1
|
Elzawawi KE, Elmakaty I, Habibullah M, Ahmed MB, Al Lahham S, Al Harami S, Albasti H, Alsherawi A. Hidradenitis suppurativa and its association with obesity, smoking, and diabetes mellitus: A systematic review and meta-analysis. Int Wound J 2024; 21:e70035. [PMID: 39267324 PMCID: PMC11393007 DOI: 10.1111/iwj.70035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 08/09/2024] [Accepted: 08/11/2024] [Indexed: 09/17/2024] Open
Abstract
Our meta-analysis aimed to quantify the association between Hidradenitis suppurativa (HS) and several risk factors including obesity, smoking, and type 2 diabetes mellitus (T2DM). We searched PubMed, Scopus, Embase, Web of Science, and cumulative index to nursing and allied health literature for articles reporting either the odds ratio (OR) or the numbers of HS cases associated with obesity, smoking, or T2DM, and including HS negative controls. Risk of bias was assessed against the risk of bias in non-randomized studies of interventions tool. Data synthesis was done using the random effects model with heterogeneity being evaluated with I2 statistic. Twenty-three studies with a total of 29 562 087 patients (average age of 36.6 years) were included. Ten studies relied on country-level data, while six studies collected their data from HS clinics. The analysis showed a significant association between HS and female sex (OR 2.34, 95% CI 1.89-2.90, I2 = 98.6%), DM (OR 2.78, 95% CI 2.23-3.47, I2 = 98.9%), obesity (OR 2.48, 95% CI 1.64-3.74, I2 = 99.9%), and smoking (OR 3.10 95% CI 2.60-3.69, I2 = 97.1%). Our meta-analysis highlights HS links to sex, DM, obesity, and smoking, with emphasis on holistic management approach. Further research is needed on molecular mechanisms and additional risk factors for improved patient care.
Collapse
Affiliation(s)
- Khaled E Elzawawi
- College of Medicine, QU Health, Qatar University, Doha, Qatar
- Department of Medical Education, Hamad Medical Corporation (HMC), Doha, Qatar
| | - Ibrahim Elmakaty
- Department of Medical Education, Hamad Medical Corporation (HMC), Doha, Qatar
| | - Mohammad Habibullah
- College of Medicine, QU Health, Qatar University, Doha, Qatar
- Department of Medical Education, Hamad Medical Corporation (HMC), Doha, Qatar
| | - Mohamed Badie Ahmed
- College of Medicine, QU Health, Qatar University, Doha, Qatar
- Department of Medical Education, Hamad Medical Corporation (HMC), Doha, Qatar
- Plastic Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Salim Al Lahham
- Plastic Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Sara Al Harami
- Plastic Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Habib Albasti
- Plastic Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Abeer Alsherawi
- Plastic Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| |
Collapse
|
2
|
Zhou P, Jiang X, Wang D. Hidradenitis suppurativa and cardiovascular diseases: A bidirectional Mendelian randomization study. Skin Res Technol 2024; 30:e13853. [PMID: 39021270 PMCID: PMC11255035 DOI: 10.1111/srt.13853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Accepted: 06/24/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND Prior investigation has indicated a link between Hidradenitis suppurativa (HS) and cardiovascular diseases (CVDs), yet the causal relationship (CR) between these conditions remains unresolved. METHODS This investigation utilized bidirectional Mendelian randomization (MR) analysis to determine the CR between HS and CVDs. Genetic instruments for both conditions were sourced from genome-wide association studies (GWAS). The GWAS summary data for CVD comprised coronary artery disease (CAD), myocardial infarction (MI), coronary atherosclerosis (CA), ischemic stroke (IS), and chronic heart failure (CHF). Four new approaches were added to the inverse variance weighted (IVW) method for the main analysis: weighted median, weighted MR-Egger, simple mode, and weighted mode. The validity of the causal conclusions was verified by sensitivity tests that included leave-one-out analysis, heterogeneity, and pleiotropy. RESULTS HS and CAD (OR = 1.024; 95%CI: 1.002-1.046, P = 0.033), MI (OR = 1.001; 95%CI: 1.000-1.002, P = 0.033), and CA (OR = 1.001; 95%CI: 1.000-1.002, P = 0.022) were identified to have a positive CR, according to the IVW analysis. Conversely, no significant association was identified between HS and either IS or CHF. Furthermore, the bidirectional analysis indicated no reverse causation between these diseases. CONCLUSION The findings of this study suggest a potential CR between HS and CAD, MI, and CA. Additional research is warranted to elucidate the biological mechanisms underlying these associations.
Collapse
Affiliation(s)
- Ping Zhou
- Clinical Medical CollegeJiangxi University of Chinese MedicineNanchangChina
| | - Xin Jiang
- Clinical Medical CollegeJiangxi University of Chinese MedicineNanchangChina
| | - Dan Wang
- Department of DermatologyAffiliated Hospital of Jiangxi University of Chinese MedicineNanchangChina
| |
Collapse
|
3
|
González-López MA. [Hidradenitis suppurativa]. Med Clin (Barc) 2024; 162:182-189. [PMID: 37968174 DOI: 10.1016/j.medcli.2023.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 09/21/2023] [Accepted: 09/27/2023] [Indexed: 11/17/2023]
Abstract
Hidradenitis suppurativa (HS) is a chronic and debilitating inflammatory disease derived from the pilosebaceous unit, that affects approximately 1% of the general population. Clinically, it is characterized by inflammatory nodules, abscesses, and tunnels in the intertriginous areas of the body, especially in the axillary, inguinal, and anogenital regions. The etiopathogenesis of HS is not completely understood, although it is considered to be multifactorial, and the result of a complex interaction between genetic, hormonal, environmental, and immunological factors. In this sense, several proinflammatory cytokines, such as tumor necrosis factor-alpha (TNF-α), interleukin (IL)-L-1β, and IL-17, among others, appear to play a crucial role in the pathogenesis of the disease. Currently, HS is recognized as a systemic disease associated with numerous comorbidities, including cardiovascular, immune-mediated, and endocrine-metabolic diseases. The treatment of HS must be carried out with an individualized and patient-oriented approach, considering medical and surgical treatment modalities.
Collapse
Affiliation(s)
- Marcos A González-López
- Servicio de Dermatología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España; Departamento de Medicina y Psiquiatría, Universidad de Cantabria, Santander, Cantabria, España; Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Cantabria, España; Real Academia de Medicina de Cantabria, Santander, Cantabria, España.
| |
Collapse
|
4
|
Krueger JG, Frew J, Jemec GBE, Kimball AB, Kirby B, Bechara FG, Navrazhina K, Prens E, Reich K, Cullen E, Wolk K. Hidradenitis suppurativa: new insights into disease mechanisms and an evolving treatment landscape. Br J Dermatol 2024; 190:149-162. [PMID: 37715694 DOI: 10.1093/bjd/ljad345] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 09/08/2023] [Accepted: 09/11/2023] [Indexed: 09/18/2023]
Abstract
Hidradenitis suppurativa (HS), also known as acne inversa, is a chronic disabling and debilitating inflammatory disease with a high unmet medical need. The prevalence of HS reported in most studies is 1-2%, although it is likely to be under-reported and estimates vary globally owing to variance in data collection methods, ethnicity, geographical location and under-diagnosis. HS is characterized by persistent, painful cutaneous nodules, abscesses and draining tunnels commonly affecting the axillary, anogenital, inguinal and perianal/gluteal areas. Over time, chronic uncontrolled inflammation results in irreversible tissue destruction and scarring. Although the pathophysiology of HS has not been fully elucidated, the tumour necrosis factor (TNF)-α and interleukin (IL)-17 pathways have an important role, involving multiple cytokines. Currently, treatment options include topical medications; systemic therapies, including repeated and/or rotational courses of systemic antibiotics, retinoids and hormonal therapies; and various surgical procedures. The anti-TNF-α antibody adalimumab is currently the only biologic approved by both the US Food and Drug Administration and the European Medicines Agency for HS; however, its efficacy varies, with a clinical response reported in approximately 50% of patients in phase III trials. HS is a rapidly evolving field of discovery, with a diverse range of agents with distinct mechanisms of action currently being explored in clinical trials. Several other promising therapeutic targets have recently emerged, and agents targeting the IL-17 and Janus kinase (JAK)/signal transducer and activator of transcription (STAT) pathways are the most advanced in ongoing or completed phase III clinical trials. Alongside limited therapeutic options, significant challenges remain in terms of diagnosis and disease management, with a need for better treatment outcomes. Other unmet needs include significant diagnostic delays, thus missing the therapeutic 'window of opportunity'; the lack of standardized outcome measures in clinical trials; and the lack of established, well-defined disease phenotypes and biomarkers.
Collapse
Affiliation(s)
- James G Krueger
- Laboratory of Investigative Dermatology, The Rockefeller University, New York, NY, USA
| | - John Frew
- Laboratory of Translational Cutaneous Medicine, Ingham Institute for Applied Medical Research, Sydney, Australia
- Department of Dermatology, Liverpool Hospital, Sydney, Australia
- University of New South Wales, Sydney, Australia
| | - Gregor B E Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
- Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark
| | - Alexa B Kimball
- Department of Dermatology, Harvard Medical School, Boston, MA, USA
- Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Brian Kirby
- Charles Department of Dermatology, St Vincent's University Hospital, Dublin, Ireland
- Charles Institute of Dermatology, University College Dublin, Dublin, Ireland
| | - Falk G Bechara
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Bochum, Germany
| | - Kristina Navrazhina
- Laboratory of Investigative Dermatology, The Rockefeller University, New York, NY, USA
- Weill Cornell/Rockefeller/Sloan Kettering Tri-Institutional MD-PhD Program, New York, NY, USA
| | - Errol Prens
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, TheNetherlands
| | - Kristian Reich
- Translational Research in Inflammatory Skin Diseases, Institute for Health Care Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Germany
- MoonLake Immunotherapeutics AG, Zug, Switzerland
| | - Eva Cullen
- MoonLake Immunotherapeutics AG, Zug, Switzerland
| | - Kerstin Wolk
- Psoriasis Research and Treatment Centre, Department of Dermatology, Venereology and Allergology and Institute of Medical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| |
Collapse
|
5
|
Mintoff D, Agius R, Fava S, Pace NP. Investigating Adiposity-Related Metabolic Health Phenotypes in Patients with Hidradenitis Suppurativa: A Cross-Sectional Study. J Clin Med 2023; 12:4847. [PMID: 37510962 PMCID: PMC10381271 DOI: 10.3390/jcm12144847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 07/20/2023] [Accepted: 07/22/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Obesity and hidradenitis suppurativa (HS) are related through meta-inflammation and are both associated with increased cardiometabolic risk. Notwithstanding, cardiometabolic pathology is not uniform in obesity and a subset of individuals with excess adiposity exhibit a healthy metabolic profile. Whilst the incidence of cardiometabolic endpoints and transitions across different adiposity-related body composition phenotypes within several populations and across different ethnicities have been investigated, data regarding metabolic health (MetH) and body composition phenotypes in individuals with HS are lacking. The objective of this study was to evaluate the relationship between different body composition phenotypes in individuals with HS. METHODS This was a cross-sectional study of 632 individuals with and without HS from a population with a high prevalence of both obesity and HS. A total of four body composition phenotypes were generated based on BMI and metabolic status (defined using either the metabolic syndrome definition or the homeostasis model of insulin resistance (HOMA-IR)): metabolically healthy overweight/obese (MHOWOB), metabolically unhealthy overweight/obese (MUOWOB), metabolically healthy normal weight (MHNW), and metabolically unhealthy normal weight (MUNW). RESULTS Generally, subjects with HS exhibited a worse metabolic profile with higher levels of indices of central adiposity measures (including Visceral Adiposity Index and waist circumference), systolic blood pressure and markers of insulin resistance, as well as a higher prevalence of the metabolic syndrome. Moreover, when sub-stratified into the different body composition phenotypes, individuals with HS typically also demonstrated adverse metabolic characteristics relative to controls matched for both adiposity and metabolic health, particularly in the normal weight category and despite being classified as metabolically healthy. Being metabolically unhealthy in addition to being overweight/obese increases an individual's risk of HS. CONCLUSIONS Metabolic risk-assessment should be prioritized in the clinical management of individuals with HS even in those who are lean. Patients attending HS clinics provide a valuable opportunity for targeted cardiovascular risk reduction with respect to the management of both obesity and metabolic health.
