a characteristic appearance in which type-1 diabetes, genitourinary, respiratory, or mental and behavioral disorders preceded the diagnosis of HS.

Following diagnosis of HS, there was a significantly increased risk of chronic obstructive pulmonary disease (relative risk, 1.57). This was also the case for pneumonia (RR, 1.18) and acute myocardial infarction (RR, 1.37).

The median time since HS diagnosis ranged from was 3.73 years for mononeuropathies in upper limbs to 8.78 years for respiratory failure.

"Because the trajectories use the first time that the diagnosis was given, diseases such as diabetes, depression, reaction to severe stress and adjustment disorders, and asthma may have preceded not only the diagnosis of HS but also the manifestation of symptoms as defined by the diagnosis of cutaneous abscesses," the researchers note.

Andersen added, "Our trajectory networks show which comorbidities physicians should particularly be aware of when they treat HS patients, and inform the physicians about when a particular comorbidity is likely to develop."

"This may help physicians restructure initial visits with patients with HS, as they know which comorbidities they need to look out for."

SOURCE: https://bit.ly/3dapy7Z JAMA Dermatology, online May 20, 2020.