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Hidradenitis suppurativa (HS) is a chronic, inflammatory condition predominantly affecting younger adults and disproportionately affecting women and Black Americans. Estimated prevalences vary significantly according to study methodology; however, true prevalence may range from approximately 0.1% to 1%. Hidradenitis suppurativa is associated with a number of comorbid conditions which also contribute to poor health outcomes and negative impact on quality of life. Recent advancements in our understanding of disease burden in hidradenitis suppurativa have allowed us to identify subgroups of the population afflicted with the disease and to implement strategies which facilitate comprehensive care., (Copyright © 2024 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Competing Interests: Conflicts of interest None disclosed.

Competing Interests: Conflicts of interest None disclosed.

The literature on hidradenitis suppurativa in sexual and gender minorities remains sparse. This review article aims to discuss critical factors for providers to consider in lesbian, gay, bisexual, transgender, queer, intersex, and asexual patients with hidradenitis suppurativa, including associated comorbidities, gender-affirming hormonal therapy, squamous cell carcinoma, infections in HIV-positive patients, and creating a welcoming clinic for sexual and gender minority patients., Competing Interests: Conflicts of interest Maria Aleshin - received research funding from UCB, consultant for Abbvie., (Copyright © 2022 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Competing Interests: Conflicts of interest Dr Garg is an advisor for AbbVie, Alcaris Therapeutics, Anaptys Bio, Aristea Therapeutics, Boehringer Ingelheim, Bristol Myers Squibb, Incyte, Insmed, Janssen, Novartis, Pfizer, Sonoma Biotherapeutics, UCB, Union Therapeutics, Ventyx Biosciences, and Viela Biosciences, and receives honoraria. Dr Garg receives receives research grants from AbbVie, UCB, National Psoriasis Foundation, and CHORD COUSIN Collaboration (C3). He is co-copyright holder of the HS-IGA and HiSQOL instruments. Nicole Mastacouris and Andrew Strunk have no conflicts to declare.

Background: The coexistence of psoriasis and hidradenitis suppurativa (HS) has been described, but the association between these conditions is yet to be firmly established., Objective: To study the association between psoriasis and HS by using a large-scale real-life computerized database., Methods: A cross-sectional study was conducted to compare the prevalence of HS among patients with psoriasis with that among age-, sex- and ethnicity-matched control subjects., Results: A total of 68,836 patients with psoriasis and 68,836 controls were included in the study. The prevalence of HS was increased in patients with psoriasis versus in those in the control group (0.3% vs 0.2%, respectively; odds ratio, 1.8; 95% confidence interval, 1.5-2.3; P < .001). In a multivariate analysis adjusting for smoking, obesity, and other comorbidities, psoriasis was still associated with HS (odds ratio, 1.8; 95% confidence interval, 1.4-2.2; P < .001). Patients with coexistent psoriasis and HS were significantly younger (39.0 ± 15.7 vs 42.6 ± 21.2 years [P = .015]) and had a higher prevalence of obesity (35.1% vs 25.3% [P = .001]) and smoking (58.5% vs 37.3% [P < .001]) compared with patients with psoriasis alone., Limitations: Retrospective data collection., Conclusions: A positive association was observed between HS and psoriasis. Further longitudinal observational studies are necessary to establish these findings in other study populations., (Copyright © 2018. Published by Elsevier Inc.)

Competing Interests: Conflicts of interest None disclosed.

Competing Interests: Conflicts of interest Dr Albrecht is an investigator for AbbVie and AiCuris. Drs Kaul, Eseaton, and Albrecht have no conflicts of interest to declare.

Competing Interests: Conflicts of interest None disclosed.

Competing Interests: Conflicts of interest None disclosed.