Collapse
Affiliation(s)
- Dillon Mintoff
- Department of Pathology, Faculty of Medicine and Surgery, University of Malta, MSD2080 Msida, Malta
- Department of Dermatology, Mater Dei Hospital, MSD2090 Msida, Malta
| | - Rachel Agius
- Department of Medicine, Faculty of Medicine and Surgery, University of Malta, MSD2080 Msida, Malta
- Department of Medicine, Mater Dei Hospital, MSD2090 Msida, Malta
| | - Stephen Fava
- Department of Medicine, Faculty of Medicine and Surgery, University of Malta, MSD2080 Msida, Malta
- Department of Medicine, Mater Dei Hospital, MSD2090 Msida, Malta
| | - Nikolai P Pace
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, MSD2080 Msida, Malta
- Centre for Molecular Medicine and Biobanking, University of Malta, MSD2080 Msida, Malta
| |
Collapse
|
6
|
Brant EG, Akilov O. Hydroxychloroquine for the treatment of hidradenitis suppurativa. JAAD Case Rep 2023; 37:64-67. [PMID: 37332363 PMCID: PMC10275947 DOI: 10.1016/j.jdcr.2023.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2023] Open
Affiliation(s)
- Elena Gonzalez Brant
- Department of Dermatology, Lahey Hospital and Medical Center, Burlington, Massachusetts
| | - Oleg Akilov
- Department of Dermatology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| |
Collapse
|
7
|
Witte K, Schneider-Burrus S, Salinas G, Mössner R, Ghoreschi K, Wolk K, Sabat R. Blood T Helper Memory Cells: A Tool for Studying Skin Inflammation in HS? Int J Mol Sci 2023; 24:ijms24108854. [PMID: 37240200 DOI: 10.3390/ijms24108854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/04/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
Hidradenitis suppurativa (HS) is an inflammatory skin disease characterized by painful lesions on intertriginous body areas such as the axillary, inguinal, and perianal sites. Given the limited treatment options for HS, expanding our knowledge of its pathogenetic mechanisms is a prerequisite for novel therapeutic developments. T cells are assumed to play a crucial role in HS pathogenesis. However, it is currently unknown whether blood T cells show specific molecular alterations in HS. To address this, we studied the molecular profile of CD4+ memory T (Thmem) cells purified from the blood of patients with HS and matched healthy participants. About 2.0% and 1.9% of protein-coding transcripts were found to be up- and down-regulated in blood HS Thmem cells, respectively. These differentially expressed transcripts (DETs) are known to be involved in nucleoside triphosphate/nucleotide metabolic processes, mitochondrion organization, and oxidative phosphorylation. The detected down-regulation of transcripts involved in oxidative phosphorylation suggest a metabolic shift of HS Thmem cells towards glycolysis. The inclusion of transcriptome data from skin from HS patients and healthy participants in the analyses revealed that in HS skin lesions, the expression pattern of transcripts identified as DETs in blood HS Thmem cells was very similar to the expression pattern of the totality of protein-coding transcripts. Furthermore, there was no significant association between the extent of the expressional changes in the DETs of blood HS Thmem cells and the extent of the expressional changes in these transcripts in HS skin lesions compared to healthy donor skin. Additionally, a gene ontology enrichment analysis did not demonstrate any association of the DETs of blood HS Thmem cells with skin disorders. Instead, there were associations with different neurological diseases, non-alcoholic fatty liver disease, and thermogenesis. The levels of most DETs linked to neurological diseases showed a positive correlation to each other, suggesting common regulatory mechanisms. In summary, the transcriptomic changes in blood Thmem cells observed in patients with manifest cutaneous HS lesions do not appear to be characteristic of the molecular changes in the skin. Instead, they could be useful for studying comorbidities and identifying corresponding blood biomarkers in these patients.
Collapse
Affiliation(s)
- Katrin Witte
- Psoriasis Research and Treatment Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Interdisciplinary Group of Molecular Immunopathology, Dermatology/Medical Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Berlin Institute of Health Center for Regenerative Therapies (BCRT), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13353 Berlin, Germany
| | - Sylke Schneider-Burrus
- Psoriasis Research and Treatment Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Center for Dermatosurgery, Havelklinik Berlin, 13595 Berlin, Germany
| | - Gabriela Salinas
- NGS-Integrative Genomics Core Unit, Institute of Human Genetics, University Medical Center Göttingen, 37073 Göttingen, Germany
| | - Rotraut Mössner
- Department of Dermatology, Georg-August-University Goettingen, 37073 Goettingen, Germany
| | - Kamran Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Kerstin Wolk
- Psoriasis Research and Treatment Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Interdisciplinary Group of Molecular Immunopathology, Dermatology/Medical Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Berlin Institute of Health Center for Regenerative Therapies (BCRT), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13353 Berlin, Germany
| | - Robert Sabat
- Psoriasis Research and Treatment Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Interdisciplinary Group of Molecular Immunopathology, Dermatology/Medical Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| |
Collapse
|
8
|
Sabat R, Šimaitė D, Gudjonsson JE, Brembach TC, Witte K, Krause T, Kokolakis G, Bartnik E, Nikolaou C, Rill N, Coulibaly B, Levin C, Herrmann M, Salinas G, Leeuw T, Volk HD, Ghoreschi K, Wolk K. Neutrophilic granulocyte-derived B-cell activating factor supports B cells in skin lesions in hidradenitis suppurativa. J Allergy Clin Immunol 2023; 151:1015-1026. [PMID: 36481267 DOI: 10.1016/j.jaci.2022.10.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 09/17/2022] [Accepted: 10/20/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is a chronic inflammatory disease characterized by painful inflamed nodules, abscesses, and pus-draining tunnels appearing in axillary, inguinal, and perianal skin areas. HS lesions contain various types of immigrated immune cells. OBJECTIVE This study aimed to characterize mediators that support lesional B/plasma cell persistence in HS. METHODS Skin samples from several cohorts of HS patients and control cohorts were assessed by mRNA sequencing, quantitative PCR on reverse-transcribed RNA, flow cytometry, and immunohistofluorescence. Blood plasma and cultured skin biopsy samples, keratinocytes, dermal fibroblasts, neutrophilic granulocytes (neutrophils), monocytes, and B cells were analyzed. Complex systems biology approaches were used to evaluate bulk and single-cell RNA sequencing data. RESULTS Proportions of B/plasma cells, neutrophils, CD8+ T cells, and M0 and M1 macrophages were elevated in HS lesions compared to skin of healthy and perilesional intertriginous areas. There was an association between B/plasma cells, neutrophils, and B-cell activating factor (BAFF, aka TNFSF13B). BAFF was abundant in HS lesions, particularly in nodules and abscesses. Among the cell types present in HS lesions, myeloid cells were the main BAFF producers. Mechanistically, granulocyte colony-stimulating factor in the presence of bacterial products was the major stimulus for neutrophils' BAFF secretion. Lesional upregulation of BAFF receptors was attributed to B cells (TNFRSF13C/BAFFR and TNFRSF13B/TACI) and plasma cells (TNFRSF17/BCMA). Characterization of the lesional BAFF pathway revealed molecules involved in migration/adhesion (eg, CXCR4, CD37, CD53, SELL), proliferation/survival (eg, BST2), activation (eg, KLF2, PRKCB), and reactive oxygen species production (eg, NCF1, CYBC1) of B/plasma cells. CONCLUSION Neutrophil-derived BAFF supports B/plasma cell persistence and function in HS lesions.
Collapse
Affiliation(s)
- Robert Sabat
- Psoriasis Research and Treatment Centre, Charité-Universitätsmedizin Berlin, Berlin, Germany; Interdisciplinary Group Molecular Immunopathology, Dermatology/Medical Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
| | - Deimantė Šimaitė
- Data and Data Sciences, Sanofi-Aventis Deutschland GmbH, Frankfurt, Germany
| | - Johann Eli Gudjonsson
- Department of Dermatology, University of Michigan, and Taubman Medical Research Institute, University of Michigan Medical School, Ann Arbor, Mich
| | - Theresa-Charlotte Brembach
- Psoriasis Research and Treatment Centre, Charité-Universitätsmedizin Berlin, Berlin, Germany; Interdisciplinary Group Molecular Immunopathology, Dermatology/Medical Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany; Department of Food Chemistry, Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
| | - Katrin Witte
- Psoriasis Research and Treatment Centre, Charité-Universitätsmedizin Berlin, Berlin, Germany; Interdisciplinary Group Molecular Immunopathology, Dermatology/Medical Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany; Inflammation and Regeneration of the Skin, BIH Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Torben Krause
- Psoriasis Research and Treatment Centre, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Georgios Kokolakis
- Psoriasis Research and Treatment Centre, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Eckart Bartnik
- Immunology & Inflammation Research TA, Sanofi-Aventis Deutschland GmbH, Frankfurt, Germany
| | - Christos Nikolaou
- Psoriasis Research and Treatment Centre, Charité-Universitätsmedizin Berlin, Berlin, Germany; Interdisciplinary Group Molecular Immunopathology, Dermatology/Medical Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Natascha Rill
- Psoriasis Research and Treatment Centre, Charité-Universitätsmedizin Berlin, Berlin, Germany; Interdisciplinary Group Molecular Immunopathology, Dermatology/Medical Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Béma Coulibaly
- Molecular Histopathology & Bio-Imaging, R&D, Sanofi-Aventis, Vitry-sur-Seine, France
| | - Clément Levin
- Molecular Histopathology & Bio-Imaging, R&D, Sanofi-Aventis, Vitry-sur-Seine, France
| | - Matthias Herrmann
- Immunology & Inflammation Research TA, Sanofi-Aventis Deutschland GmbH, Frankfurt, Germany
| | - Gabriela Salinas
- NGS-Integrative Genomics Core Unit, Institute of Human Genetics, University Medical Center Göttingen, Göttingen, Germany
| | - Thomas Leeuw
- Immunology & Inflammation Research TA, Sanofi-Aventis Deutschland GmbH, Frankfurt, Germany
| | - Hans-Dieter Volk
- BIH Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Berlin, Germany; Institute of Medical Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Kamran Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Kerstin Wolk
- Psoriasis Research and Treatment Centre, Charité-Universitätsmedizin Berlin, Berlin, Germany; Interdisciplinary Group Molecular Immunopathology, Dermatology/Medical Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany; Inflammation and Regeneration of the Skin, BIH Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Berlin, Germany.
| |
Collapse
|
9
|
Oba MC, Askin O, Gunver MG, Kocaarslan G, Alis DC, Engin B. Subclinical atherosclerosis in patients with hidradenitis suppurativa treated with TNF inhibitors. Skin Res Technol 2023; 29:e13302. [PMID: 36973990 PMCID: PMC10155849 DOI: 10.1111/srt.13302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 02/20/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is an independent risk factor for the development of subclinical atherosclerosis. Tumour necrosis factor (TNF) inhibitors are effective for the treatment of recalcitrant moderate-to-severe HS. However, the effect of treatment with TNF inhibitors on subclinical atherosclerosis in HS patients has not been previously investigated. OBJECTIVES In this study, we aimed to assess changes in biochemical parameters (fasting blood glucose and lipid levels) and carotid intima-media thickness (CIMT) values in Hurley stage II and III HS patients undergoing treatment with TNF inhibitors. METHODS This was a single center prospective study including 30 patients with Hurley stage II and III HS and 30 healthy controls (HCs). Baseline values of biochemical parameters and CIMT were compared to the values recorded after at least 6 months of TNF inhibitor therapy. RESULTS CIMT values of the HS patients significantly exceeded those of HCs (for right p = 0.011 and for left p = 0.017). After at least 6 months of TNF inhibitor therapy, there was a statistically significant decrease in fasting blood glucose (p = 0.001), whereas total cholesterol levels significantly increased (p = 0.001). CIMT values also significantly increased (for right p = 0.02 and for left p = 0.01). STUDY LIMITATIONS AND CONCLUSIONS Small sample size is limitation of the current study. Our study shows that patients with Hurley stage II and III HS undergoing TNF inhibitor therapy are under risk for progression of subclinical atherosclerosis.
