Hidradenitis Suppurativa and Ocular Diseases: Real-world Evidence of 57,972 Patients
DOI:
https://doi.org/10.2340/actadv.v105.42716Keywords:
real-world data, : Hidradenitis Suppurativa, Ocular disease, ComorbiditiesAbstract
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by recurring dermal abscesses and cutaneous fistulas of intertriginous skin regions, significantly impacting patients’ quality of life. While HS has been associated with various comorbidities such as metabolic and chronic inflammatory diseases, many systemic effects of this systemic disease remain to be investigated. In this study, 2 cohorts of patients with and without HS were created – matched for sex, age, and nicotine dependence – each comprising 28,986 patients, using the real-world database TriNetX, to investigate the association of ocular diseases and HS. Not only an increased risk of disorders of refraction and accommodation in HS patients (OR 3.466; 95% CI 3.100, 3.876), but also a higher risk of ocular diseases, including disorders of the lacrimal system, was demonstrated when compared with the control cohort (OR 3.523; 95%CI 2.912, 4.263). Although previous studies have suggested an increased risk of ocular comorbidities in HS patients, ocular history is not routinely queried during visits. Here, the need for further exploration of the association of ocular diseases and HS and for incorporating this into clinical practice is emphasized.
Downloads
References
Saunte DML, Jemec GBE. Hidradenitis suppurativa: advances in diagnosis and treatment. JAMA 2017; 318: 2019–2032.
https://doi.org/10.1001/jama.2017.16691 DOI: https://doi.org/10.1001/jama.2017.16691
Sabat R, Jemec GBE, Matusiak L, Kimball AB, Prens E, Wolk K. Hidradenitis suppurativa. Nat Rev Dis Primers 2020; 6: 18.
https://doi.org/10.1038/s41572-020-0149-1 DOI: https://doi.org/10.1038/s41572-020-0149-1
Matusiak L, Bieniek A, Szepietowski JC. Hidradenitis suppurativa markedly decreases quality of life and professional activity. J Am Acad Dermatol 2010; 62: 706–708, 708 e701.
https://doi.org/10.1016/j.jaad.2009.09.021 DOI: https://doi.org/10.1016/j.jaad.2009.09.021
Schneider-Burrus S, Tsaousi A, Barbus S, Huss-Marp J, Witte K, Wolk K, et al. Features associated with quality of life impairment in hidradenitis suppurativa patients. Front Med (Lausanne) 2021; 8: 676241.
https://doi.org/10.3389/fmed.2021.676241 DOI: https://doi.org/10.3389/fmed.2021.676241
Hanna N, Silverberg OM, Reaume M, Gladman D, Davis MDP, Piguet V, et al. Incidence, prevalence, and predictors of inflammatory arthritis in patients with hidradenitis suppurativa: a systematic review and meta-analysis. Int J Dermatol 2022; 61: 1069–1079.
https://doi.org/10.1111/ijd.15860 DOI: https://doi.org/10.1111/ijd.15860
Sabat R, Chanwangpong A, Schneider-Burrus S, Metternich D, Kokolakis G, Kurek A, et al. Increased prevalence of metabolic syndrome in patients with acne inversa. PLoS One 2012; 7: e31810.
https://doi.org/10.1371/journal.pone.0031810 DOI: https://doi.org/10.1371/journal.pone.0031810
Egeberg A, Jemec GBE, Kimball AB, Bachelez H, Gislason GH, Thyssen JP, et al. Prevalence and risk of inflammatory bowel disease in patients with hidradenitis suppurativa. J Invest Dermatol 2017; 137: 1060–1064.
https://doi.org/10.1016/j.jid.2016.11.040 DOI: https://doi.org/10.1016/j.jid.2016.11.040
Shlyankevich J, Chen AJ, Kim GE, Kimball AB. Hidradenitis suppurativa is a systemic disease with substantial comorbidity burden: a chart-verified case-control analysis. J Am Acad Dermatol 2014; 71: 1144–1150.
https://doi.org/10.1016/j.jaad.2014.09.012 DOI: https://doi.org/10.1016/j.jaad.2014.09.012
Motlagh M, Fortenbach C, Maibach HI, Modjtahedi BS. Identifying and treating ocular manifestations in psoriasis. Am J Clin Dermatol 2022; 23: 51–60.
https://doi.org/10.1007/s40257-021-00648-x DOI: https://doi.org/10.1007/s40257-021-00648-x
Conic RRZ, Fabbrocini G, Marasca C, Bragazzi NL, Watad A, Adawi M, et al. Burden of ocular comorbidities in patients with hidradenitis suppurativa. JAMA Dermatol 2021; 157: 226–227.
https://doi.org/10.1001/jamadermatol.2020.5087 DOI: https://doi.org/10.1001/jamadermatol.2020.5087
Liu F, Panagiotakos D. Real-world data: a brief review of the methods, applications, challenges and opportunities. BMC Med Res Methodol 2022; 22: 287.
https://doi.org/10.1186/s12874-022-01768-6 DOI: https://doi.org/10.1186/s12874-022-01768-6
Palchuk MB, London JW, Perez-Rey D, Drebert ZJ, Winer-Jones JP, Thompson CN, et al. A global federated real-world data and analytics platform for research. JAMIA Open 2023; 6: ooad035.