Background: Hidradenitis suppurativa (HS) is associated with comorbidities that contribute to poor health, impaired life quality, and mortality risk., Objective: To provide evidence-based screening recommendations for comorbidities linked to HS., Methods: Systematic reviews were performed to summarize evidence on the prevalence and incidence of 30 comorbidities in patients with HS relative to the general population. The screening recommendation for each comorbidity was informed by the consistency and quality of existing studies, disease prevalence, and magnitude of association, as well as benefits, harms, and feasibility of screening. The level of evidence and strength of corresponding screening recommendation were graded by using the Strength of Recommendation Taxonomy (SORT) criteria., Results: Screening is recommended for the following comorbidities: acne, dissecting cellulitis of the scalp, pilonidal disease, pyoderma gangrenosum, depression, generalized anxiety disorder, suicide, smoking, substance use disorder, polycystic ovary syndrome, obesity, dyslipidemia, diabetes mellitus, metabolic syndrome, hypertension, cardiovascular disease, inflammatory bowel disease, spondyloarthritis, and sexual dysfunction. It is also recommended to screen patients with Down syndrome for HS. The decision to screen for specific comorbidities may vary with patient risk factors. The role of the dermatologist in screening varies according to comorbidity., Limitations: Screening recommendations represent one component of a comprehensive care strategy., Conclusions: Dermatologists should support screening efforts to identify comorbid conditions in HS., Competing Interests: Conflicts of interest Dr Garg has served as a consultant for AbbVie, Amgen, Boehringer Ingelheim, Incyte, Janssen, Novartis, Pfizer, UCB, and Viela Bio; has received honoraria from AbbVie, Amgen, Boehringer Ingelheim, Incyte, Janssen, Novartis, Pfizer, UCB, and Viela Bio; and has received grants: from AbbVie and the National Psoriasis Foundation. Dr Alavi has served as a consultant for AbbVie, Boehringer Ingelheim, Incyte, Janssen, Pfizer, UCB, Actelion, Celgene, Galderma, GlaxoSmithKline, Leo Pharma, Novartis, Sanofi-Genzyme, Kymera, Eli Lily, InflaRx, Sanofi, and Bausch; has received honoraria from AbbVie, Boehringer Ingelheim, Incyte, Janssen, Pfizer, UCB, Actelion, Celgene, Galderma, GlaxoSmithKline, Leo Pharma, Novartis, Genzyme, Kymera, Eli Lily, Sanofi, and Bausch; has received grants from AbbVie; and has received donations of medical equipment from Galderma and Swift. Dr Alhusayen has served as a consultant for AbbVie, Janssen, Leo Pharma, Hidramed Solutions and has received honoraria from AbbVie, and Eli Lilly. Dr Daveluy has served as a consultant for AbbVie; has received honoraria from AbbVie; has served on the speakers bureau for AbbVie; and has received grants from AbbVie, InflaRx, Regeneron, and Pfizer. Dr Delorme has served as a consultant for AbbVie, Celgene, Eli-Lilly, Janssen, Novartis, and Sanofi-Genzyme; has received honoraria from AbbVie, Amgen, Avene, Celgene, Eli Lilly, Janssen, Novartis, and UCB Pharma; has served on the speakers bureau for AbbVie, Bausch Health, Celgene, Eli Lilly, Janssen, Novartis, and Sanofi Genzyme; and has received grants from AbbVie, InflaRx, Regeneron, and Pfizer. Dr Gulliver has served as a consultant for AbbVie, Amgen, Bausch Health, Celgene, Cipher, Eli Lilly, Janssen, LEO Pharma, Novartis, PeerVoice, Pfizer, Sanofi-Genzyme, UCB, and Valeant; has received honoraria from AbbVie, Amgen, Bausch Health, Celgene, Cipher, Eli Lilly, Janssen, LEO Pharma, Novartis, PeerVoice, Pfizer, Sanofi-Genzyme, UCB, and Valeant; and has received grants from AbbVie, Amgen, Eli Lilly, Novartis, and Pfizer. Dr Hamzavi has served as a consultant for Incyte, UCB, and Pfizer and has received grants from Lenicura and Boehringer Ingelheim. Dr Jaleel has served as a consultant for Eli Lilly and ChemoCentryx/IQVIA and has received grants from the Dermatology Foundation and Skin of Color Society. Dr Kimball has served as a consultant for AbbVie, Janssen, Lilly, Novartis, Pfizer, UCB, and Kymera; has received honoraria from AbbVie, Janssen, Lilly, Novartis, Pfizer, UCB, and Kymera; and has received royalties from Pfizer, Trifecta, and UCB. Dr Kirby has served as a consultant for AbbVie, ChemoCentryx, Incyte, Novartis, and UCB; has received honoraria from AbbVie, Incyte, and Viela Bio; and has served on the speakers bureau for AbbVie. Dr Kirchhof has served as a consultant for AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, UCB, Sanofi-Genzyme; has served on the speakers bureau for AbbVie, Janssen, Novartis, Pfizer, UCB, and Sanofi-Genzyme; and has received grants from the Canadian Dermatology Foundation. Dr Lev-Tov has served as a consultant for Pfizer, Mölnlycke, and