Collapse
Affiliation(s)
- Muazzez Cigdem Oba
- Istanbul University‐CerrahpasaCerrahpasa Medical FacultyDepartment of Dermatology and VenereologyIstanbulTurkey
| | - Ozge Askin
- Istanbul University‐CerrahpasaCerrahpasa Medical FacultyDepartment of Dermatology and VenereologyIstanbulTurkey
| | - Mehmet Guven Gunver
- Istanbul UniversityIstanbul Medical FacultyDepartment of BiostatisticsIstanbulTurkey
| | - Gokce Kocaarslan
- Istanbul University‐CerrahpasaCerrahpasa Medical FacultyDepartment of RadiologyIstanbulTurkey
| | - Deniz Can Alis
- Istanbul University‐CerrahpasaCerrahpasa Medical FacultyDepartment of RadiologyIstanbulTurkey
| | - Burhan Engin
- Istanbul University‐CerrahpasaCerrahpasa Medical FacultyDepartment of Dermatology and VenereologyIstanbulTurkey
| |
Collapse
|
10
|
Sánchez-Díaz M, Salvador-Rodríguez L, Cuenca-Barrales C, Arias-Santiago S, Molina-Leyva A. Potential Predictors of Cardiovascular Risk Improvement in Patients with Hidradenitis Suppurativa Treated with Adalimumab: A Pivotal Study of Factors Associated with Carotid Intima-Media Thickness Reduction. Dermatol Ther (Heidelb) 2023; 13:817-826. [PMID: 36787042 PMCID: PMC9984601 DOI: 10.1007/s13555-023-00898-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 01/30/2023] [Indexed: 02/15/2023] Open
Abstract
INTRODUCTION Hidradenitis suppurativa (HS) has been linked to higher cardiovascular risk (CVR) due to its inflammatory burden. There is little evidence on how biologic treatment could modify the cardiovascular risk of patients with HS. The aims of the present study were to explore the modification of CVR in patients under adalimumab treatment and to explore the potential factors associated with CVR improvement. METHODS A prospective longitudinal study was performed. A cohort of patients with HS treated with adalimumab was followed up. Carotid intima-media thickness (IMT) and other clinical and biochemical CVR factors were collected at baseline and 32 weeks after starting the treatment. RESULTS Twenty-seven patients with severe HS were included. Overall, there were no differences in IMT between baseline (633 μm) and 32 weeks follow-up (634 μm). However, 40.7% (11/27) of the patients presented an improvement in IMT. This group (IMT responders) had a higher prevalence of dyslipidemia, diabetes mellitus, higher HbA1c levels, consumed more tobacco, and had higher BMI at baseline. Moreover, these patients had lower IHS4 scores at baseline and tended to have a greater IMT basal value, indicating a higher burden of subclinical atherosclerosis. CONCLUSIONS Adalimumab treatment might benefit a subset of patients with HS in terms of cardiovascular risk reduction. In light of the results of the present study patients with classical cardiovascular risk factors, and those with higher burden of subclinical atherosclerosis and with less inflammatory load, may be more likely to improve their IMT during adalimumab treatment.
Collapse
Affiliation(s)
- Manuel Sánchez-Díaz
- grid.411380.f0000 0000 8771 3783Dermatology Unit, Hospital Universitario Virgen de las Nieves, IBS Granada, Avenida de las Fuerzas Armadas 2, 18014 Granada, Spain
| | - Luis Salvador-Rodríguez
- grid.411380.f0000 0000 8771 3783Dermatology Unit, Hospital Universitario Virgen de las Nieves, IBS Granada, Avenida de las Fuerzas Armadas 2, 18014 Granada, Spain
| | - Carlos Cuenca-Barrales
- grid.411380.f0000 0000 8771 3783Dermatology Unit, Hospital Universitario Virgen de las Nieves, IBS Granada, Avenida de las Fuerzas Armadas 2, 18014 Granada, Spain ,grid.411380.f0000 0000 8771 3783Hidradenitis Suppurativa Clinic, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Salvador Arias-Santiago
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, IBS Granada, Avenida de las Fuerzas Armadas 2, 18014, Granada, Spain. .,Dermatology Department, School of Medicine, University of Granada, Granada, Spain.
| | - Alejandro Molina-Leyva
- grid.411380.f0000 0000 8771 3783Dermatology Unit, Hospital Universitario Virgen de las Nieves, IBS Granada, Avenida de las Fuerzas Armadas 2, 18014 Granada, Spain ,grid.411380.f0000 0000 8771 3783Hidradenitis Suppurativa Clinic, Hospital Universitario Virgen de las Nieves, Granada, Spain ,European Hidradenitis Suppurativa Foundation (EHSF), Dessau-Roßlau, Germany
| |
Collapse
|
11
|
The Development of Systemic Inflammatory Diseases in Hidradenitis Suppurativa. Diagnostics (Basel) 2023; 13:diagnostics13030502. [PMID: 36766606 PMCID: PMC9914736 DOI: 10.3390/diagnostics13030502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 01/23/2023] [Accepted: 01/29/2023] [Indexed: 01/31/2023] Open
Abstract
It is understood that the skin is a peripheral lymphoid tissue that defends against external environmental stimuli. Continuous activation from these factors, on the other hand, promotes persistent inflammation at the local location and, occasionally, tissue damage. Hidradenitis suppurativa (HS) is a typical inflammatory skin disease and becomes a source of numerous inflammatory cytokines due to the chronic intractable repeated inflamed tissues. Because inflammatory cells and cytokines circulate throughout the body from the inflamed organ, it has been hypothesized that HS-mediated skin inflammation impacts the systemic functioning of numerous organs. Recent updates to clinical and experimental investigations revealed that HS has a significant connection with systemic inflammatory disorders. We provide the details and comprehensive molecular mechanisms associated with systemic inflammatory illnesses due to HS.
Collapse
|
12
|
Coromilas A, Micheletti RG. Strategies for Effective Management of Hidradenitis Suppurativa in the Hospital Setting. CURRENT DERMATOLOGY REPORTS 2022. [DOI: 10.1007/s13671-022-00373-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2022]
|
13
|
González-López MA, Ocejo-Viñals JG, López-Sundh AE, Guiral S, Ruiz-Solana M, Mata C, Portilla V, Corrales A, Blanco R, Hernández JL. Biomarkers of endothelial dysfunction and atherosclerosis in hidradenitis suppurativa. J Dermatol 2022; 49:1052-1056. [PMID: 35661237 DOI: 10.1111/1346-8138.16484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/03/2022] [Accepted: 05/24/2022] [Indexed: 11/30/2022]
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory disease associated with an increased prevalence of subclinical atherosclerosis and cardiovascular risk. Angiopoietin-2 (Ang-2), asymmetric dimethylarginine (ADMA), and osteoprotegerin (OPG) are molecules related to endothelial dysfunction (ED) and atherosclerosis, but also to disease severity in patients with chronic inflammatory disorders. In this case-control study, we aimed to investigate serum Ang-2, ADMA, and OPG levels in patients with HS, and to assess the potential relationship between these levels and disease severity. Seventy-five patients with HS and 60 controls were assessed. Serum Ang-2, ADMA, and OPG concentrations were determined in all participants. HS patients had significantly higher Ang-2 and ADMA levels than controls after adjusting for confounders. Besides, Ang-2 concentrations positively correlated with disease severity in the adjusted multivariable analysis. Nevertheless, serum OPG levels did not significantly differ between HS patients and controls. Our results indicate that serum Ang-2 and ADMA levels are significantly increased in patients with HS. Furthermore, Ang-2 might be a suitable marker of HS severity.
Collapse
Affiliation(s)
- Marcos A González-López
- Division of Dermatology, Hospital Universitario Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Spain
| | - J Gonzalo Ocejo-Viñals
- Division of Immunology, Hospital Universitario Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Spain
| | - Ana E López-Sundh
- Division of Dermatology, Hospital Universitario Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Spain
| | - Sandra Guiral
- Division of Immunology, Hospital Universitario Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Spain
| | - Marta Ruiz-Solana
- Division of Dermatology, Hospital Universitario Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Spain
| | - Cristina Mata
- Division of Rheumatology, Hospital Comarcal, Laredo, Spain
| | - Virginia Portilla
- Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Spain
| | - Alfonso Corrales
- Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Spain
| | - Ricardo Blanco
- Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Spain
| | - Jose L Hernández
- Division of Internal Medicine, Hospital Universitario Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Spain
| |
Collapse
|
14
|
Navrazhina K, Renert-Yuval Y, Frew JW, Grand D, Gonzalez J, Williams SC, Garcet S, Krueger JG. Large-scale serum analysis identifies unique systemic biomarkers in psoriasis and hidradenitis suppurativa. Br J Dermatol 2022; 186:684-693. [PMID: 34254293 DOI: 10.1111/bjd.20642] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is now recognized as a systemic inflammatory disease, sharing molecular similarities with psoriasis. Direct comparison of the systemic inflammation in HS with psoriasis is lacking. OBJECTIVES To evaluate the serum proteome of HS and psoriasis, and to identify biomarkers associated with disease severity. METHODS In this cross-sectional study, 1536 serum proteins were assessed using the Olink Explore (Proximity Extension Assay) high-throughput panel in patients with moderate-to-severe HS (n = 11), patients with psoriasis (n = 10) and age- and body mass index-matched healthy controls (n = 10). RESULTS HS displayed an overall greater dysregulation of circulating proteins, with 434 differentially expressed proteins (absolute fold change ≥ 1·2; P ≤ 0·05) in patients with HS vs. controls, 138 in patients with psoriasis vs. controls and 503 between patients with HS and patients with psoriasis. Interleukin (IL)-17A levels and T helper (Th)1/Th17 pathway enrichment were comparable between diseases, while HS presented greater tumour necrosis factor- and IL-1β-related signalling. The Th17-associated markers peptidase inhibitor 3 (PI3) and lipocalin 2 (LCN2) were able to differentiate psoriasis from HS accurately. Both diseases presented increases of atherosclerosis-related proteins. Robust correlations between clinical severity scores and immune and atherosclerosis-related proteins were observed across both diseases. CONCLUSIONS HS and psoriasis share significant Th1/Th17 enrichment and upregulation of atherosclerosis-related proteins. Despite the greater body surface area involved in psoriasis, HS presents a greater serum inflammatory burden.
Collapse
Affiliation(s)
- K Navrazhina
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, USA
- Weill Cornell/Rockefeller/Sloan Kettering Tri-Institutional MD-PhD program, New York, NY, USA
| | - Y Renert-Yuval
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, USA
| | - J W Frew
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, USA
| | - D Grand
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, USA
| | - J Gonzalez
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, USA
| | - S C Williams
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, USA
- Weill Cornell/Rockefeller/Sloan Kettering Tri-Institutional MD-PhD program, New York, NY, USA
| | - S Garcet
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, USA
| | - J G Krueger
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, USA
| |
Collapse
|
15
|
Hojman L, Karsulovic C. Cardiovascular Disease-Associated Skin Conditions. Vasc Health Risk Manag 2022; 18:43-53. [PMID: 35210782 PMCID: PMC8859268 DOI: 10.2147/vhrm.s343319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 02/04/2022] [Indexed: 11/23/2022] Open
Abstract
According to data from the American Heart Association and the World Health Organization, cardiovascular disease (CVD) is the most frequent cause of premature death. Several inflammatory and non-inflammatory skin diseases have been associated with metabolic syndrome and cardiovascular risk (CVR). Here, we classified these conditions into traditionally CVR-associated and those that have been linked to a lesser degree. Psoriasis and hidradenitis suppurativa are commonly associated with CVD, sharing common inflammatory pathways and a higher prevalence of traditional cardiovascular risk factors. Many other diseases could be associated indirectly – with no common pathogenic features with the atheromatous disease – but share a higher prevalence of standard cardiovascular risk and chronic inflammatory state. This review aims to highlight the associated cardiovascular risk that exists for some dermatologic diseases and sensitize cardiologists, dermatologists, and first care providers to implement risk factor control promptly.