https://doi.org/10.1093/jamiaopen/ooad035 DOI: https://doi.org/10.1093/jamiaopen/ooad035
Pinazo-Duran MD, Zanon-Moreno V, Garcia-Medina JJ, Arevalo JF, Gallego-Pinazo R, Nucci C. Eclectic ocular comorbidities and systemic diseases with eye involvement: a review. Biomed Res Int 2016; 2016: 6215745.
https://doi.org/10.1155/2016/6215745 DOI: https://doi.org/10.1155/2016/6215745
Gau SY, Liu PY, Chen SN, Chiu TM, Tsai RY, Chang HC, et al. Risk of keratitis and keratopathy in hidradenitis suppurativa patients: a global federated health network analysis. In Vivo 2024; 38: 1375–1383.
https://doi.org/10.21873/invivo.13578 DOI: https://doi.org/10.21873/invivo.13578
Schargus M, Langhorst CA, Joachim S, Frings A, Krause K, Reifenberger J, et al. Hidradenitis suppurativa is associated with symptoms of keratoconjunctivitis sicca. Curr Eye Res 2021; 46: 23–30.
https://doi.org/10.1080/02713683.2020.1775259 DOI: https://doi.org/10.1080/02713683.2020.1775259
Saygin D, Syed AU, Lowder CY, Srivastava S, Maya JJ, Hajj-Ali RA. Characteristics of inflammatory eye disease associated with hidradenitis suppurativa. Eur J Rheumatol 2018; 5: 165–168.
https://doi.org/10.5152/eurjrheum.2018.17163 DOI: https://doi.org/10.5152/eurjrheum.2018.17163
Li CP, Lin CY, Lu HY, Chen SN, Tsai RY, Chang HC, et al. Patients with hidradenitis suppurativa are associated with risk of new-onset glaucoma: a propensity-score-matched cohort study. Int J Med Sci 2024; 21: 2208–2214.
https://doi.org/10.7150/ijms.95395 DOI: https://doi.org/10.7150/ijms.95395
Cheng CY. Risk of incident cataract in patients with psoriasis: a population-based cohort study. J Dermatol 2022; 49: 359–367.
https://doi.org/10.1111/1346-8138.16261 DOI: https://doi.org/10.1111/1346-8138.16261
Akcam HT, Karagun E, Iritas I, Eyup Y. Keratoconus could be associated with psoriasis: novel findings from a comparative study. Cornea 2019; 38: 1524–1530.
https://doi.org/10.1097/ICO.0000000000002161 DOI: https://doi.org/10.1097/ICO.0000000000002161
Manfredini M, Ragusa E, Gibertini M, Bigi L, Ferrari B, Lasagni C, et al. Retinal microvascular alterations in hidradenitis suppurativa patients: a pilot study using optical coherence tomography angiography. J Clin Med 2024; 13: 1464.
https://doi.org/10.3390/jcm13051464 DOI: https://doi.org/10.3390/jcm13051464
Demirci G, Erdur SK, Aydin R, Balevi A, Eliacik M, Ozsutcu M, et al. Tear osmolarity and ocular surface parameters in patients with psoriasis. Arq Bras Oftalmol 2017; 80: 1–3.
https://doi.org/10.5935/0004-2749.20170002 DOI: https://doi.org/10.5935/0004-2749.20170002
Zengin N, Tol H, Balevi S, Gunduz K, Okudan S, Endogru H. Tear film and meibomian gland functions in psoriasis. Acta Ophthalmol Scand 1996; 74: 358–360.
https://doi.org/10.1111/j.1600-0420.1996.tb00708.x DOI: https://doi.org/10.1111/j.1600-0420.1996.tb00708.x
Kudasiewicz-Kardaszewska A, Grant-Kels JM, Grzybowski A. Meibomian gland dysfunction and blepharitis: a common and still unsolved ophthalmic problem. Clin Dermatol 2023; 41: 491–502.
https://doi.org/10.1016/j.clindermatol.2023.08.005 DOI: https://doi.org/10.1016/j.clindermatol.2023.08.005
Goel R, Saini S, Golhait P, Shah S. Association of primary chronic dacryocystitis and meibomian gland dysfunction. Indian J Ophthalmol 2024; 72: 185–189.
https://doi.org/10.4103/IJO.IJO_1449_23 DOI: https://doi.org/10.4103/IJO.IJO_1449_23
Galor A, Lee DJ. Effects of smoking on ocular health. Curr Opin Ophthalmol 2011; 22: 477–482.
https://doi.org/10.1097/ICU.0b013e32834bbe7a DOI: https://doi.org/10.1097/ICU.0b013e32834bbe7a
Konig A, Lehmann C, Rompel R, Happle R. Cigarette smoking as a triggering factor of hidradenitis suppurativa. Dermatology 1999; 198: 261–264.
https://doi.org/10.1159/000018126 DOI: https://doi.org/10.1159/000018126
Additional Files
Published
How to Cite
License
Copyright (c) 2025 Jennifer von Stebut-Marx, Robert Preissner, Sylke Schneider-Burrus, Saskia Preissner

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All digitalized ActaDV contents is available freely online. The Society for Publication of Acta Dermato-Venereologica owns the copyright for all material published until volume 88 (2008) and as from volume 89 (2009) the journal has been published fully Open Access, meaning the authors retain copyright to their work.
Unless otherwise specified, all Open Access articles are published under CC-BY-NC licences, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for non-commercial purposes, provided proper attribution to the original work.