NextScience; has received honoraria from Essity; has received grants from NextScience and Essity; and has received donations of medical equipment from Essity, Mölnlycke, and NextScience. Dr Lowes has served as a consultant for AbbVie, Janssen, Viela Bio, Almirall, BSN, Incyte, Janssen, Kymera, and XBiotech. Dr Naik has served as a consultant for Boehringer Ingelheim, Janssen, and 23andme and has received grants from AbbVie, Hidradenitis Suppurativa Foundation. Dr Orenstein has received a Hidradenitis Suppurativa Foundation Danby Research Grant. Dr Piguet has served as a consultant for Pfizer, AbbVie, Janssen, UCB, Novartis, Almirall, and Celgene; has received honoraria from Kyowa Kirin Co Ltd, AbbVie, and Novartis; has received grants from AbbVie, Bausch Health, Celgene, Janssen, LEO Pharma, Lilly, NAOS, Novartis, Pfizer, Pierre-Fabre, and Sanofi; and has received a donation of medical equipment from La Roche-Posay. Dr Sayed has served as a consultant for UCB, InflaRx, and AbbVie; has received honoraria from UCB and AbbVie; and has served on the speakers bureau for AbbVie and Novartis. Dr Tan has served as a consultant for Almirall, Bausch, Boots/Walgreens, Botanix, Cipher, Galderma, Incyte, L’Oréal, Novartis, Pfizer, Promius, Sun, and UCB; has received honoraria from Almirall, Bausch, Boots/Walgreens, Botanix, Galderma, L’Oréal, Novartis, Pfizer, Promius, and Sun; has served on the speakers bureau for Galderma and L’Oréal; and has received grants from Incyte and UCB. Drs Alikhan and Goldfarb, Author Lester, Drs Malviya and Micheletti, and Authors Strunk and Wright have no conflicts of interest to declare., (Copyright © 2021 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Background: Information on prevalence of depression among children, adolescents, and adults with hidradenitis suppurativa (HS) is limited., Objective: To compare prevalence of depression in HS patients with that of controls., Methods: Cross-sectional analysis of 38,140 adult and 1162 pediatric HS patients and controls identified using data from electronic health records. Primary outcome was prevalent depression., Results: Prevalence of depression among adults with HS was 30.0% (95% Confidence interval [CI], 29.6-30.5), compared with 16.9% (95% CI, 16.7-17.1) among controls. Among children and adolescents with HS, prevalence of depression was 11.7% (95% CI, 10.0-13.7), compared with 4.1% (95% CI, 3.6-4.7) among controls. In adjusted analyses, adults and children/adolescents with HS had 1.26 (95% CI, 1.25-1.28; P < .001) and 1.42 (95% CI, 0.999-2.01; P = .051) times the odds of having depression relative to controls, respectively., Limitations: We could not evaluate the influence of disease severity on the outcome., Conclusion: Depression is prevalent among children, adolescents, and adults with HS. Periodic screening for depression may be warranted., Competing Interests: Conflicts of interest Dr. Garg has served as an advisor for AbbVie, Amgen, Boehringer Ingelheim, Janssen, Pfizer, Incyte, InfalRx, Viela Bio, UCB, and has received honoraria. Authors Wright and Strunk have no conflicts of interest to disclose., (Copyright © 2021 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Interest in and research on hidradenitis suppurativa (HS) have increased during the past decade, resulting in expanded knowledge about associated comorbidities and treatment efficacy. Knowledge about pediatric-onset HS is still limited, based on case studies, small case series, and extrapolation from adult studies. With increasing prevalence of childhood obesity, decreasing pubertal age, and increasing awareness of HS, physicians may start encountering younger HS patients. This review presents an updated discussion on the epidemiology, pathophysiology, and associated comorbidities in HS, with a focus on pediatric and adolescent patients. It also suggests recommendations for investigation and treatment based on current evidence., (Copyright © 2020 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Background: Many women affected by hidradenitis suppurativa (HS) are of childbearing age. To date, the literature is limited on pregnancy-related outcomes for women with HS., Objective: To investigate maternal and obstetric outcomes and treatment utilization among women with HS., Methods: This retrospective analysis used the IBM MarketScan Commercial Claims Database. Pregnant women with HS (n = 998) and 5:1 age-matched pregnant women without HS (n = 5065) were identified and information on claims related to diagnoses, procedures, and medications were analyzed., Results: Compared to women without HS, pregnant women with HS had significantly lower odds of having a live birth (odds ratio [OR], 0.45; 95% confidence interval [CI], 0.39-0.51) and significantly higher odds of having elective terminations (OR, 2.51; 