Collapse
Affiliation(s)
- Lia Hojman
- Dermatology Department, Universidad del Desarrollo, Facultad de Medicina Clínica Alemana, Santiago, Region Metropolitana, Chile
| | - Claudio Karsulovic
- Internal Medicine Department, Universidad del Desarrollo, Facultad de Medicina Clínica Alemana, Santiago, Region Metropolitana, Chile
- Correspondence: Claudio Karsulovic, Internal Medicine Department, Universidad del Desarrollo, Facultad de Medicina Clinica Alemana, Avenida Vitacura 5951, Vitacura, Santiago, Region Metropolitana, Chile, Email
| |
Collapse
|
16
|
Increased Serum Levels of S100A4 and S100A15 in Individuals Suffering from Hidradenitis Suppurativa. J Clin Med 2021; 10:jcm10225320. [PMID: 34830597 PMCID: PMC8617841 DOI: 10.3390/jcm10225320] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 11/02/2021] [Accepted: 11/10/2021] [Indexed: 12/25/2022] Open
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease. Recently, some S100 proteins have been suggested to play an important role in the pathogenesis of chronic immune-mediated inflammatory diseases and they may constitute valuable biomarkers for these diseases’ diagnosis and monitoring. The objective of the current study was to investigate, for the first time, serum levels of S100A4 and S100A15 in individuals suffering from HS. Furthermore, we assessed the associations between S100A4 and S100A15 serum levels and the severity of disease, CRP serum concentration and some demographic and clinical data. Serum levels of S100A4 and S100A15 were evaluated with the commercially available ELISA kit according to the manufacturer’s instructions. The serum level of S100A4 in individuals with HS was significantly elevated as compared to controls, with the highest level found in the individuals in Hurley stage II. The S100A15 serum level was positively correlated with the CRP concentration and was associated with the severity of the disease. The serum level of S100A15 in the individuals in Hurley stage III was significantly elevated compared to that of the controls and the individuals with HS in Hurley stages I and II. S100A4 and S100A15 may be considered as new serum biomarkers for the monitoring of HS progression, and they may play a role in the pathogenesis of HS by promoting inflammatory process and fibrosis.
Collapse
|
17
|
Sánchez-Díaz M, Salvador-Rodríguez L, Montero-Vílchez T, Martínez-López A, Arias-Santiago S, Molina-Leyva A. Cumulative Inflammation and HbA1c Levels Correlate with Increased Intima-Media Thickness in Patients with Severe Hidradenitis Suppurativa. J Clin Med 2021; 10:jcm10225222. [PMID: 34830503 PMCID: PMC8625299 DOI: 10.3390/jcm10225222] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 11/02/2021] [Accepted: 11/05/2021] [Indexed: 12/31/2022] Open
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that has been associated with a greater risk of metabolic and cardiovascular comorbidities. The aim of this study is to assess cardiovascular risk by means of intima-media thickness (IMT), metabolic syndrome, and other potential biomarkers in patients with severe hidradenitis suppurativa who are candidates for biologic therapy and to explore potentially associated factors. A cross-sectional study was performed. Body mass index (BMI), carotid intima-media thickness (IMT), and blood tests, including glycemic and lipid profile, insulin, vitamin D, and inflammation markers were performed. Fifty patients were included in the study; the male/female ratio was 3:2. The mean age was 38 years, and the mean disease duration was 21.8 years. The mean carotid IMT was 651.39 μm. A positive association of IMT with disease duration, tobacco consumption, and HbA1c levels was observed. HbA1c correlated with the age of onset, hypertension, metabolic syndrome, and glucose levels. Vitamin D levels inversely correlated with the number of areas affected. In conclusion, patients with severe HS present a higher cardiovascular risk, but it is not distributed equally within the patients: Tobacco consumption, inadequate glycemic control, and disease duration could be useful clinical and biochemical markers to identify patients at higher risk.
Collapse
Affiliation(s)
- Manuel Sánchez-Díaz
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, IBS Granada, 18002 Granada, Spain; (M.S.-D.); (L.S.-R.); (T.M.-V.); (A.M.-L.); (A.M.-L.)
| | - Luis Salvador-Rodríguez
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, IBS Granada, 18002 Granada, Spain; (M.S.-D.); (L.S.-R.); (T.M.-V.); (A.M.-L.); (A.M.-L.)
| | - Trinidad Montero-Vílchez
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, IBS Granada, 18002 Granada, Spain; (M.S.-D.); (L.S.-R.); (T.M.-V.); (A.M.-L.); (A.M.-L.)
| | - Antonio Martínez-López
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, IBS Granada, 18002 Granada, Spain; (M.S.-D.); (L.S.-R.); (T.M.-V.); (A.M.-L.); (A.M.-L.)
| | - Salvador Arias-Santiago
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, IBS Granada, 18002 Granada, Spain; (M.S.-D.); (L.S.-R.); (T.M.-V.); (A.M.-L.); (A.M.-L.)
- Dermatology Department, School of Medicine, University of Granada, 18016 Granada, Spain
- Correspondence: ; Tel.: +34-958023465
| | - Alejandro Molina-Leyva
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, IBS Granada, 18002 Granada, Spain; (M.S.-D.); (L.S.-R.); (T.M.-V.); (A.M.-L.); (A.M.-L.)
- Hidradenitis Suppurativa Clinic, Hospital Universitario Virgen de las Nieves, 18002 Granada, Spain
| |
Collapse
|
18
|
Mintoff D, Benhadou F, Pace NP, Frew JW. Metabolic syndrome and hidradenitis suppurativa: epidemiological, molecular, and therapeutic aspects. Int J Dermatol 2021; 61:1175-1186. [PMID: 34530487 DOI: 10.1111/ijd.15910] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 08/28/2021] [Indexed: 12/12/2022]
Abstract
Hidradenitis suppurativa (HS) is a chronic, suppurative condition of the pilosebaceous unit. Patients suffering from HS demonstrate a molecular profile in keeping with a state of systemic inflammation and are often found to fit the criteria for a diagnosis of metabolic syndrome (MetS). In this paper, we review the literature with regards to established data on the prevalence of MetS in HS patients and revise the odds ratio of comorbid disease. Furthermore, we attempt to draw parallels between inflammatory pathways in HS and MetS and evaluate how convergences may explain the risk of comorbid disease, necessitating the need for multidisciplinary care.
Collapse
Affiliation(s)
- Dillon Mintoff
- Department of Dermatology, Mater Dei Hospital, Msida, Malta.,European Hidradenitis Suppurativa Foundation e.V, Dessau, Germany.,Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Farida Benhadou
- European Hidradenitis Suppurativa Foundation e.V, Dessau, Germany.,Department of Dermatology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Nikolai P Pace
- Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.,Centre for Molecular Medicine and Biobanking, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - John W Frew
- Department of Dermatology, Liverpool Hospital, University of New South Wales, Sydney, NSW, Australia
| |
Collapse
|
19
|
Evaluation of serum omentin-1 and apelin concentrations in patients with hidradenitis suppurativa. Postepy Dermatol Alergol 2021; 38:450-454. [PMID: 34377127 PMCID: PMC8330847 DOI: 10.5114/ada.2021.107932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 01/20/2020] [Indexed: 01/14/2023] Open
Abstract
Introduction Recent studies suggest a role of adipokines in the pathogenesis of hidradenitis suppurativa (HS). Omentin-1 and apelin are two recently identified adipokines that have been involved in the regulation of metabolic and inflammatory responses. Aim To investigate serum omentin-1 and apelin levels in patients with HS and to assess their associations with metabolic parameters, disease severity and HS risk. Material and methods This case-control study included 139 non-diabetic individuals (78 HS patients and 61 ageand sex-matched controls). Serum concentrations of omentin-1 and apelin and the homeostasis model assessment of insulin resistance (HOMA-IR) were measured in all participants. Results Serum omentin-1 concentrations were significantly higher in HS patients compared to controls, whereas apelin serum levels did not significantly differ between both groups. These differences in omentin-1 concentrations remained significant even after adjusting for age, sex, and body mass index (BMI). The results of logistic regression analysis showed that increased omentin-1 plasma levels were an independent risk factor for HS. However, we found no association between serum levels of both omentin-1 and apelin with HS severity. Conclusions Our results show that patients with HS have raised omentin-1 serum levels, which are associated with HS risk.
Collapse
|
20
|
Wolk K, Brembach T, Šimaitė D, Bartnik E, Cucinotta S, Pokrywka A, Irmer M, Triebus J, Witte‐Händel E, Salinas G, Leeuw T, Volk H, Ghoreschi K, Sabat R. Activity and components of the granulocyte colony‐stimulating factor pathway in hidradenitis suppurativa*. Br J Dermatol 2021; 185:164-176. [DOI: 10.1111/bjd.19795] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2020] [Indexed: 12/12/2022]
Affiliation(s)
- K. Wolk
- Psoriasis Research and Treatment Centre Charité – Universitätsmedizin Berlin Berlin Germany
- Inflammation and Regeneration of Skin BIH Center for Regenerative Therapies Charité – Universitätsmedizin Berlin Berlin Germany
| | - T.‐C. Brembach
- Psoriasis Research and Treatment Centre Charité – Universitätsmedizin Berlin Berlin Germany
- University of PotsdamInstitute of Nutritional ScienceDepartment of Food Chemistry Potsdam Germany
| | - D. Šimaitė
- Data and Data Sciences Sanofi‐Aventis Deutschland GmbH FrankfurtGermany
| | - E. Bartnik
- Immunology and Inflammation Research Sanofi‐Aventis Deutschland GmbH Frankfurt Germany
| | - S. Cucinotta
- Psoriasis Research and Treatment Centre Charité – Universitätsmedizin Berlin Berlin Germany
| | - A. Pokrywka
- Department of Dermatology, Venereology and Allergology Charité – Universitätsmedizin Berlin Germany
| | - M.L. Irmer
- Psoriasis Research and Treatment Centre Charité – Universitätsmedizin Berlin Berlin Germany
| | - J. Triebus
- Psoriasis Research and Treatment Centre Charité – Universitätsmedizin Berlin Berlin Germany
| | - E. Witte‐Händel
- Psoriasis Research and Treatment Centre Charité – Universitätsmedizin Berlin Berlin Germany
| | - G. Salinas
- Transcriptome and Genome Core Unit University Medical Center Göttingen Göttingen Germany
| | - T. Leeuw
- Immunology and Inflammation Research Sanofi‐Aventis Deutschland GmbH Frankfurt Germany
| | - H.‐D. Volk
- BIH Center for Regenerative Therapies Charité – Universitätsmedizin Berlin Berlin Germany
- Institute of Medical Immunology Charité – Universitätsmedizin Berlin Germany
| | - K. Ghoreschi
- Department of Dermatology, Venereology and Allergology Charité – Universitätsmedizin Berlin Germany
| | - R. Sabat
- Psoriasis Research and Treatment Centre Charité – Universitätsmedizin Berlin Berlin Germany
- Interdisciplinary group Molecular Immunopathology Dermatology/Medical Immunology Charité – Universitätsmedizin Berlin Berlin Germany
| |
Collapse
|
21
|
Namazi N, Amani M, Haghighatkhah HR, Noori E, Abdollahimajd F. Increased risk of subclinical atherosclerosis and metabolic syndrome in patients with vitiligo: a real association or a coincidence? Dermatol Ther 2021; 34:e14803. [PMID: 33496053 DOI: 10.1111/dth.14803] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 12/25/2020] [Accepted: 01/17/2021] [Indexed: 12/11/2022]
Abstract
Inflammatory and autoimmune skin diseases such as vitiligo may be associated with systemic disorders, including endocrine and cardiovascular diseases, due to some similarities in the pathogenesis. It was aimed to evaluate metabolic syndrome and subclinical atherosclerosis in patients with vitiligo. Seventy patients with nonsegmental vitiligo and 70 age-matched and gender-matched healthy controls participated in the study. These participants were investigated for metabolic syndrome criteria. The mean intima-media thickness of the common carotid artery (MIMT-CCA) of the subjects was measured for assessment of subclinical atherosclerosis. Metabolic syndrome and subclinical atherosclerosis were significantly more frequent in vitiligo patients compared with the controls (P = .006 and P = .002, respectively). In addition, metabolic syndrome and subclinical atherosclerosis had positive, significant correlations with the severity and duration of vitiligo (P = .031 and r = .482; P < .01, respectively). Our study suggested that patients with vitiligo, especially those with more chronic and severe disease or concomitant metabolic syndrome, are at a higher risk of developing cardiovascular diseases. Therefore, early diagnosis and treatment of metabolic syndrome in patients with vitiligo to prevent cardiovascular complications were recommended.
