Hidradenitis Suppurativa Comorbidities in a Time Perspective – Even Mild Disease Shows Increased Hazard Ratio of Pain and Depression in the Time Before Diagnosis: A Prospective Cohort Study on Danish Blood Donors | Abstract

Rune Kjærsgaard Andersen, Isabella Charlotte Loft, Kristoffer Burgdorf, Christian Erikstrup, Ole B. Pedersen, Gregor B.E. Jemec
DOI: 10.2340/00015555-3737

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Hidradenitis suppurativa is a common recurrent inflammatory skin disease. It is associated with multiple comorbidities whose temporal relationships are unknown due to long diagnostic delays. This study of otherwise healthy blood donors with self-reported symptoms of hidradenitis suppurativa investigated the temporal relationships of comorbidities. A prospective survival analysis on a nationwide cohort of blood donors, using registry data on drug prescription, was used to calculate the hazard ratio of time until first prescription of medical treatment for the following hidradenitis suppurativa-related comorbidities: heart disease, diabetes, depression, thyroid disease and pain. Hidradenitis suppurativa status was determined by a validated questionnaire, and the survival analysis was adjusted for age, sex, body mass index, smoking status and having an International Classification of Diseases Version 10 (ICD-10) diagnosis of hidradenitis suppurativa. Of the participants, 1,012 reported hidradenitis suppurativa symptoms, and these symptoms increased the hazard ratio of antidepressants (1.73, 95% confidence interval 1.17–2.56, p ≈ 0.006) and analgesics (hazard ratio 1.24, 95% confidence interval 1.11–1.39, p 

Hidradenitis suppurativa is a common recurrent inflammatory skin disease, which is underdiagnosed by physicians. Severe disease is associated with multiple comorbidities, but mild disease with fewer symptoms has been poorly investigated. This study of otherwise healthy blood donors with self-reported hidradenitis suppurativa symptoms and their registry data on drug prescription, found that people with symptoms of mild hidradenitis suppurativa had 1.73 times the risk of depression and 1.24 times the risk of needing pain medication compared with healthy controls. As people with even mild hidradenitis suppurativa are at risk of pain and depression, clinical practice should increase its focus on diagnosis of this disease.