95% CI, 2.13-2.96), gestational hypertension (OR, 1.44; 95% CI, 1.12-1.84), and cesarean deliveries (OR, 1.28; 95% CI, 1.06-1.55), and of receiving HS designated treatment during pregnancy (OR, 4.41; 95% CI, 3.56-5.46)., Limitations: Retrospective and convenience sampling and absence of clinical information to correlate HS severity and outcomes., Conclusion: Pregnant women with HS have an increased probability of select complicated maternal and obstetric outcomes. Women planning for pregnancy or who are currently pregnant may benefit from coordinated care by dermatologists and obstetric providers., Competing Interests: Conflicts of interest Dr Kirby is a consultant and speaker for AbbVie, receives honoraria for participating on an Advisory Board for AbbVie, and receives honoraria as a consultant for ChemoCentryx, Incyte, Janssen, Novartis, and UCB Pharma. Authors Sakya and Maczuga and Dr Hallan certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria, educational grants, participation in speakers' bureaus, membership, employment, consultancies, stock ownership, other equity interest, or expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript., (Copyright © 2021 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Background: Hidradenitis suppurativa (HS) disproportionately affects women of childbearing age. However, pregnancy and maternal outcomes for women with HS are unknown., Objective: To compare risk of adverse pregnancy and maternal outcomes among women with and without HS and to evaluate the influence of comorbid conditions., Methods: Retrospective cohort analysis between January 1, 2011, and September 30, 2015., Results: Compared to control pregnancies (n = 64,218), HS pregnancies (n = 1862) had a higher risk of spontaneous abortion (15.5% vs 11.3%), preterm birth (9.1% vs 6.7%), gestational diabetes mellitus (11.6% vs 8.4%), gestational hypertension (6.1% vs 4.4%), preeclampsia (6.6% vs 3.8%), and cesarean section (32.4% vs 27.1%). Relative risk of some pregnancy and maternal outcomes were attenuated after comorbidity adjustment. In the fully adjusted model, HS pregnancies were independently associated with spontaneous abortion (odds ratio, 1.20; 95% CI, 1.04-1.38), gestational diabetes mellitus (odds ratio, 1.26; 95% CI, 1.07-1.48), and cesarean section (odds ratio, 1.09; 95% CI, 1.004-1.17)., Limitations: We could not evaluate potential influences of disease duration, activity, or severity. Newborn outcomes could not be evaluated., Conclusion: HS appears to be an independent risk factor for adverse pregnancy and maternal outcomes. This risk is influenced by comorbidities that may be modifiable with early identification and management., Competing Interests: Conflicts of interest Dr Hsiao has served as an advisor for Novartis. Dr Garg is an advisor for AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, InflaRx, Incyte, Janssen, Novartis, Pfizer, UCB, and Viela Biosciences, and receives research grants from AbbVie and National Psoriasis Foundation. Dr Fitzpatrick and Authors Tannenbaum and Strunk have no conflicts of interest to declare., (Copyright © 2021 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Background: The coexistence of hidradenitis suppurativa (HS) and atopic dermatitis (AD) had been reported but, to our knowledge, was not investigated in controlled studies., Objective: To evaluate the bidirectional association between HS and AD., Methods: A population-based retrospective cohort study was conducted to compare the incidence rate of AD among patients with HS (n = 6779) and age-, sex-, and ethnicity-matched control individuals (n = 33,260). Adjusted hazard ratios (HRs) and adjusted odds ratios were estimated., Results: The incidence of AD was 2.51 (95% confidence interval [CI], 2.07-3.02) and 1.24 (95% CI, 1.10-1.40) per 1000 person-years among patients with HS and control individuals, respectively. Patients with HS were twice as likely to develop AD as control individuals (HR, 2.06; 95% CI, 1.64-2.58). Furthermore, the prevalence of pre-existing AD was higher in patients with HS than in control individuals (2.5% vs 1.8%, respectively; P < .001). A history of AD was associated with a 40% increase in the odds of HS (odds ratio, 1.41; 95% CI, 1.19-1.67). Relative to patients with isolated HS, those with a dual diagnosis of HS and AD were younger and had a female predominance, lower prevalence of smoking, and lower body mass index., Limitations: Retrospective data collection., Conclusions: A bidirectional association between HS and AD was observed. Dermatologists should be aware of this association., Competing Interests: Conflicts of interest Dr Tzur Bitan has received a research grant from Pfizer. Dr Cohen has received research grants from Janssen, Novartis, AbbVie, and Sanofi and has served as a consultant, advisor, or