Collapse
Affiliation(s)
- Nastaran Namazi
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maliheh Amani
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Haghighatkhah
- Department of Radiology and Medical Imaging Center, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ehsan Noori
- Department of Anesthesiology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fahimeh Abdollahimajd
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Clinical Research Development Unit, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
22
|
Comorbidity screening in hidradenitis suppurativa: Evidence-based recommendations from the US and Canadian Hidradenitis Suppurativa Foundations. J Am Acad Dermatol 2021; 86:1092-1101. [PMID: 33493574 PMCID: PMC8298595 DOI: 10.1016/j.jaad.2021.01.059] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 01/07/2021] [Accepted: 01/18/2021] [Indexed: 12/21/2022]
Abstract
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.
Collapse
|
23
|
Alatas E, Biteker M, Alatas O. Aortic stiffness in hidradenitis suppurativa: A case-control study. DERMATOL SIN 2021. [DOI: 10.4103/ds.ds_39_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
24
|
Zouboulis CC, Benhadou F, Byrd AS, Chandran NS, Giamarellos‐Bourboulis EJ, Fabbrocini G, Frew JW, Fujita H, González‐López MA, Guillem P, Gulliver WPF, Hamzavi I, Hayran Y, Hórvath B, Hüe S, Hunger RE, Ingram JR, Jemec GB, Ju Q, Kimball AB, Kirby JS, Konstantinou MP, Lowes MA, MacLeod AS, Martorell A, Marzano AV, Matusiak Ł, Nassif A, Nikiphorou E, Nikolakis G, Nogueira da Costa A, Okun MM, Orenstein LA, Pascual JC, Paus R, Perin B, Prens EP, Röhn TA, Szegedi A, Szepietowski JC, Tzellos T, Wang B, van der Zee HH. What causes hidradenitis suppurativa ?—15 years after. Exp Dermatol 2020; 29:1154-1170. [DOI: 10.1111/exd.14214] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 10/05/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Christos C. Zouboulis
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Departments of Dermatology, Venereology, Allergology and Immunology Dessau Medical Center Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg Dessau Germany
| | - Farida Benhadou
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Department of Dermatology Hôpital Erasme Universite Libre de Bruxelles Bruxelles Belgium
| | - Angel S. Byrd
- Department of Dermatology Howard University College of Medicine Washington DC USA
| | - Nisha S. Chandran
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Division of Dermatology Department of Medicine National University Hospital Singapore
| | - Evangelos J. Giamarellos‐Bourboulis
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- 4th Department of Internal Medicine National and Kapodistrian University of Athens Medical School Athens Greece
| | - Gabriella Fabbrocini
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Section of Dermatology Department of Clinical Medicine and Surgery University of Naples Federico II Naples Italy
| | | | - Hideki Fujita
- Division of Cutaneous Science Department of Dermatology Nihon University School of Medicine Tokyo Japan
| | - Marcos A. González‐López
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Division of Dermatology Hospital Universitario Marqués de Valdecilla University of Cantabria IDIVAL Santander Spain
| | - Philippe Guillem
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Department of Surgery Clinique du Val d’Ouest (Lyon), ResoVerneuil (Paris) and Groupe de Recherche en Proctologie de la Société Nationale Française de ColoProctologie Paris France
| | - Wayne P. F. Gulliver
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Faculty of Medicine Memorial University of Newfoundland, and NewLab Clinical Research Inc St. John's Canada
| | - Iltefat Hamzavi
- Department of Dermatology Henry Ford Hospital Wayne State University Detroit MI USA
| | - Yildiz Hayran
- Department of Dermatology Ankara Numune Training and Research Hospital Ankara Turkey
| | - Barbara Hórvath
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Department of Dermatology University Medical Centre Groningen University of Groningen Groningen The Netherlands
| | | | - Robert E. Hunger
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Department of Dermatology, Inselspital Bern University Hospital Bern Switzerland
| | - John R. Ingram
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Department of Dermatology & Academic Wound Healing Division of Infection and Immunity Cardiff University Cardiff UK
| | - Gregor B.E. Jemec
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Department of Dermatology Zealand University Hospital Roskilde Denmark
| | - Qiang Ju
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Department of Dermatology RenJi Hospital School of Medicine Shanghai Jiaotong University Shanghai China
| | - Alexa B. Kimball
- Department of Dermatology Beth Israel Deaconess Medical Center and Harvard Medical School Boston MA USA
| | - Joslyn S. Kirby
- Department of Dermatology Penn State Milton S. Hershey Medical Center Hershey PA USA
| | - Maria P. Konstantinou
- Dermatology Department Paul Sabatier University University Hospital of Toulouse Toulouse France
| | | | - Amanda S. MacLeod
- Department of Dermatology Department of Immunology Department of Molecular Genetics and Microbiology Duke University Durham NC USA
| | - Antonio Martorell
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Department of Dermatology Hospital of Manises Valencia Spain
| | - Angelo V. Marzano
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Dermatology Unit Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milan Italy
- Department of Pathophysiology and Transplantation Università degli Studi di Milano Milan Italy
| | - Łukasz Matusiak
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Department of Dermatology, Venereology and Allergology Wrocław Medical University Wrocław Poland
| | - Aude Nassif
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Institut Pasteur Paris France
| | - Elena Nikiphorou
- Centre for Rheumatic Diseases King’s College London, and Department of Rheumatology King’s College Hospital London UK
| | - Georgios Nikolakis
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Departments of Dermatology, Venereology, Allergology and Immunology Dessau Medical Center Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg Dessau Germany
| | - André Nogueira da Costa
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Translational Science and Experimental Medicine Early Respiratory and Immunology Biopharmaceuticals R&D AstraZeneca Gothenburg Sweden
| | | | | | - José Carlos Pascual
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Alicante University General Hospital Alicante Institute for Health and Biomedical Research (ISABIAL‐FISABIO Foundation) Alicante Spain
| | - Ralf Paus
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA
| | - Benjamin Perin
- Division of Dermatology University of Washington Seattle WA USA
| | - Errol P. Prens
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Department of Dermatology Erasmus University Medical Center Rotterdam The Netherlands
| | - Till A. Röhn
- Autoimmunity, Transplantation and Inflammation Novartis Institutes for BioMedical Research Novartis Pharma AG Basel Switzerland
| | - Andrea Szegedi
- Division of Dermatological Allergology Department of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
| | - Jacek C. Szepietowski
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Department of Dermatology, Venereology and Allergology Wrocław Medical University Wrocław Poland
| | - Thrasyvoulos Tzellos
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Department of Dermatology Nordland Hospital Trust Bodø Norway
| | - Baoxi Wang
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Department of Dermatology Plastic Surgery Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China
| | - Hessel H. van der Zee
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Department of Dermatology Erasmus University Medical Center Rotterdam The Netherlands
| |
Collapse
|
25
|
Özkur E, Erdem Y, Altunay İK, Demir D, Dolu NÇ, Serin E, Çerman AA. Serum irisin level, insulin resistance, and lipid profiles in patients with hidradenitis suppurativa: a case-control study. An Bras Dermatol 2020; 95:708-713. [PMID: 33008659 PMCID: PMC7672402 DOI: 10.1016/j.abd.2020.04.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 04/09/2020] [Indexed: 01/11/2023] Open
Abstract
Background Hidradenitis suppurativa is a chronic inflammatory skin disease of terminal follicular acroinfundibulum. Objectives This study aimed to evaluate serum irisin, plasma glucose, insulin, and lipid levels in hidradenitis suppurativa, and elucidate possible associations with disease activity, inflammatory, or metabolic parameters. Methods This case-control study included 37 patients (M/F: 9/28) and 37 sex-, age- and body mass index -matched healthy controls (M/F: 11/26). Demographic data, Hurley stage of disease, fasting glucose, insulin, total cholesterol, high density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, C-reactive protein levels, erythrocyte sedimentation rate, hematologic parameters, and serum irisin were assessed. Results The hidradenitis suppurativa group had significantly higher waist circumference than controls (p < 0.001). Insulin resistance, defined as a homeostatic model assessment for insulin resistance value greater than 2.5, was observed in 45.9% of patients and 8.1% of controls (p = 0.003), whereas metabolic syndrome was observed in 32.4% of patients and 5.4% of controls (p < 0.001). Furthermore, plasma triglycerids, glucose, and insulin levels were significantly higher in the hidradenitis suppurativa (p = 0.013, p = 0.001, and p = 0.004), respectively. Mean irisin level was insignificantly higher in the hidradenitis suppurativa group (37.4 ± 32.6) than in controls (26.2 ± 24.7, p = 0.217). Study limitation Physical activity and the exercise levels of participants were not documented. Conclusion This study indicates that hidradenitis suppurativa patients have higher serum irisin, fasting plasma glucose, insulin, and triglycerides levels than healthy controls. Thus, the authors suggest that hidradenitis suppurativa patients should be evaluated for insulin resistance and metabolic syndrome, and monitored accordingly.
Collapse
Affiliation(s)
- Ezgi Özkur
- Department of Dermatology, University of Health Sciences, Şişli Etfal Training and Research Hospital, İstanbul, Turkey.
| | - Yasemin Erdem
- Department of Dermatology, University of Health Sciences, Şişli Etfal Training and Research Hospital, İstanbul, Turkey
| | - İlknur Kıvanç Altunay
- Department of Dermatology, University of Health Sciences, Şişli Etfal Training and Research Hospital, İstanbul, Turkey
| | - Damla Demir
- Department of Dermatology, University of Health Sciences, Şişli Etfal Training and Research Hospital, İstanbul, Turkey
| | - Nurcihan Çalışkan Dolu
- Department of Biochemistry, University of Health Sciences, Şişli Etfal Training and Research Hospital, İstanbul, Turkey
| | - Erdinç Serin
- Department of Biochemistry, University of Health Sciences, Şişli Etfal Training and Research Hospital, İstanbul, Turkey
| | - Aslı Aksu Çerman
- Department of Dermatology, University of Health Sciences, Şişli Etfal Training and Research Hospital, İstanbul, Turkey
| |
Collapse
|
26
|
Hernández JL, Baldeón C, López-Sundh AE, Ocejo-Vinyals JG, Blanco R, González-López MA. Atherogenic index of plasma is associated with the severity of Hidradenitis Suppurativa: a case-control study. Lipids Health Dis 2020; 19:200. [PMID: 32861241 PMCID: PMC7456502 DOI: 10.1186/s12944-020-01377-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 08/26/2020] [Indexed: 01/19/2023] Open
Abstract
Background Hidradenitis suppurativa (HS) is a chronic inflammatory disease associated with several comorbidities and vascular risk factors, such as dyslipidemia. The present study aimed to assess the possible associations between the lipid profile and atherogenic indexes and the severity of HS. Methods This case-control study enrolled 78 HS patients and 62 healthy controls. Classic lipid profile and lipoprotein ratios, including the atherogenic index of plasma (AIP), were evaluated. The severity of HS was measured by the HS Physician Global Assessment (PGA). Results HS-patients had lower serum total cholesterol and HDL-C levels and higher AIP than the control group. AIP was positively correlated to BMI, waist circumference, systolic and diastolic blood pressure, LDL-C, triglycerides, non-HDL-C, ApoB, HOMA, and hs-CRP and negatively to HDL-C and ApoA1. For the overall lipid profile, only AIP was related to a more severe HS (PGA ≥ 3) after controlling for age, sex, BMI, insulin resistance (IR), active smoking, and statin use (r = 0.268; p = 0.023). Multiple logistic regression adjusted for age, sex, BMI, IR, smoking status and statin use, showed that AIP ≥ 0.11 was significantly associated with the severity of HS (OR, 4.38; CI 95%, 1.09–17.50; p = 0.037). Conclusions In conclusion, these results showed that AIP is significantly and independently associated with HS severity.
