Hidradenitis suppurativa in patients with inflammatory bowel disease: a national multicenter study from the GETECCU-ENEIDA Registry

Abstract

Background: Hidradenitis suppurativa (HS) is a chronic, recurrent skin disease that may be associated with inflammatory bowel disease (IBD). Objectives: This study aimed to describe the features and therapeutic requirements of IBD and HS in patients who present both entities and the risk factors for HS development in patients with IBD. Methods: Case-controlled, retrospective study of all patients diagnosed with IBD-HS in the ENEIDA registry. Cases were paired 1:2 with controls (IBD without HS). Design: This was a retrospective, case–control study. Results: A total of 819 patients were included: 273 patients with IBD-HS and 546 controls. Female sex (62% vs 44%, p = 0.0001), active smoking (45% vs 18%, p = 0.0001), Crohn’s disease (CD; 83% vs 55%, p = 0.0001), perianal disease (59% vs 33%, p = 0.0001), extraintestinal manifestations (38% vs 17%, p = 0.0001), and psychiatric disorders (18% vs 2%, p < 0.05) were more frequent among patients with IBD-HS than in controls. The average body mass index was greater in the IBD-HS group. The most frequently HS-affected locations were axillary (57%) and genital (43%) areas. Use of biologicals and CD-related perianal surgery was more common among patients with CD-HS (77% vs 66%, p = 0.003; 37% vs 13%, p < 0.001), compared to controls with only CD. Conclusion: Patients with IBD-HS exhibit a distinctive phenotype with higher therapeutic requirements for the subset of patients with CD-HS compared to those without HS. Assessment of this comorbidity should be considered in patients with suggestive skin lesions and IBD to improve the outcomes of both conditions.