speaker for AbbVie, Amgen, Boehringer Ingelheim, Dexcel Pharma, Janssen, Kamedis, Lilly, Neopharm, Novartis, Perrigo, Pfizer, Rafa, Samsung Bioepis, Sanofi, Sirbal, and Taro. Drs Sherman, Kridin, Leshem, and Hodak have no conflicts of interest to declare., (Copyright © 2020 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Hidradenitis suppurativa (HS) is an inflammatory disorder that is characterized by chronic deep-seated nodules, abscesses, fistulae, sinus tracts, and scars in the axilla, inguinal area, submammary folds, and perianal area. This disfiguring condition is accompanied by pain, embarrassment, and a significantly decreased quality of life. Although the mechanism of HS has not been entirely elucidated, lesion formation is believed to center around follicular hyperkeratosis within the pilosebaceous-apocrine unit. Recent research has provided new insight into the role of cytokines in the pathogenesis of HS, helping close some existing knowledge gaps in the development of this condition. The first article in this continuing medical education series reviews HS epidemiology, clinical presentation, and classification. We also provide an update on the most recent understanding of HS pathogenesis, including the central role of inflammatory cytokines and other contributing factors, such as genetics, hormones, and pathogenic microorganisms., (Copyright © 2019 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Background: Hidradenitis suppurativa (HS) and pyoderma gangrenosum (PG) are reported to coexist, although the prevalence of PG among patients with HS has not been systematically evaluated., Objective: To evaluate PG prevalence among patients with HS., Methods: Cross-sectional analysis of adults with PG among patients with HS and patients without HS through use of electronic health records data from a population-based sample of 55 million patients., Results: The prevalence of PG among 68,232 patients with HS was 0.18% (125 of 68,232), compared with 0.01% (1835 of 31,435,166) among those without HS (P < .0001). Prevalence was markedly higher among patients with HS and Crohn's disease (CD) (3.68%) than among patients with HS but without CD (0.12%). The odds of having PG were 21.14 (95% confidence interval [CI], 17.51-25.51) times greater among patients with HS than among those without HS. Patients with HS with CD had 12.38 (95% CI, 9.15-16.74) times the odds of having PG than did patients without HS but with CD. Among patients without CD, compared with patients without HS, those with HS had 26.51 (95% CI, 21.07-33.36) times the odds of having PG., Limitations: We could not establish HS phenotype among those having coexistent PG, nor could we distinguish syndromic from nonsyndromic cases., Conclusion: Patients with HS have an increased prevalence of PG, regardless of CD status. Painful ulcerations among patients with HS warrant additional evaluation for PG., (Copyright © 2019 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Background: Evidence establishing a link between acne vulgaris (AV) and hidradenitis suppurativa (HS) is limited, and the burden of AV in adults with HS is unknown., Objective: To determine the prevalence of AV among adults with HS and determine the strength of this association., Methods: Cross-sectional analysis identifying adults with AV among patients with and without HS by using electronic health record data from a population-based sample of more than 55 million patients., Results: The prevalence of AV among adults with HS was 15.2% (7315 of 48,085) compared with 2.9% (497,360 of 16,899,470) for adults without HS (P < .001). The prevalence was greatest among patients with HS who were female (5870 of 35,790 [16.4%]), were 18 to 44 years old (5260 of 28,870 [18.2%]), were nonwhite (3120 of 17,825 [17.5%]), were obese (5430 of 35,135 [15.5%]), and had polycystic ovarian syndrome (685 of 2385 [28.7%]). Patients with HS had 4.51 [95% confidence interval, 4.40-4.63] times the odds of having AV than did patients without HS, with the higher likelihood of having AV persisting across all subgroups of patients with HS. The association between HS and AV was generally stronger for patients who were male, and 65 years of age or older., Limitations: Influence of disease severity in HS, or in acne, on the strength of the association could not be assessed., Conclusion: Patients with HS may benefit from assessment of acne status and optimization of comanagement strategies., (Copyright © 2018 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Background: Patients with hidradenitis suppurativa (HS) experience chronic pain and have significant physical, emotional, and psychological disease impact. These patients may be at risk for substance abuse., Objective: To evaluate substance use disorder (SUD) among patients with