Collapse
Affiliation(s)
- José L Hernández
- Division of Internal Medicine, Hospital Universitario Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Spain
| | - Cristina Baldeón
- Division of Internal Medicine, Hospital Universitario Marqués de Valdecilla, University of Cantabria, Santander, Spain
| | - Ana E López-Sundh
- Division of Dermatology, Hospital Universitario Marqués de Valdecilla, University of Cantabria, Santander, Spain
| | - J Gonzalo Ocejo-Vinyals
- Division of Immunology, Hospital Universitario Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Spain
| | - Ricardo Blanco
- Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Spain
| | - Marcos A González-López
- Division of Dermatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, 39008, Santander, Spain.
| |
Collapse
|
27
|
González‐López MA, Ocejo‐Viñals JG, Mata C, Vilanova I, Guiral S, Portilla V, Blanco R, Hernández JL. Association of retinol binding protein4 (RBP4) and ghrelin plasma levels with insulin resistance and disease severity in non‐diabetic patients with hidradenitis suppurativa. Exp Dermatol 2020; 29:828-832. [DOI: 10.1111/exd.14132] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/26/2020] [Accepted: 06/14/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Marcos A. González‐López
- Division of Dermatology Hospital Universitario Marqués de Valdecilla University of CantabriaIDIVAL Santander Spain
| | - J. Gonzalo Ocejo‐Viñals
- Division of Immunology Hospital Universitario Marqués de Valdecilla University of CantabriaIDIVAL Santander Spain
| | - Cristina Mata
- Division of Rheumatology Hospital Comarcal Laredo Spain
| | - Iosune Vilanova
- Division of Dermatology Hospital Universitario Marqués de Valdecilla University of CantabriaIDIVAL Santander Spain
| | - Sandra Guiral
- Division of Immunology Hospital Universitario Marqués de Valdecilla University of CantabriaIDIVAL Santander Spain
| | - Virginia Portilla
- Division of Rheumatology Hospital Universitario Marqués de Valdecilla University of CantabriaIDIVAL Santander Spain
| | - Ricardo Blanco
- Division of Rheumatology Hospital Universitario Marqués de Valdecilla University of CantabriaIDIVAL Santander Spain
| | - José L. Hernández
- Division of Internal Medicine Hospital Universitario Marqués de Valdecilla University of CantabriaIDIVAL Santander Spain
| |
Collapse
|
28
|
Abstract
Hidradenitis suppurativa (HS; also designated as acne inversa) is a chronic inflammatory disorder, which affects the intertriginous skin and is associated with numerous systemic comorbidities. The estimated prevalence of HS is ~1% in most studied countries. Typically starting in early adulthood, cutaneous inflamed nodules, abscesses and pus-discharging tunnels develop in axillary, inguinal, gluteal and perianal body sites. The comorbidities of HS include metabolic and cardiovascular disorders, which contribute to reduced life expectancy. A genetic predisposition, smoking, obesity and hormonal factors are established aetiological factors for HS. Cutaneous changes seem to start around hair follicles and involve activation of cells of the innate and adaptive immune systems, with pivotal roles for pro-inflammatory cytokines such as tumour necrosis factor, IL-1β and IL-17. The unrestricted and chronic immune response eventually leads to severe pain, pus discharge, irreversible tissue destruction and scar development. HS has profound negative effects on patients' quality of life, which often culminate in social withdrawal, unemployment, depression and suicidal thoughts. The therapeutic options for HS comprise antibiotic treatment, neutralization of tumour necrosis factor and surgical intervention together with lifestyle modification. Nevertheless, there is an enormous need for awareness of HS, understanding of its pathogenesis and novel treatments.
Collapse
|
29
|
Tzellos T, Zouboulis CC. Review of Comorbidities of Hidradenitis Suppurativa: Implications for Daily Clinical Practice. Dermatol Ther (Heidelb) 2020; 10:63-71. [PMID: 31955366 PMCID: PMC6994573 DOI: 10.1007/s13555-020-00354-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Indexed: 02/07/2023] Open
Abstract
Hidradenitis suppurativa (HS) is a chronic, recurrent skin inflammatory disease associated with a variety of comorbidities, like reduced quality of life, metabolic syndrome, sexual dysfunction, working disability, axial spondyloarthritis, inflammatory bowel disease, depression, and anxiety. Like psoriasis, HS patients have been found to have higher risk of cardiovascular death and suicide risk. Clinicians should be informed about these comorbidities so that appropriate screening is implemented. All this evidence suggests that for such a chronic, multi-comorbid disease, the use of validated outcomes to assess severity and effect of treatment, along with the use of clinically important patient reported outcomes, is essential. The potential of available treatments to negatively and positively affect these comorbidities should also be taken into account when designing treatment strategies. This review provides an outline of important HS comorbidities with emphasis on possible implications for daily clinical practice.
Collapse
Affiliation(s)
- Thrasyvoulos Tzellos
- Department of Dermatology, Nordland Hospital Trust, Bodø, Norway.
- Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway.
| | - Christos C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School, Theodor Fontane, Dessau, Germany
- European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany
| |
Collapse
|
30
|
González-López MA, Vilanova I, Ocejo-Viñals G, Arlegui R, Navarro I, Guiral S, Mata C, Pérez-Paredes MG, Portilla V, Corrales A, González-Vela MC, González-Gay MA, Blanco R, Hernández JL. Circulating levels of adiponectin, leptin, resistin and visfatin in non-diabetics patients with hidradenitis suppurativa. Arch Dermatol Res 2019; 312:595-600. [PMID: 31786710 DOI: 10.1007/s00403-019-02018-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 10/29/2019] [Accepted: 11/20/2019] [Indexed: 12/24/2022]
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory disease associated with insulin resistance (IR), metabolic syndrome and increased cardiovascular risk. Adipokines are biologically active, pleotropic molecules which have been involved in the development of IR and in the pathogenesis of several chronic inflammatory conditions. The aim of the present study was to analyze serum concentrations of adiponectin, leptin, resistin and visfatin in patients with HS, and investigate their possible associations with IR, HS risk and disease severity. This case-control study enrolled 137 non-diabetic individuals (76 HS-patients and 61 age and sex-matched controls). Serum concentrations of adiponectin, leptin, resistin and visfatin, and the homeostasis model assessment of IR (HOMA-IR) were measured in all the participants. Serum adiponectin concentrations were found to be significantly lower, and leptin, resistin and visfatin levels were significantly higher in HS-patients than in controls. These differences remained significant even after adjusting for age, sex and body mass index, except for leptin. In a multivariate regression analysis, HOMA-IR was inversely correlated with adiponectin and positively associated with resistin levels. Furthermore, serum levels of resistin and visfatin were independently associated with HS risk. However, we found no association between serum levels of adipokines and HS severity. Our results suggest that reduced adiponectin and increased resistin serum levels may be surrogate biomarkers for IR in patients with HS. Moreover, resistin and visfatin might be independent risk factors for the development of HS.
Collapse
Affiliation(s)
- Marcos A González-López
- Division of Dermatology, Hospital Universitario Marqués de Valdecilla, University of Cantabria, IDIVAL, Avda. de Valdecilla s/n, 39008, Santander, Cantabria, Spain.
| | - Iosune Vilanova
- Division of Dermatology, Hospital Universitario Marqués de Valdecilla, University of Cantabria, IDIVAL, Avda. de Valdecilla s/n, 39008, Santander, Cantabria, Spain
| | - Gonzalo Ocejo-Viñals
- Division of Immunology, Hospital Universitario Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Cantabria, Spain
| | - Rubén Arlegui
- Division of Dermatology, Hospital Universitario Marqués de Valdecilla, University of Cantabria, IDIVAL, Avda. de Valdecilla s/n, 39008, Santander, Cantabria, Spain
| | - Iñigo Navarro
- Division of Dermatology, Hospital Universitario Marqués de Valdecilla, University of Cantabria, IDIVAL, Avda. de Valdecilla s/n, 39008, Santander, Cantabria, Spain
| | - Sandra Guiral
- Division of Immunology, Hospital Universitario Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Cantabria, Spain
| | - Cristina Mata
- Division of Rheumatology, Hospital Comarcal, Laredo, Cantabria, Spain
| | - M Genma Pérez-Paredes
- Division of Dermatology, Hospital Universitario Marqués de Valdecilla, University of Cantabria, IDIVAL, Avda. de Valdecilla s/n, 39008, Santander, Cantabria, Spain
| | - Virginia Portilla
- Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Cantabria, Spain
| | - Alfonso Corrales
- Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Cantabria, Spain
| | - M Carmen González-Vela
- Division of Pathology, Hospital Universitario Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Cantabria, Spain
| | - Miguel A González-Gay
- Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Cantabria, Spain
| | - Ricardo Blanco
- Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Cantabria, Spain
| | - José L Hernández
- Division of Internal Medicine, Hospital Universitario Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Cantabria, Spain
| |
Collapse
|
31
|
Jørgensen A, Yao Y, Ghazanfar M, Ring H, Thomsen S. Burden, predictors and temporal relationships of comorbidities in patients with hidradenitis suppurativa: a hospital‐based cohort study. J Eur Acad Dermatol Venereol 2019; 34:565-573. [DOI: 10.1111/jdv.15904] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 07/03/2019] [Indexed: 12/17/2022]
Affiliation(s)
- A.‐H.R. Jørgensen
- Department of Dermato‐Venereology & Wound Healing Centre Bispebjerg Hospital Copenhagen Denmark
| | - Y. Yao
- Department of Dermato‐Venereology & Wound Healing Centre Bispebjerg Hospital Copenhagen Denmark
| | - M.N. Ghazanfar
- Department of Dermato‐Venereology & Wound Healing Centre Bispebjerg Hospital Copenhagen Denmark
| | - H.C. Ring
- Department of Dermato‐Venereology & Wound Healing Centre Bispebjerg Hospital Copenhagen Denmark
| | - S.F. Thomsen
- Department of Dermato‐Venereology & Wound Healing Centre Bispebjerg Hospital Copenhagen Denmark
- Department of Biomedical Sciences University of Copenhagen Copenhagen Denmark
| |
Collapse
|
32
|
Byrd AS, Carmona-Rivera C, O'Neil LJ, Carlucci PM, Cisar C, Rosenberg AZ, Kerns ML, Caffrey JA, Milner SM, Sacks JM, Aliu O, Broderick KP, Reichner JS, Miller LS, Kang S, Robinson WH, Okoye GA, Kaplan MJ. Neutrophil extracellular traps, B cells, and type I interferons contribute to immune dysregulation in hidradenitis suppurativa. Sci Transl Med 2019; 11:eaav5908. [PMID: 31484788 PMCID: PMC11369904 DOI: 10.1126/scitranslmed.aav5908] [Citation(s) in RCA: 91] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 03/20/2019] [Accepted: 07/26/2019] [Indexed: 09/05/2024]
Abstract
Hidradenitis suppurativa (HS), also known as acne inversa, is an incapacitating skin disorder of unknown etiology manifested as abscess-like nodules and boils resulting in fistulas and tissue scarring as it progresses. Given that neutrophils are the predominant leukocyte infiltrate in HS lesions, the role of neutrophil extracellular traps (NETs) in the induction of local and systemic immune dysregulation in this disease was examined. Immunofluorescence microscopy was performed in HS lesions and detected the prominent presence of NETs. NET complexes correlated with disease severity, as measured by Hurley staging. Neutrophils from the peripheral blood of patients with HS peripheral also displayed enhanced spontaneous NET formation when compared to healthy control neutrophils. Sera from patients recognized antigens present in NETs and harbored increased antibodies reactive to citrullinated peptides. B cell dysregulation, as evidenced by elevated plasma cells and IgG, was observed in the circulation and skin from patients with HS. Peptidylarginine deiminases (PADs) 1 to 4, enzymes involved in citrullination, were differentially expressed in HS skin, when compared to controls, in association with enhanced tissue citrullination. NETs in HS skin coexisted with plasmacytoid dendritic cells, in association with a type I interferon (IFN) gene signature. Enhanced NET formation and immune responses to neutrophil and NET-related antigens may promote immune dysregulation and contribute to inflammation. This, along with evidence of up-regulation of the type I IFN pathway in HS skin, suggests that the innate immune system may play important pathogenic roles in this disease.
Collapse
Affiliation(s)
- Angel S Byrd
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Carmelo Carmona-Rivera
- Systemic Autoimmunity Branch, Intramural Research Program, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, USA.
| | - Liam J O'Neil
- Systemic Autoimmunity Branch, Intramural Research Program, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Philip M Carlucci
- Systemic Autoimmunity Branch, Intramural Research Program, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Cecilia Cisar
- VA Palo Alto Health Care System, Palo Alto, CA, USA
- Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, CA, USA
| | - Avi Z Rosenberg
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michelle L Kerns
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Julie A Caffrey
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Stephen M Milner
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Justin M Sacks
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Oluseyi Aliu
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kristen P Broderick
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jonathan S Reichner
- Division of Surgical Research, Department of Surgery, Rhode Island Hospital, Providence, RI, USA
| | - Lloyd S Miller
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sewon Kang
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - William H Robinson
- VA Palo Alto Health Care System, Palo Alto, CA, USA
- Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, CA, USA
| | - Ginette A Okoye
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mariana J Kaplan
- Systemic Autoimmunity Branch, Intramural Research Program, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, USA.
| |
Collapse
|
33
|
Elkin K, Daveluy S, Avanaki K(M. Hidradenitis suppurativa: Current understanding, diagnostic and surgical challenges, and developments in ultrasound application. Skin Res Technol 2019; 26:11-19. [DOI: 10.1111/srt.12759] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 06/28/2019] [Indexed: 12/18/2022]
Affiliation(s)
- Kenneth Elkin
- Wayne State University School of Medicine Detroit MI USA
| | - Steven Daveluy
- Department of Dermatology Wayne State University School of Medicine Detroit MI USA
| | - Kamran (Mohammad) Avanaki
- Wayne State University School of Medicine Detroit MI USA
- Department of Biomedical Engineering Wayne State University Detroit MI USA
| |
Collapse
|
34
|
Durán-Vian C, Arias-Loste MT, Hernández JL, Fernández V, González M, Iruzubieta P, Rasines L, González-Vela C, Vaqué JP, Blanco R, Crespo J, González-López MA. High prevalence of non-alcoholic fatty liver disease among hidradenitis suppurativa patients independent of classic metabolic risk factors. J Eur Acad Dermatol Venereol 2019; 33:2131-2136. [PMID: 31260574 DOI: 10.1111/jdv.15764] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 06/18/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Some chronic inflammatory skin diseases, such as psoriasis, have been associated with an increased prevalence of non-alcoholic fatty liver disease (NAFLD). Nevertheless, this prevalence in hidradenitis suppurativa (HS) has not been assessed to date. OBJECTIVES To determine the prevalence of NAFLD in patients with HS and the risk factors associated with this disorder. METHODS This case-control study enrolled 70 HS patients and 150 age- and gender-matched controls who were evaluated by hepatic ultrasonography (US) and transient elastography (TE) after excluding other secondary causes of chronic liver disease. The diagnosis of NAFLD was established if US and/or TE were altered. RESULTS The prevalence of NAFLD was significantly increased in patients with HS compared to controls (72.9% vs. 24.7%: P < 0.001). In the multivariable regression model adjusted for age, sex and classic metabolic risk factors for NAFLD, HS was significantly and independently associated with the presence of NAFLD [OR 7.75 confidence interval (CI) 2.54-23.64; P < 0.001]. CONCLUSIONS Our results show a high prevalence of NAFLD in HS patients independent of classic metabolic risk factors. Therefore, we suggest HS patients to be evaluated for NAFLD and managed accordingly.
Collapse
Affiliation(s)
- C Durán-Vian
- Dermatology Department, University Hospital Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Spain
| | - M T Arias-Loste
- Gastroenterology and Hepatology Department, University Hospital Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Spain.,Investigation Institute Marques de Valdecilla, Infection, Immunity and Digestive Diseases Group, IDIVAL, Santander, Spain
| | - J L Hernández
- Internal Medicine Department, University Hospital Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Spain
| | - V Fernández
- Radiology Department, University Hospital Marqués de Valdecilla, University of Cantabria, Santander, Spain
| | - M González
- Gastroenterology and Hepatology Department, University Hospital Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Spain
| | - P Iruzubieta
- Gastroenterology and Hepatology Department, University Hospital Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Spain.,Investigation Institute Marques de Valdecilla, Infection, Immunity and Digestive Diseases Group, IDIVAL, Santander, Spain
| | - L Rasines
- Investigation Institute Marques de Valdecilla, Infection, Immunity and Digestive Diseases Group, IDIVAL, Santander, Spain
| | - C González-Vela
- Pathology Department, University Hospital Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Spain
| | - J P Vaqué
- Investigation Institute Marques de Valdecilla, Infection, Immunity and Digestive Diseases Group, IDIVAL, Santander, Spain.,Molecular Biology Department, University of Cantabria, Santander, Spain
| | - R Blanco
- Rheumatology Department, University Hospital Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Spain
| | - J Crespo
- Gastroenterology and Hepatology Department, University Hospital Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Spain.,Investigation Institute Marques de Valdecilla, Infection, Immunity and Digestive Diseases Group, IDIVAL, Santander, Spain
| | - M A González-López
- Dermatology Department, University Hospital Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Spain
| |
Collapse
|
35
|
Poveda I, Vilarrasa E, Martorell A, García-Martínez FJ, Segura JM, Hispán P, Sánchez-Payá J, Álvarez PJ, González I, Pascual JC. Serum Zinc Levels in Hidradenitis Suppurativa: A Case-Control Study. Am J Clin Dermatol 2018; 19:771-777. [PMID: 30043129 DOI: 10.1007/s40257-018-0374-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Serum zinc levels in patients with hidradenitis suppurativa (HS) have not been previously studied. OBJECTIVE The aim was to investigate the association between HS and serum zinc levels. METHODS A multicenter, prospective clinical and analytical case-control study was designed to assess the possible association between HS and serum zinc levels. Consecutive patients with moderate or severe HS (Hurley II or III exclusively) were enrolled. A control population was recruited from primary care clinics. Fasting blood samples were extracted from each patient and serum zinc levels determined. Candidate predictors for low serum zinc levels were determined using logistic regression models. RESULTS In total, 122 patients with HS and 122 control subjects were studied. Of the 122 HS patients, 79 (64.8%) were Hurley II and 43 (35.2%) were Hurley III. Low serum zinc levels (≤ 83.3 µg/dL) were more prevalent in HS (adjusted odds ratio [ORa] 6.7, P < 0.001). After logistic regression analysis, low serum zinc levels were associated with Hurley III (ORa 4.4, P < 0.001), Dermatology Life Quality Index ≥ 9 (ORa 3.1, P = 0.005), number of affected sites ≥ 3 (ORa 2.4, P = 0.042), genital location (ORa 2.9, P = 0.009), and perineal location (ORa 2.5, P = 0.025). CONCLUSION Low serum zinc levels are more prevalent in HS than in a healthy population, an indicator that may also be associated with disease severity.
Collapse
|
36
|
Loo CH, Tan WC, Tang JJ, Khor YH, Manikam MT, Low DE, Chan KH, Chan KH, Teoh YM, Sohot NQA, Tang MM, Chan LC. The clinical, biochemical, and ultrasonographic characteristics of patients with hidradenitis suppurativa in Northern Peninsular Malaysia: a multicenter study. Int J Dermatol 2018; 57:1454-1463. [DOI: 10.1111/ijd.14210] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 06/05/2018] [Accepted: 08/06/2018] [Indexed: 12/22/2022]
Affiliation(s)
- Chai Har Loo
- Department of Dermatology; Hospital Kuala Lumpur; Kuala Lumpur Malaysia
| | - Wooi Chiang Tan
- Department of Dermatology; Hospital Pulau Pinang; Penang Malaysia
| | - Jyh Jong Tang
- Department of Dermatology; Hospital Raja Permaisuri Bainun; Ipoh Malaysia
| | - Yek Huan Khor
- Department of Dermatology; Hospital Pulau Pinang; Penang Malaysia
| | | | - Dyoi-E Low
- Department of Dermatology; Hospital Raja Permaisuri Bainun; Ipoh Malaysia
| | - Kam Hong Chan
- Department of Radiology; Hospital Pulau Pinang; Penang Malaysia
| | - Kok Hoe Chan
- Department of Radiology; Hospital Raja Permaisuri Bainun; Ipoh Malaysia
| | - Yuen Mey Teoh
- Department of Radiology; Hospital Sultanah Bahiyah; Kedah Malaysia
| | | | - Min Moon Tang
- Department of Dermatology; Hospital Kuala Lumpur; Kuala Lumpur Malaysia
| | - Lee Chin Chan
- Department of Dermatology; Hospital Pulau Pinang; Penang Malaysia
| |
Collapse
|
37
|
Vilanova I, Hernández JL, Mata C, Durán C, García-Unzueta MT, Portilla V, Fuentevilla P, Corrales A, González-Vela MC, González-Gay MA, Blanco R, González-López MA. Insulin resistance in hidradenitis suppurativa: a case-control study. J Eur Acad Dermatol Venereol 2018; 32:820-824. [PMID: 29485215 DOI: 10.1111/jdv.14894] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 01/24/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND The association between chronic inflammatory diseases, such as rheumatoid arthritis and psoriasis, and insulin resistance (IR) has been well established. Hidradenitis suppurativa (HS) is a chronic inflammatory cutaneous disease that affects the apocrine gland-bearing areas of the body. OBJECTIVE We aimed to determine the prevalence of IR in patients with HS. METHODS This cross-sectional, case-control study enrolled 137 subjects, 76 patients with HS and 61 age- and gender-matched controls. Demographic data, clinical examination of HS patients, anthropometric measures, cardiovascular risk factors and laboratory studies were recorded. The homeostasis model assessment of IR (HOMA-IR) was calculated in all participants by measuring fasting plasma glucose and insulin levels. RESULTS The median (IQR) HOMA-IR value in HS patients was significantly higher [2.0 (1.0-3.6)] than in controls [1.5 (0.9-2.3)] (P = 0.01). The prevalence of IR was significantly higher in cases (43.4%) compared with controls (16.4%) (P = 0.001). In the linear regression multivariable analysis after adjusting for age, sex and body mass index (BMI), HS remained as a significant factor for a higher HOMA-IR [2.51 (0.18) vs 1.92(0.21); P = 0.04]. The HOMA-IR value and the prevalence of IR did not differ significantly among HS patients grouped by severity of the disease. CONCLUSION Our results show an increased frequency of IR in HS. Thus, we suggest HS patients to be evaluated for IR and managed accordingly.