HS in the United States., Methods: This cross-sectional analysis of adult HS patients (n = 32,625) identified using electronic health records data was pulled from a population-based sample of >50 million patients., Results: The prevalence of SUD among patients with HS was 4.0% (1315/32,625) compared to 2.0% (195,260/9,581,640) for patients without HS (P < .001). The most common forms of substance misuse among HS patients were alcohol (630/1315, 47.9% of SUD cases), followed by opioids (430/1315, 32.7% of SUD cases) and cannabis (430/1315, 29.7% of SUD cases). Patients with HS had 1.50 (95% confidence interval 1.42-1.59) times the adjusted odds of SUD compared to patients without HS. Patients with HS had significantly greater odds of SUD across demographic subgroups. The association between HS and SUD was generally stronger for patients 45 to 64 years of age, nonwhites, privately insured, and those without depressive or anxiety disorder., Limitations: SUD may not be accurately diagnosed., Conclusion: Patients with HS have higher odds of SUD and may benefit from periodic screening for substance abuse., (Copyright © 2018 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Background: Hidradenitis suppurativa (HS) is associated with various somatic and psychiatric comorbidities. Data regarding comorbidities in young patients with HS are sparse., Objective: We analyzed both somatic and psychiatric comorbidities in young patients in a nationwide HS cohort., Methods: In this retrospective case-control study, data from cases of HS in young (age 5 to <18 years) patients and age-matched controls with benign melanocytic nevi were collected from the Finnish Care Register for Health Care. The prevalence of preselected comorbidities was compared between the HS and control groups., Results: A total of 153 HS cases were found in the specified age group. Of these, 34.0% had at least 1 somatic comorbidity compared with 4.9% of the controls. At least 1 of the preselected psychiatric diagnoses was present before the age of 18 years in 15.7% of case patients with HS compared with in 5.6% of the controls. By the age of 23 years, 23.5% of the patients with HS and 8.7% of the controls had at least 1 identified psychiatric comorbidity., Limitations: Despite this being one of the largest HS cohorts ever studied, the number of young patients with HS was relatively low. Because this was a registry-based study, it was not possible to verify the accuracy of the International Classification of Diseases codes., Conclusion: Physicians should monitor young patients with HS for both somatic and psychiatric comorbidities., (Copyright © 2018 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Background: Few studies have evaluated the relationship between hidradenitis suppurativa (HS) and type 2 diabetes mellitus (T2DM), and the existing data show conflicting results., Objective: To determine the prevalence of T2DM among patients with HS and identify at-risk demographic subgroups., Methods: Cross-sectional analysis identifying T2DM among patients with and without HS from a demographically heterogeneous population-based sample of more than 50 million patients in the United States., Results: The overall prevalence of T2DM among patients with HS was 24.8% (10,705 of 43,105) compared with 15.6% (1,993,320 of 12,527,570) among patients without HS. The prevalence was highest among patients with HS who were male (3045 of 10,785 [28.2%]), older (1945 of 3950 [49.2%]), nonwhite (4665 of 17,495 [26.7%]), obese (9065 of 30,855 [29.4%]), tobacco smokers (6880 of 25,005 [27.5%]), hypertensive (8595 of 19,610 [43.8%]), and hyperlipidemic (7965 of 17,190 [46.3%]). In univariable and multivariable analyses, patients with HS had 1.75 (95% confidence interval [CI], 1.71-1.79) and 1.58 (95% CI, 1.54-1.62) times the odds, respectively, of having T2DM. HS was associated with T2DM across all demographic subgroups. The association was stronger for younger patients (an OR of 1.67 and 95% CI of 1.60-1.72 for ages 18-44 years vs an OR of 1.50 and 95% CI of 1.41-1.61 for ages ≥65 years)., Limitations: We lacked information on HS disease severity., Conclusion: Patients with HS with risk factors, signs, or symptoms of T2DM should be screened., (Copyright © 2018 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Background: The relationship between hidradenitis suppurativa and diabetes mellitus is not well understood., Objective: To compare the prevalence of diabetes mellitus between patients with and without hidradenitis suppurativa., Methods: We conducted a systematic review and meta-analysis, which included primary observational studies that reported the prevalence of diabetes mellitus among patients with hidradenitis suppurativa in the PubMed, Embase, Cochrane Library, LILACS, and Scielo databases from 1947 to June 13, 2017. A random effects model for pooled odds ratio was used for data analysis. Publication bias was assessed by funnel plot and the Egger test., Results: The systematic review included 107,050 patients from 14 studies; the meta-analysis included 104,373 patients from 7 studies. On the basis of meta-analysis, the prevalence of diabetes mellitus was 10.6% in patients with hidradenitis suppurativa and 3.8% in patients without hidradenitis suppurativa. Compared with the general population, patients with hidradenitis suppurativa were nearly 3 times more likely to have diabetes mellitus (pooled odds ratio, 2.78; 95% confidence interval, 1.79-4.31)., Limitations: We were restricted by the quantity and quality of available data., Conclusion: Hidradenitis suppurativa is significantly associated with an increased prevalence of diabetes mellitus., (Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Background: The true incidence of hidradenitis suppurativa (HS) is unknown., Objective: To determine standardized incidence estimates for HS in the United States., Methods: We used a retrospective cohort analysis, including incident HS cases identified using electronic health records data for a demographically heterogeneous population-based sample of >48 million unique patients across all 4 census regions. We calculated standardized 1- and 10-year cumulative incidences for the overall population and for sex-, age-, and race-specific groups., Results: There were 5410 new HS diagnoses over a 1-year period, with an incidence of 11.4 (95% confidence interval [CI], 11.1-11.8) cases per 100,000 population. One-year incidence in women was 16.1 (95% CI, 15.5-16.6) per 100,000, more than twice that of men [6.8 (95% CI, 6.5-7.2) per 100,000; P < .0001]. Age group-specific incidence was highest among patients 18 to 29 years of age [22.0 (95% CI, 21.0-23.2) per 100,000]. Incidence among African Americans [30.6 (95% CI, 29.1-32.2) per 100,000] was >2.5 times that of whites [11.7 (95% CI, 11.3-12.2) per 100,000; P < .0001]. The average annual overall incidence over 10 years was 8.6 (95% CI, 8.6-8.7) per 100,000 population., Limitations: The use of deidentified claims prevented validation for a larger case subset., Conclusion: HS incidence has increased over the past decade and disproportionately involves women, young adults, and African Americans., (Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Background: Hidradenitis suppurativa (HS) is often associated with inflammatory bowel disease (IBD; Crohn's disease or ulcerative colitis). However, the prevalence of IBD in HS patients is unknown., Objective: To determine the prevalence of IBD in HS patients, and determine if patients with HS and IBD have a distinct HS phenotype., Methods: For this multicenter, cross-sectional study, HS patients were asked during their first consultation if they had IBD. The diagnosis of IBD was checked in the medical files, and clinical characteristics were collected., Results: IBD had a prevalence of 3.3% (95% CI 2.3-4.4) in 1076 HS patients. The prevalence of Crohn's disease was 2.5% (95% CI 1.6-3.4) and the prevalence of ulcerative colitis was 0.8% (95% CI 0.3-1.4). HS-IBD patients were less frequently obese (13.9% vs 31.2%, P = .04) than HS-only patients, but there were no differences in gender, family history of HS, disease severity, body areas affected by HS, or smoking status., Limitations: The prevalence might be underestimated since HS patients might still develop IBD., Conclusion: The prevalence of IBD in HS patients (3.3%) is 4-8 times higher than the prevalence in the general northern European population (0.41%-0.74%), however HS-IBD patients do not have a distinct HS phenotype., (Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Background: Hidradenitis suppurativa (HS) is a chronic debilitating disease, whereby school attendance and employment can be disturbed., Objective: We sought to determine the socioeconomic status (SES) in patients with HS relative to other dermatologic patients, and whether specific clinical HS characteristics correlate with SES., Methods: For this multicenter cross-sectional reference study, data were collected from patients with HS and sex- and age-matched dermatologic patients in a 1:2 ratio. SES was derived from the mean household income and real estate value on a neighborhood level., Results: The SES distribution among 1018 patients with HS was significantly lower than among 2039 age- and sex-matched dermatologic control patients (P < .001). In patients with HS a low SES was associated with axillary involvement (odds ratio 1.42, P = .04), high body mass index (odds ratio 1.03, P = .003), and lower age at inclusion (odds ratio 0.98, P = .001), but not with disease severity or age of disease onset., Limitations: SES was based on postal