Collapse
Affiliation(s)
- I Vilanova
- Division of Dermatology, Hospital Universitario Marques de Valdecilla, IDIVAL, University of Cantabria, Santander, Cantabria, Spain
| | - J L Hernández
- Division of Internal Medicine, Hospital Universitario Marques de Valdecilla, IDIVAL, University of Cantabria, Santander, Cantabria, Spain
| | - C Mata
- Division of Rheumatology, Hospital Comarcal, Laredo, Cantabria, Spain
| | - C Durán
- Division of Dermatology, Hospital Universitario Marques de Valdecilla, IDIVAL, University of Cantabria, Santander, Cantabria, Spain
| | - M T García-Unzueta
- Division of Medical Laboratory, Hospital Universitario Marques de Valdecilla, IDIVAL, University of Cantabria, Santander, Cantabria, Spain
| | - V Portilla
- Division of Rheumatology, Hospital Universitario Marques de Valdecilla, IDIVAL, University of Cantabria, Santander, Cantabria, Spain
| | - P Fuentevilla
- Division of Rheumatology, Hospital Universitario Marques de Valdecilla, IDIVAL, University of Cantabria, Santander, Cantabria, Spain
| | - A Corrales
- Division of Rheumatology, Hospital Universitario Marques de Valdecilla, IDIVAL, University of Cantabria, Santander, Cantabria, Spain
| | - M C González-Vela
- Division of Pathology, Hospital Universitario Marques de Valdecilla, IDIVAL, University of Cantabria, Santander, Cantabria, Spain
| | - M A González-Gay
- Division of Rheumatology, Hospital Universitario Marques de Valdecilla, IDIVAL, University of Cantabria, Santander, Cantabria, Spain
| | - R Blanco
- Division of Rheumatology, Hospital Universitario Marques de Valdecilla, IDIVAL, University of Cantabria, Santander, Cantabria, Spain
| | - M A González-López
- Division of Dermatology, Hospital Universitario Marques de Valdecilla, IDIVAL, University of Cantabria, Santander, Cantabria, Spain
| |
Collapse
|
38
|
González-López MA, Lacalle M, Mata C, López-Escobar M, Corrales A, López-Mejías R, Rueda J, González-Vela MC, González-Gay MA, Blanco R, Hernández JL. Carotid ultrasound is useful for the cardiovascular risk stratification in patients with hidradenitis suppurativa. PLoS One 2018; 13:e0190568. [PMID: 29300768 PMCID: PMC5754122 DOI: 10.1371/journal.pone.0190568] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 12/18/2017] [Indexed: 11/20/2022] Open
Abstract
Introduction Hidradenitis suppurativa (HS) is a chronic inflammatory cutaneous disease which has been associated with an increased risk of adverse cardiovascular (CV) outcomes. Adequate stratification of the CV risk is an issue of major importance in patients with HS. To analyze the usefulness of carotid ultrasound (US) assessment for the CV disease risk stratification compared with a traditional score, the Framingham risk score (FRS), in a series of patients with HS. Methods Cross-sectional study of 60 patients with HS without history of CV events, diabetes mellitus or chronic kidney disease. Information on CV risk factors was collected and the FRS was calculated. Thus, the patients were classified into low, intermediate and high-CV disease risk categories based on FRS. Carotid US was performed in all participants, and the presence of atherosclerotic plaques was considered as a marker of high CV risk. Results HS patients had a mean age of 45.1±10.2 years, and 55% were female. The median FRS was 5.7 (IQR: 3.1–14.7). Twenty-four (40%) of the patients were classified into the low risk group, 28 (46.7%) in the intermediate risk group, and 8 (13.3%) into the FRS-high risk category. Noteworthy, carotid US revealed that about one-third of the patients (17/52; 32.6%) in the FRS-based low and intermediate risk categories had carotid plaques, and, therefore, they were reclassified into a high-risk category. Conclusion CV risk in HS patients may be underestimated by using the FRS. Carotid US may be useful to improve the CV risk stratification of patients with HS.
Collapse
Affiliation(s)
- Marcos A. González-López
- Division of Dermatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, Santander, Cantabria, Spain
- * E-mail:
| | - Marina Lacalle
- Division of Dermatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, Santander, Cantabria, Spain
| | - Cristina Mata
- Division of Rheumatology, Hospital Comarcal, Laredo, Cantabria, Spain
| | - María López-Escobar
- Division of Dermatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, Santander, Cantabria, Spain
| | - Alfonso Corrales
- Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, Santander, Cantabria, Spain
| | - Raquel López-Mejías
- Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, Santander, Cantabria, Spain
| | - Javier Rueda
- Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, Santander, Cantabria, Spain
| | - M. Carmen González-Vela
- Division of Pathology Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, Santander, Cantabria, Spain
| | - Miguel A. González-Gay
- Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, Santander, Cantabria, Spain
| | - Ricardo Blanco
- Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, Santander, Cantabria, Spain
| | - José L. Hernández
- Division of Internal Medicine. Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, Santander, Cantabria, Spain
| |
Collapse
|
39
|
Juhl C, Miller I, Jemec G, Kanters J, Ellervik C. Hidradenitis suppurativa and electrocardiographic changes: a cross‐sectional population study. Br J Dermatol 2017; 178:222-228. [DOI: 10.1111/bjd.15778] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2017] [Indexed: 01/22/2023]
Affiliation(s)
- C.R. Juhl
- Faculty of Health and Medical Sciences University of Copenhagen CopenhagenDenmark
| | - I.M. Miller
- Department of Dermatology Zealand University Hospital RoskildeDenmark
- Health Sciences Faculty University of Copenhagen CopenhagenDenmark
| | - G.B. Jemec
- Department of Dermatology Zealand University Hospital RoskildeDenmark
| | - J.K. Kanters
- Laboratory of Experimental Cardiology, Department of Biomedical Sciences University of Copenhagen CopenhagenDenmark
| | - C. Ellervik
- Department of Laboratory Medicine Boston Children's Hospital Boston MAU.S.A
- Department of Production Research and Innovation Region Zealand, Sorø Denmark
- Department of Clinical Medicine Faculty of Health and Medical Sciences University of Copenhagen CopenhagenDenmark
| |
Collapse
|
40
|
Dauden E, Lazaro P, Aguilar M, Blasco A, Suarez C, Marin I, Queiro R, Bassas-Vila J, Martorell A, García-Campayo J. Recommendations for the management of comorbidity in hidradenitis suppurativa. J Eur Acad Dermatol Venereol 2017; 32:129-144. [DOI: 10.1111/jdv.14517] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 07/20/2017] [Indexed: 12/18/2022]
Affiliation(s)
- E. Dauden
- Department of Dermatology; Instituto de Investigación Sanitaria Princesa (IIS-IP); Hospital Universitario de la Princesa; Madrid Spain
| | - P. Lazaro
- Independent Researcher in Health Services Research; Madrid Spain
| | - M.D. Aguilar
- Independent Researcher in Health Services Research; Madrid Spain
| | - A.J. Blasco
- Independent Researcher in Health Services Research; Madrid Spain
| | - C. Suarez
- Department of Internal Medicine; Instituto de Investigación Sanitaria Princesa (IIS-IP); Hospital Universitario de la Princesa, UAM; Madrid Spain
| | - I. Marin
- Department of Gastroenterology; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM); Madrid Spain
| | - R. Queiro
- Rheumatology Division; Hospital Universitario Central de Asturias; Oviedo Spain
| | - J. Bassas-Vila
- Department of Dermatology; Hospital Universitari Germans Trias i Pujol; Autonomous University of Barcelona; Barcelona Spain
| | - A. Martorell
- Department of Dermatology; Hospital de Manises; Valencia Spain
| | - J. García-Campayo
- Aragonese Institute of Health Sciences; Miguel Servet University Hospital; University of Zaragoza; Zaragoza Spain
| |
Collapse
|
41
|
Abstract
The association of the metabolic syndrome (MetS) and its components with immune-mediated chronic inflammatory disorders has attracted much interest within the last two decades. In addition to the well-established association of psoriasis with MetS, recent data point to an association between MetS and hidradenitis suppurativa, as well. The association of hidradenitis suppurativa with MetS and its components, such as diabetes, obesity, and dyslipidemia, has been consistently identified in controlled studies. This relationship is not only limited to older individuals but also applicable to younger patients and those with mild disease. This review documents the link between these disorders and discusses its practical implications, mainly highlighting the importance of prevention and routine screening for early diagnosis to prevent cardiovascular-related morbidity.
Collapse
Affiliation(s)
- Tulin Ergun
- Department of Dermatology, Marmara University School of Medicine, Istanbul, Turkey.
| |
Collapse
|
42
|
Smith MK, Nicholson CL, Parks-Miller A, Hamzavi IH. Hidradenitis suppurativa: an update on connecting the tracts. F1000Res 2017; 6:1272. [PMID: 28794864 PMCID: PMC5538037 DOI: 10.12688/f1000research.11337.1] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/24/2017] [Indexed: 12/18/2022] Open
Abstract
Hidradenitis suppurativa (HS) is a devastating disease involving abscesses, sinus tracts, and inflammation classically affecting the axilla, groin, and/or anogenital region. Although the disease pathogenesis is not fully understood, recent advances suggest that HS pathology runs much deeper than the cutaneous manifestations. It is now believed that HS is a systemic inflammatory disease that gives rise to the characteristic cutaneous manifestations. This disease is problematic for both patients and physicians to manage because of a variety of diagnostic and management difficulties. This article seeks to provide updates on the current understanding of HS to increase awareness and improve management.
Collapse
|
43
|
González I, Pascual JC, Corona D, Hispán P, Ramos JM, Sánchez-Paya J, Jemec GB. Assessment of subclinical atherosclerosis in hidradenitis suppurativa: Reply to Dr Vinkel's letter. J Eur Acad Dermatol Venereol 2017; 31:e413-e414. [PMID: 28300331 DOI: 10.1111/jdv.14226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- I González
- Department of Dermatology, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
| | - J C Pascual
- Department of Dermatology, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
| | - D Corona
- Department of Neurology, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
| | - P Hispán
- Department of Dermatology, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
| | - J M Ramos
- Department of Internal Medicine, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
| | - J Sánchez-Paya
- Epidemiology Unit, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
| | - G B Jemec
- Department of Dermatology, Zealand University Hospital Roskilde, Copenhagen, Denmark.,Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
44
|
Pascual J, González I, Corona D, Hispán P, Ramos J, Sánchez-Paya J, Jemec G. Assessment of subclinical atherosclerosis in hidradenitis suppurativa. J Eur Acad Dermatol Venereol 2017; 31:1229-1238. [DOI: 10.1111/jdv.14076] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 11/23/2016] [Indexed: 01/02/2023]
Affiliation(s)
- J.C. Pascual
- Department of Dermatology; Alicante University General Hospital; Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation); Alicante Spain
| | - I. González
- Department of Dermatology; Alicante University General Hospital; Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation); Alicante Spain
| | - D. Corona
- Department of Neurology; Alicante University General Hospital; Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation); Alicante Spain
| | - P. Hispán
- Department of Dermatology; Alicante University General Hospital; Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation); Alicante Spain
| | - J.M. Ramos
- Department of Internal Medicine; Alicante University General Hospital; Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation); Alicante Spain
| | - J. Sánchez-Paya
- Epidemiology Unit; Alicante University General Hospital; Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation); Alicante Spain
| | - G.B. Jemec
- Department of Dermatology; Zealand University Hospital Roskilde; Health Sciences Faculty; University of Copenhagen; Copenhagen Denmark
| |
Collapse
|