code level and causality cannot be determined., Conclusion: In the general population, low SES is associated with an unhealthy lifestyle such as smoking and obesity. Therefore, low SES might be a risk factor for developing HS., (Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Background: Fistulous tracts in hidradenitis suppurativa (HS) are key signs of severity and their clinical evaluation alone may be limited for assessing their presence and morphology. There is also a need to determine the factors that allow reversibility of the anatomic changes in HS., Objective: We sought to categorize fistulous tracts in HS., Methods: A retrospective study of color Doppler ultrasound images of cases with positive clinical and sonographic criteria of HS with fistulous tracts was performed. The sonographic staging of HS, location, and anatomic characteristics of the tracts were registered and graded. Statistical analysis for correlating variables was performed using bivariate and multivariate studies., Results: In all, 52 patients presenting 96 fistulous tracts met the criteria. Morphology was defined and a sonographic classification into 3 types of fistulae was developed. Type 3 concentrated 71% of the cases presenting communicating tracts, and type 2, 29%. Types 2 and 3 represented 63% of patients with multiple fistulous tracts. Fistulous tracts types 2 and 3 were significantly correlated with age 35 years or older and groin location., Limitations: Ultrasound cannot detect lesions less than 0.1 mm., Conclusion: Fistulous tracts in HS can be categorized using ultrasound, which may support earlier and more precise management., (Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Background: Chronic inflammatory diseases have been associated with increased prevalence of subclinical atherosclerosis. Hidradenitis suppurativa (HS) is a chronic inflammatory disease involving intertriginous skin., Objective: We sought to investigate the potential association between HS and subclinical atherosclerosis., Methods: This study included 68 patients with HS and 136 age- and sex-matched healthy control subjects. Patients with history of cardiovascular events, diabetes mellitus, chronic kidney disease, or another concomitant inflammatory condition were excluded. Carotid intima-media thickness and carotid plaques were measured by carotid ultrasonography. Adjustments were made for age, sex, and traditional cardiovascular risk factors., Results: Patients had greater carotid intima-media thickness values than control subjects (0.615 ± 0.097 vs 0.578 ± 0.098 mm; P = .012). Carotid plaques were also more frequent in patients than in control subjects (30.9% vs 22.1%). In the multivariable regression model adjusted for age, sex, and traditional cardiovascular risk factors, HS was significantly related to the presence of carotid plaques (odds ratio 2.99, 95% confidence interval 1.26-7.13; P = .013)., Limitations: Causality could not be assessed., Conclusions: These results indicate an increased frequency of subclinical atherosclerosis in patients with HS. Accordingly, HS should be considered a disease associated with potentially increased cardiovascular risk., (Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Hidradenitis suppurativa (HS) is a chronic inflammatory disease involving painful, deep abscesses and chronic, draining sinus tracts. Because of the variable signs and symptoms displayed by patients, it remains widely unrecognized and difficult to treat, resulting in significant diagnostic delay and inconsistent treatment process. No medical specialty has successfully designated a criterion standard of treatment, resulting in variable care and unmet patient needs. Widespread causes and effects of HS are difficult to determine because the prevalence is dependent on a variety of things, including how and where data are collected, resulting in significant bias. Therefore, the task must be to assess existing studies to produce a best estimate of prevalence. In addition, the 3 types of studies available for HS (ie, self-report, registry-based, and group examination studies) must be evaluated because each offers important insights into who is impacted by this disease. The exact prevalence of HS remains unknown because of the difficulty in collecting and extrapolating data and the usefulness of studies; however, high comorbidity and disease severity is observed, resulting in increased hospital visits for patients with HS--nearly double that of other diseases. Finally, comparisons between HS and psoriasis are worth mentioning because the similarities are clear, but the severity of HS appears to be more debilitating in many aspects of life. This article will address the epidemiology of HS through current available research., (Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)